Management Of Childhood Dysarthria Flashcards
Approaches to Reduce Physiologic Impairment and Increase Speech Function
- Making speech loud enough
- Making acoustically definable contrasts
- Increase speaker’s physiologic support for speech
Addresses the functional components of speech production subsystem
Components Approach
Approaches to Maximize Speech Intelligibility and Acceptability
- Consistent use of distinguishable phonetic contrasts at SEGMENTAL and SUPRASEGMENTAL levels of production
- Use of Compensatory, Exaggerated
Articulatory Movements, Overall Increased Physiologic E ort during speech, Slower S
● Increase control of the respiratory/laryngeal system to manipulate production of stress on words in a target utterance
● The child varies word stress using the same utterance to respond di erentially
Contrastive Stress Activities
Approaches to Increase Comprehensibility
iimprove lang naten ung understanding ng kabila/ung listener by complementing the speech performance with some language and other strategies.
cueing your listener kung ano ung initial letter na sinasabe mo
Initial letter cueing
repeating pero you’re going to not just repeat as is but siguro repeat it slowly, repeat it with a little bit more stress or kaya babaguhin mo ung length.
Modifying production on repetition
may context mas maiintindihan sya.
Contextual cues
You want to rephrase, paraphrase; repeat the idea over and over again para maintindihan niya.
Redundancy
You could complement ung sinasabe mo with pictures or with some gestures.
Visual Information
○ Poor regulating arousal level
○ Limited sensory channels
○ Poor adaptation/continuous frightening, hypersensitivity
○ No head control
○ Total extensor with hypertonus
○ Less movement
○ Poor eyeball movement (eyeball deviation)
○ Poor survival functions
Severe Spastic Quadriplegia
Primary impairment of sever spastic quadriplegia
- always in a state of half-awake
- inattentive
- startle to slight sounds
○ Expression of two total pattern: hypertonus, & associated reactions
○ Poor head control
○ Asymmetrical posture
○ Immobility of the body
○ Contracture & deformity
○ Phonation and speech problems
○ Pulling arms
Moderate spastic quadriplegia
moderate spastic quadriplegia impairment:
Head control
Principles of treatment for spastic quadriplegia
- Increase arousal level
- Vestibulo-ocular relfex
- Change movement patterns
Simple whole body deep pressure
Activation of face muscles
Slow and smooth mobilization of face muscles
Movement of the forehead muscles
Look for eye movement
Increase arousal level
Head and both eyes: Eye movement follows head automatically
Check the function of the VOR
Change the posture and bring the arm and body and head.
Vestibulo-ocular reflex
MOBILIZATION
○ pelvis → legs
○ Spine
○ scapula and shoulder girdle (one side elongated) other side
Change movement patterns
ARM PROPPING while sitting
○ anterior pelvic tilt while sitting
○ pelvis at right angle while sitting
○ head control while sitting
○ promote sucking
○ breathing pattern changes with ribcage mobilization
Change movement patterns
Improve breathing pattern.
○ Spine Mobilization
○ Ribcage Manipulation
Change movement patterns
- Poor postural set and Poor postural control
- Associated problems: vision, oromotor, breathing, speech, communication, hand function
Athetosis
○ Unstable emotion
○ Poor midline orientation
○ Poor grading and dissociation of movement
Athetosis Normal Cognitive Level
○ Poor head righting reaction
○ Poor body righting function
○ Equilibrium reaction’
None or Low cognitive level athetosis
○ Head stability, midline orientation, relax
○ Gradin and dissociated movement
○ Hand grasping, interlink to trunk, grading movement
normal cognitive athetosis treatment
