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1
Q

Motor speech disorders (MSD) aka neurogenic speech disorders

A

Group of speech difficulties caused by damage to the neurological system (stoke, TBI, diseases etc) that affects planning, programming, control or execution of speech movements

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2
Q

Cerebral palsy (CP)

A

Neurological disorders that affect movement, muscle tone and posture. Caused by damage to the developing brain usually before, during birth or in early infancy

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3
Q

Features that make cerebral palsy different from other causes of neurogenic speech disorders

A

It’s a developmental disorder, NOT a disease; non progressive, non infectious, motor patterns are more predictable than those in acquired neurogenic disorders

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4
Q

Spastic cerebral palsy

A

Most common (approx. 60% of CP cases) , damage to the motor cortex of the brain, hypertonia (increased muscle tone), rigidity, infantile reflex patterns (ex. Rooting)

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5
Q

Athetoid cerebral palsy

A

Approx. 30% of CP cases, injury to the basal ganglia, slow involuntary flailing movements

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6
Q

Ataxic Cerebral palsy

A

Approx. 30% of CP cases, injury to cerebellum, uncoordinated movement, disturbed balance, seems clumsy and awkward

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7
Q

Most common causes of cerebral palsy

A

Anoxia and hemorrhage

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8
Q

Management team for cerebral palsy

A

Pediatrician, physical therapist, SLP, ENT, OT, special education teacher, audiologist, social worker, clinical psychologist, ophthalmologist etc.

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9
Q

6 types of dysarthria

A

Flaccid, spastic, ataxic, hypokinetic, hyperkinetic, mixed

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10
Q

Dysarthria

A

Speech impairments where a person has trouble speaking clearly because the muscles used for talking are weak and/ or hard to control. May affect speed, range, direction, strength, timing of motor movements

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11
Q

Etiology of dysarthria

A

Damage to the different parts of the central and peripheral nervous system

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12
Q

Flaccid dysarthria characteristics

A

Hypotonia (low muscle tone, weak, soft, flabby tone), diminished reflexes, weakness or paralysis of the affected muscle

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13
Q

Spastic dysarthria characteristics

A

Hypertonia (increased muscle tone), hyperactive reflexes, stiff and rigid muscles, weakness of motion of tongue, lips or jaw

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14
Q

Ataxic dysarthria characteristics

A

Coordination problems combined with hypotonia, errors in accuracy, timing,and direction of movements, damage to cerebellum

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15
Q

Hypokinetic dysarthria characteristics

A

Muscle stiffness, bradykinesia (slowness of movement), major cause is Parkinson’s disease and dyskinesias (involuntary movement)

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16
Q

Hyperkinetic dysarthria characteristics

A

Involuntary movements ranging from rapid to slow movements affecting speech production, major cause Huntington’s chorea

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17
Q

Mixed dysarthria characteristics

A

Mix of two or more pure dysarthria type, major cause is amyotrophic lateral sclerosis (ALS) aka Lou Gehrig s disease

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18
Q

Parkinson’s disease

A

Brain disorder that affects movement. Some symptoms are resting tremor, slow/ involuntary movement and balance problems. Cause is unknown

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19
Q

Dyskinesias

A

Involuntary movements due to overdosing on medications

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20
Q

Huntington’s chorea

A

Genetic disorder affecting the brain and worsens over time. Causes uncontrolled, jerky movements, and changes in thinking, behavior and emotions

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21
Q

Amyotrophic lateral sclerosis (ALS) AKA Lou Gehrig’s disease

A

Progressive disease that affects the nerve cells controlling muscles, over time the nerve cells weaken and die leading to muscle weakness, difficulty moving, speaking, swallowing (flaccid-spastic mixed dysarthria) cause is unknown

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22
Q

Apraxia of speech

A

Difficulty speaking/ moving voluntarily, disorder of motor programming (organizing and planning)

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23
Q

Etiology of apraxia of speech

A

Broca’s area in the frontal lobe

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24
Q

Management of apraxia of speech

A

Begin therapy at a point that will challenge but not frustrate, hierarchical approach (start easier and progress to harder) , use augmentative communication to supplement verbal attempts (gesture, writing, communication board etc)

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25
Number of graphemes (letters) in the English language
26
26
Number of phonemes (speech sounds) in English language
41-43
27
Transcription
Listening and writing down symbols for spoken sounds
28
Articulation
Shaping of the speech sounds by the articulators (lips, tongue, mouth etc)
29
Vowels vs consonants production
Vowels produced with open vocal tract, consonants produced with some degree of vocal tract constriction
30
Characteristics to look for in vowels
Tongue advancement (front, middle, back), tongue height (high, mid, low), lip position (rounded vs retracted), amount of tension in articulations (tense vs lax)
31
Characteristics to look for in vowels
Tongue advancement (front, middle, back), tongue height (high, mid, low), lip position (rounded vs retracted), amount of tension in articulations (tense vs lax)
32
Consonants are classified according to
PLACE of articulation (which articulators are used), MANNER of production (how the sound is made), VOICING (whether or not there is vocal fold vibration to produce the sound)
33
Diphthong
Combining two vowels that are in close proximity and treated as a single phoneme ( ex. In “out” the “a” and “u” blend to make a single sound, “boy” the “o” and “I” sounds blend together to make one sound)
34
Phonology vs articulation
Phonology is the study of the sounds of a language and the rules that govern the production and combination of those sounds. Articulation is the physical production of these sounds
35
Phonology impairments
having trouble understanding or using the basic rules of a language (conceptualization or rules of the language)
36
Articulation impairments
Due to sound production difficulties
37
Functional disorders
Difficulties in phonology, articulation, or swallowing with unknown cause (ex. Child who struggled to pronounce “r” or “s” but there is no issue with their tongue or mouth structure)
38
Developmental impairment in children
Delays or difficulties in the child’s ability to develop normal speech, language, or communication skills (ex. Difficulty producing sounds correctly, problems with speech patterns substituting sounds or omitting the dysarthria, apraxia, cleft palate etc)
39
Aphasia
Language impairment due to neurological disorder, affects all language modalities (reading, writing, verbal expression, auditory comprehension) person appears as if they are not cognitively competent when they actually are
40
Fluent aphasia
Ability to produce fluent speech but often lack meaning (content), reduced comprehension on language, substitution errors (phonemic paraphasias: koot/boot, verbal paraphasias: sandal/ boot, neologism: lakapa/ boot)
41
Non fluent aphasia
Slow speech and struggle to produce speech sounds, limited vocabulary, good auditory comprehension
42
Crossed aphasia
Rare form that occurs when a person experiences language impairment after damage to the non dominant hemisphere (right side) of the brain
43
2 major types of aphasia
Occlusive: blockage or reduction in blood flow to brain usually due to blood clot (thrombus or embolus) Hemorrhagic: bleeding in or around the brain due to ruptured blood vessel
44
Phonemic paraphasias
Substitutions of a sound for another one (ex. Koot/ boot)
45
Verbal paraphasias
Substitute a word that is semantically related (ex. sandal/ boot)
46
Neologisms
Making up new words (lapkata/ boot)
47
Jargon
Sentences of meaningless and unrelated words
48
Agrammatism
Omission of grammatical elements
49
Recurrent utterance or stereotypy (associated with global aphasia)
Using a single word with different tones to convey different meanings
50
Wernicke’s aphasia (fluent aphasia)
Struggle to understand spoken or written language even though speech may sound fluent, very rapid speech that is incoherent, difficulty with imitation, jargon
51
Anomic aphasia (fluent aphasia)
Fluent speech but difficulties in finding the right words, auditory and reading comprehension are generally functional for typical daily tasks
52
Conduction aphasia (isolation) (fluent aphasia)
Rare, poor repetition skills, mild comprehension deficit, anomia (lack of words)
53
Transcortical sensory aphasia (fluent aphasia)
Relatively rare, good repetition skills, severely reduced auditory comprehension, anomia (lack of words)
54
Broca’s aphasia (non fluent aphasia)
Slow speech and writing, mild auditory and reading comprehension difficulties, difficulty understanding functor words (small words)
55
Transcortical motor aphasia (non fluent aphasia)
Good verbal imitative skills, mild auditory comprehension deficits
56
Global aphasia (non fluent aphasia)
Most severe aphasia, significant impairments in all aspects of language including reading, writing, speaking, understanding, recurrent utterance or stereotypy
57
Right hemisphere brain injury (RHI)
Causes: stroke, focal lesion to the nondominant RH Injury causes impairments in areas related to visual perception, pragmatic features (prosody, gestures, facial expressions), neglect of left side of body, reduced judgment and self monitoring, lack of motivation, inattention
58
Traumatic brain injury (TBI)
Causes: car accidents, assaults, sporting accidents, falls, shaken baby syndrome Diffuse injury to the entire brain, inattention, reduced memory, problem solving and reasoning skills, pragmatics
59
Rancho los amigos scale
Rates recovery patterns on an 8- point scale (for brain injury’s)
60
Dementia
Generalized brain damage due to degenerative disease, worsens over time, word finding difficulties, memory loss, disorientation, severe cognitive and language deficits
61
Reversible vs irreversible dementia
Irreversible: Alzheimer’s disease, vascular dementia (multiple mini strokes) Reversible: metabolic disturbances (substance abuse, vitamin deficiencies, thyroid disorders etc)
62
Early stages of dementia
Word finding difficulties
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Mid stage dementia
Disorientation, memory loss
64
Late stage dementia
Severe cognitive and language deficits
65
Ingest
Bringing food, liquids, medications, saliva to the mouth
66
Swallow
Attend to move food, liquids etc from the mouth to pharynx in preparation to the esophagus
67
Penetration
Food, liquids etc passes through the vocal folds (food gets into the airway)
68
Aspiration
Continued movement into lungs (food goes further down into lungs)
69
Aspiration pneumonia
Potentially life threatening medical condition due to entry of foreign material and bacteria
70
Anticipatory stage
Sensory stimulation factors (aesthetic appeal), motivational factors (hunger), integrity of upper extremity motor skills (do they have the ability to eat
71
Oral preparatory stage (four stages of swallow)
Bolus formation, breakdown the ingested material (chewing)
72
Oral stage (four stages of swallow)
Bolus transit from the front to the back of the mouth before it enters the pharynx
73
Pharyngeal stage (four stages of swallow)
Material enters pharynx and travels to the top of esophagus, involuntary action occur (action of larynx, epiglottis etc) protective function
74
Esophageal stage (four stages of swallow)
Material enters esophagus and then travels to stomach for digestion, involuntary
75
6 main causes of pediatric dysphasia
Cerebral palsy, spina bifida, mental retardation and developmental delays, autism, HIV/ AIDS, structural and physiological anomalies (cleft lip/ palate, Pierre robin syndrome, treacher Collin’s syndrome, esophageal atresia, pyloric stenosis)
76
Cerebral palsy pediatric dysphasia characteristics
Impaired muscle movement (difficult to chew, suck, swallow), impaired posture for safe position during feeding, exaggerated gag reflex so difficult to get food in mouth
77
Spina bifid pediatric dysphasia characteristics
Results in sensory and motor problems which can affect one or more stages of swallowing
78
Mental retardation and developmental delay pediatric dysphasia characteristics
Can result in nutrition/ hydration problems, delayed motor skills (can affect more than one stage of swallow)
79
HIV/ AIDS pediatric dysphasia characteristics
Mouth soreness/ lesions results from oral herpes (very painful therefore reduced food intake), may have other developmental problems which pose as added risk for dysphasia
80
10 main causes of adult dysphasia
Stoke, cancer (mouth, throat, larynx), HIV/ AIDS, MS, ALS, Parkinson’s disease, spinal cord injury, medications and nonfood substances, dementia, depression and isolation
81
Stroke adult dysphasia characteristics
10-20% of stroke victims have dysphasia during the first 6 months post, after then 5-10% of survivors continue to have dysphasia problems
82
Cancer (mouth, throat, larynx) adult dysphagia characteristics
Swallowing impairments might be caused by surgical treatment, radiology, chemotherapy
83
Multiple sclerosis (MS) adult dysphagia characteristics
Reduced muscle strength and coordination
84
ALS adult dysphasia characteristics
Greatly impacts muscles for speech and swallowing, likely develop severe dysphagia, ends up on feeding tube
85
Parkinson’s disease adult dysphagia characteristics
Have reduced sensation so at risk for silent aspiration
86
Spinal cord injury adult dysphagia characteristics
Higher incidence of esophageal dysphagia (results in heartburn, chest pain, slow abnormal peristaltic movement of the esophagus)
87
What is audiology as a profession
Involved with prevention, identification, and evaluation of hearing
88
Four major work settings for audiologists
Rehabilitation, education, medicine, industry
89
Outer ear (ACOUSTIC ENERGY)
Pinna (collects vibrations), external auditory meatus/ ear canal (channels the vibrations)
90
Middle ear (MECHANICAL ENERGY)
Tympanic membrane/ eardrum, ossicles (malleus, incus, stapes), middle ear space (opening that leads to Eustachian tube(ET)), ET connects middle ear space with upper portion of pharynx
91
Inner ear (HYDRAULIC ENERGY)
Cochlea, hair cells, auditory nerve comes out of base of cochlea (ELECTROCHEMICAL ENERGY)
92
Types of hearing loss: conductive (OUTER/ MIDDLE EAR)
Excessive cerumen, perforated eardrum, ossicular disarticulation, growth on eardrum, inflammation of middle ear
93
Types of hearing loss: sensorineural (INNER EAR)
Tumor on auditory nerve, noise induced temporary OR permanat threshold shift, aging and deterioration of hair cells and acoustic nerve)
94
Types of hearing loss: mixed
Both conductive and sensorineural (SNHL)
95
Augmentative communication
Approaches that “augment” or improve the persons current means of verbal communication
96
Alternative communication
Approaches that provide an “alternate” means of communication for people who can no longer communicate verbally
97
Forms of AAC
Gestures, signing, pictures/drawing, print/ writing, picture communication board “ low tech”, computerized communication “hi tech”, computer assisted voice production
98
Different types of signing
ASL, American Indian gestural communication, finger spelling, cued speech, iconic (easily recognizable) vs opaque (requires memorization)
99
Populations that benefit from AAC
Deaf, mental retardation, ASD, aphasia, TBI, motor speech disorders (dysarthria, apraxia, CP), glossectomy, laryngectomy

intro to communication disorders (2 decks)

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