from acquired AOS through end

Question 1

acquired AOS

Answer 1

segmental articulation errors: primarily with consonants, mostly distortions, but also substitutions and omissions; reduced fluency: repetitions, groping, difficulty initiating (especially on command); disruption in temporal prosody: slowed rate, prolonged V + C, extra pauses; scanning speech pattern–important for differentiating AOS from aphasia

Question 2

other speech characteristics of AOS

Answer 2

errors increase with word length and phonetic complexity; more errors in less practiced utterances and in nonsense words

Question 3

phonemic paraphasia vs. AOS

Answer 3

PP: near normal rate, normal timing, clear substitutions (not distortions); AOS: inconsistent errors, groping, successive trials

Question 4

dysarthria vs. AOS

Answer 4

d: paralysis, paresis, involuntary movements (noticeable on oral mech), disturbance of other speech subsystems; AOS: absent neuromuscular deficits

Question 5

CAS

Answer 5

different from AOS b/c problem with acquiring normal motor programs (during developmental stage); may not have identifiable neuro impairment, but still presumed to have underlying neurological basis

Question 6

criteria used for diagnosing CAS (survey)

Answer 6

inconsistent productions, general oral-motor difficulties, groping, inability to imitate sounds, difficulty with increasing utterance length, poor sound sequencing; MOST IMPORTANT=inconsistent C and V errors, disrupted coarticulation, inappropriate prosody (esp. stress)

Question 7

CAS possible associated deficits

Answer 7

nonverbal oral apraxia, sensory, cognitive, perceptual deficits, dysarthria, dysphagia, language deficits including selecting/sequencing, expressive language, reading, metalinguistic

Question 8

CAS vs. speech sound delay/disorder

Answer 8

the latter has typical substitution/omission patterns which are predictable and consistent; no suprasegmental difficulties; can learn correct production quickly, no motor skill difficulties, acceptable progress and more normal speech milestones; CAS characteristics change over time and require changing treatment

Question 9

differential dx tasks

Answer 9

oral mech, DDK, AMR, speech repetition, contextual speech

Question 10

what to classify in dx

Answer 10

dysarthria type, disease type, severity (intelligibility)

Question 11

acoustic similarities across dysarthrias

Answer 11

slow rate, compressed vowel space, reduced rate of formant change (slope), reduced phonetic contrasts; acoustic metrics useful for detecting presence/absence of dysarthria, but not reliable indicators of subtype

Question 12

respiratory/phonation tx (optimal subglottal pressure)

Answer 12

expiratory muscle strength training; biofeedback; inspiratory checking and breath groups (pause is 100-200 msec); postural adjustment and effortful closure

Question 13

articulation/speech movement tx

Answer 13

motor learning (distribution of practice, feedback, etc.); PROMPT (more for AOS: uses tactile-proprioceptive-kinesthetic cues applied physically, and requires extensive training); 8 step continuum of speech (cueing hierarchy for AOS); sound production treatment (also hierarchy of steps for AOS); general: don’t know how speech is organized in the brain (at what level), so difficult to treat

Question 14

rate and rhythm tx

Answer 14

rate may be most modifiable; delayed auditory feedback; pacing board; finger/hand tapping; rhythmic cueing (metronome, etc.)

Question 15

loudness tx

Answer 15

LSVT; voice aerobics; biofeedback; masking (increase in volue with background noise)

Question 16

prosody tx

Answer 16

LSVT; contrastive stress drills; music-based; visual feedback

Question 17

resonance tx

Answer 17

(velopharyngeal competence); surgery or prosthetics; speech therapy combined with sx, mostly for nasality, nasal emissions, weak consonants

Question 18

deep brain stimulation

Answer 18

consists of inhibition and stimulation; inconsistent data about whether speech improves, but sometimes actually deteriorates; will not do if only symptoms affecting speech; subthalamic nucleus (BG) or globus pallidus interna (BG)

Question 19

(essays) speech movement

Answer 19

high degree of variability

Question 20

motor equivalence

Answer 20

different articulatory movements can produce the same sound; too much or little variability for disordered? we haven’t yet defined the “normal” variability

Question 21

perception

Answer 21

if only thing used for dx, only right 35-40% of time; adding in acoustics = 32-60%; can use acoustics to measure progression of dysarthria or efficacy of tx or suprasegmentals, but for other things, not quite there yet

Question 22

oromotor non-speech tasks

Answer 22

not supported by the research because non-speech requires more gross motor skills and has different neural pathways

Question 23

DIVA model

Answer 23

feed forward and back; relationship between phonemic goals and production; different from brain structure; can model speech sounds no, but not connected speech

Question 24

speech perception

Answer 24

incorporate individual’s own speech perception into motor control (feedback monitoring); re-map auditory and biofeedback

Question 25

review

Answer 25

dysarthria PDF and marked pages in notes; diagram on phone from quiz