L2/3: Assessment

Question 1

5 components of assessment

Answer 1

history and interview

motor speech exam (non speech tasks)

motor speech exam (speech tasks)

assess of intelligibility

acoustic and physiological analysis (not essential)

Question 2

why is history/interview of onset and course important? what are the main ideas of the questions you would ask?

Answer 2

useful for neurological diagnosis, prognosis, and management decisions

also reveals the patient’s perception of the prob

main ideas: was it sudden/gradual, other difficulties, did it change, other factors (ex. medication)

Question 3

why is history/interview of associated problems important?

Answer 3

may provide confirmatory info

Question 4

why is history/interview of the patient’s perception of the problem important?

Answer 4

can provide useful confirmatory info

Question 5

why is history/interview of the consequences of the disorder important?

Answer 5

address functional consequences of MSDs

Question 6

why is history/interview of the management of the disorder important?

Answer 6

gain info about what the pt and others (including other professionals) have done to manage the speech disorder

useful for determining prognosis and future management recommendations

Question 7

why is examination of speech mechanism during non-speech activities informative?

Answer 7

they provide info about orofacial movements - particularly of the jaw, face, tongue, and palate

Question 8

how is the examination of speech mechanism during non-speech activities completed? (4 types of observations)

Answer 8

observations are primarily visual and tactile but also auditory

the observations can be made:
- at rest
- during sustained postures
- during movement
- reflexes

Question 9

what do observations of the speech mechanism during non-speech activities tell us?

Answer 9

may support conclusions drawn about speech

even if not confirmatory of a speech diagnosis they may nonetheless be important

Question 10

assessment of mandibular musculature during non-speech activities tests…

Answer 10

V - trigeminal

Question 11

assessment of lip and facial musculature during non-speech activities tests…

Answer 11

VII facial and III oculomotor

Question 12

assessment of palatopharyngeal musculature during non-speech activities tests…

Answer 12

IX - Glossopharyngeal, X - vagus

Question 13

assessment of laryngeal musculature during non-speech activities tests…

Answer 13

X-Vagus

Question 14

assessment of tongue musculature during non-speech activities tests…

Answer 14

XII - hypoglossal

Question 15

assessment of respiratory musculature can be done during non-speech activities tests by…

Answer 15

strong sniffs/gasps (inhalatory) etc

Question 16

palmomental reflex

Answer 16

in response to brisk stroking of right and left palms leads to contraction of R/L mentalis or lower lip (ex. in ALS pts)

Question 17

fasciculations

Answer 17

a spontaneous, involuntary muscle contraction and relaxation, involving groups of muscle fibers

Question 18

vocal flutter is associated w

Answer 18

laryngeal weakness

Question 19

what are the 5 ways the speech mechanism is examined in speech activities?

Answer 19

vowel prolongation

prolongation of /s/ and /z/

alternating movement rates (AMRs or DDKs)

stress counting: counting from 1-200 (ex. important in MG)

contextual speech (reading aloud, picture description, conversation)

Question 20

norm of max phonation time for adult female 13-65

Answer 20

21 seconds

Question 21

norm of max phonation time for adult male 13-65

Answer 21

25.89 seconds

Question 22

norm of max phonation time for geriatric female 65+

Answer 22

13.55 seconds

Question 23

norm of max phonation time for geriatric male 65+

Answer 23

14.68 seconds (SD=6.25)

Question 24

what is the general rule for s/z ratios?

Answer 24

ratio of 1.4 considered upper limit for normal, expect 1.0 in adults

Question 25

s/z ratio above 1.4 suggests

Answer 25

ratio above 1.4 suggests inadequate/inefficient laryngeal valving (/s/ longer than /z/)

Question 26

sedate geriatrics s/z ratio norm

Answer 26

0.76

Question 27

activate geriatrics s/z ratio norm

Answer 27

0.82

Question 28

norm of rate of repetition for /pΛ/ for adults (syllables per sec)

Answer 28

4.5 - 7.5 syllables/second

Question 29

what are the three measures of intelligibility in dysarthria?

Answer 29

rating scores
severity scores
phonetic intell testing

Question 30

what is the sentence intelligibility test (SIT) at single word?

Answer 30

50 words, patient reads, naive listener picks from 10 possible words for each word

number of correct/total = % intell

Question 31

what is the sentence intelligibility test (SIT) at sentence level?

Answer 31

22 sentences, patient reads sentences, naive listener transcribes them

number of words correct/total = % intell

Question 32

sentence intell test (SIT) provides what type of score? what does it not provide?

Answer 32

severity score

does not provide a phonetic explanation for the intell deficit

Question 33

describe the phonetic intelligibility test… what can it be used for?

Answer 33

70 word test

attempts to provide a phonetic explanation for the patient’s intell deficit

examines 19 phonetic errors that commonly occur in dysarthria

provides a phonetic error profile that shows the proportion off error for each phonetic error

profile can be used to determine which phonetic errors are contributing the most to the intell deficit

Question 34

why is rate important to consider for intellgibility?

Answer 34

rate is an important component of intell

we may want to tweak a patient’s rate to see if it changes their intell

patients dont often find the optimum rate on their own - need help to find it