Intervention

Question 1

Purpose of intervention

Answer 1

Restore lost function.
Develop speech that's intelligible, natural and effecient as possible.
Compensate for lost function.
Establish a means of communication.
Facilitate adjustment to lost function.
Maximise communication success.
Reduce the impact of dysarthria.

Question 2

For intervention what should the focus be?

Answer 2

Focus should be on communication not just speech.

Question 3

What are the factors influencing intervention?

Answer 3

Cognitive Status-including patient awareness and insight
Psychological Status
Underlying medical condition, it’s complications, likely prognosis, speed of deterioration etc.
The patient needs and priorities
Important to also involve family.

Question 4

Goal Setting

Answer 4

Clearly Defined
Agreed with patient
Short and Long term
Use ICF think about impairment, activity and participation- also consider personal and env. factors (influencing factors)

Question 5

What is it important to do throughout intervention?

Answer 5

Monitor and evaluate :)

Question 6

When to offer intervention.

If dysarthria is due to a sudden onset e.g. stroke, TBI- what is best?

Answer 6

It is best for direct treatment to commence if and when the patient is mentally stable and ready to engage.
The patient has to be in a stable condition :)

Question 7

In intervention, what’s encouraged?

Answer 7

Individual practice of direct treatment.

Question 8

What is the best timing for intervention in progressive conditions, and why?

Answer 8

Early intervention is the goal in progressive conditions. This is in order to:

• Increase awareness and monitoring of speech
• Promote purposeful activity
• Prevent maladaptive behaviour

Question 9

In degenerative conditions, what can the individual decide?

Answer 9

If they want shorter but frequent input at repeated intervals
OR
Input in response to changes
OR
input to prepare for the likely changes

We have to respect if people don’t want intervention, but have a plan in place for future etc.

Question 10

Types of intervention.

Patient

Answer 10

Treatment of impairment
Compensatory Strategies
Education and awareness training
Introduction and practice of AAC
Psychosocial support
Individual or group based

Question 11

Types of intervention.

Communication partner.

Answer 11

Education and advice about dysarthria and underlying neurological condition.
Increase awareness of their role in communication exchange.
Education and advice on how to support communication.
Psychological support.

Question 12

Types of intervention.

Indirect

Answer 12

Environmental modifications e.g. reduce background noise, appropriate positioning, seating, lighting etc.
Education and awareness training for care staff and general public.

Question 13

Name the different intervention methods.

Answer 13

Behavioural
Biofeedback/instrumental
Surgical and prosthetic
Pragmatic

Question 14

Behavioural Intervention.

Answer 14

The behavioural approach to dysarthria involves teaching patients new skills, compensations or adjustments that us traditional stimulus presentation, patient response and subsequent response contingencies.

Question 15

What are the advantages of behavioural intervention?

Answer 15

The ability to conduct these techniques in any situation.

Relatively little or no cost for equipment.

Question 16

Give an example of a behavioural intervention.

Answer 16

LSVT - Lee Silverman Voice Treatment for PD and other neurological conditions. “speak loud”

Question 17

instrumental approach involving…

Answer 17

biofeedback techniques.

Question 18

What do biofeedback methods provide?

Answer 18

They provide an effective method of establishing motor control of sensory input at all levels of the speech production mechanism.

Question 19

What does the biofeedback encourage?

Answer 19

It encourages patient self-monitoring.

but the therapist must ensure that over reliance doesn’t occur.

Question 20

Give examples of biofeedback .

Answer 20

volume meter, vispitch and sound meter apps.

Question 21

What is an alternative to traditional or biofeedback therapy techniques?

Answer 21

Surgical and prosthetic approach.

Question 22

Define prosthetic treatment.

Answer 22

any method that alters the physical properties of the motor speech system.

Question 23

Give examples of prosthetic treatment.

Answer 23

Amplification Devices.

Palatal lift- improves palatopharyngeal closure to improve resonance and articulation

Question 24

Name examples of surgical procedure.

Answer 24

Botocx into thyroarytenoid muscle where hypo-adduction of vocal folds occurs.

Nasal obturator- reduces nasal escape of airflow-unlikely to find this socially acceptable though.

Question 25

When should botox injections only be considered?

Answer 25

only considered if poor voicing is the main reason for communication breakdown.

Question 26

Name some specific approaches.

Answer 26

AAC

Treatment techniques specifically designed to target neurologically impaired subsystems of speech.

Question 27

Who would be best suited to use AAC?

Answer 27

People with progressive dysarthria, to overcome problems with intelligibility.

Question 28

What does introduction of AAC depend on?

Answer 28

Patient Needs
Cognitive skills
Motor skills
Staging of neurological disorder.

Question 29

What is the fourth approach?

Answer 29

The Pragmatic Approach

Question 30

What is the pragmatic approach?

Answer 30

Helping the patient to maximise communication within situations and contexts of daily life.

Question 31

What does the pragmatic approach require?

Answer 31

SLT to work closely with the patient and family.

Question 32

Give examples of pragmatic treatment

Answer 32

Alter the communication environment in order to enhance communication.
Modify utterance length
Teach effective repair strategies
Effective self-monitoring
Improve topic orientation.

Question 33

What are some environmental changes?

Answer 33

avoid dark, noisy places, reduce distance to compensate for volume deficits, use non-verbal and verbal cues.