Management Of Childhood Dysarthria

Question 1

Approaches to Reduce Physiologic Impairment and Increase Speech Function

Answer 1

1. Making speech loud enough
2. Making acoustically definable contrasts
3. Increase speaker’s physiologic support for speech

Question 2

Addresses the functional components of speech production subsystem

Answer 2

Components Approach

Question 3

Approaches to Maximize Speech Intelligibility and Acceptability

Answer 3

1. Consistent use of distinguishable phonetic contrasts at SEGMENTAL and SUPRASEGMENTAL levels of production
2. Use of Compensatory, Exaggerated
   Articulatory Movements, Overall Increased Physiologic E ort during speech, Slower S

Question 4

● 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

Answer 4

Contrastive Stress Activities

Question 5

Approaches to Increase Comprehensibility

Answer 5

iimprove lang naten ung understanding ng kabila/ung listener by complementing the speech performance with some language and other strategies.

Question 6

cueing your listener kung ano ung initial letter na sinasabe mo

Answer 6

Initial letter cueing

Question 7

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.

Answer 7

Modifying production on repetition

Question 8

may context mas maiintindihan sya.

Answer 8

Contextual cues

Question 9

You want to rephrase, paraphrase; repeat the idea over and over again para maintindihan niya.

Answer 9

Redundancy

Question 10

You could complement ung sinasabe mo with pictures or with some gestures.

Answer 10

Visual Information

Question 11

○ 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

Answer 11

Severe Spastic Quadriplegia

Question 12

Primary impairment of sever spastic quadriplegia

Answer 12

• always in a state of half-awake
• inattentive
• startle to slight sounds

Question 13

○ 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

Answer 13

Moderate spastic quadriplegia

Question 14

moderate spastic quadriplegia impairment:

Answer 14

Head control

Question 15

Principles of treatment for spastic quadriplegia

Answer 15

1. Increase arousal level
2. Vestibulo-ocular relfex
3. Change movement patterns

Question 16

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

Answer 16

Increase arousal level

Question 17

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.

Answer 17

Vestibulo-ocular reflex

Question 18

MOBILIZATION
○ pelvis → legs
○ Spine
○ scapula and shoulder girdle (one side elongated) other side

Answer 18

Change movement patterns

Question 19

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

Answer 19

Change movement patterns

Question 20

Improve breathing pattern.
○ Spine Mobilization
○ Ribcage Manipulation

Answer 20

Change movement patterns

Question 21

• Poor postural set and Poor postural control
• Associated problems: vision, oromotor, breathing, speech, communication, hand function

Answer 21

Athetosis

Question 22

○ Unstable emotion
○ Poor midline orientation
○ Poor grading and dissociation of movement

Answer 22

Athetosis Normal Cognitive Level

Question 23

○ Poor head righting reaction
○ Poor body righting function
○ Equilibrium reaction’

Answer 23

None or Low cognitive level athetosis

Question 24

○ Head stability, midline orientation, relax
○ Gradin and dissociated movement
○ Hand grasping, interlink to trunk, grading movement

Answer 24

normal cognitive athetosis treatment

Question 25

Subcortical approaches, equilibrium reactions
righting reactions

Answer 25

None or low cognitive athetosis treatment

Question 26

● Shoulder retraction
- Scapula is the retractive part, if nag-retract observe mo what happens to your posture.
● Thoracic extension
● Head and neck stabilization

Answer 26

Stabilization Activities

Question 27

● Therapists assist in the occipital level during sitting activities
● Feet on the ground
● Toys elevated in front

Answer 27

Head Control Activities

Question 28

● Child on a vestibular ball with feet on the floor
● Therapist is in front keeping the ball stable
● Assist on the waist level

Answer 28

Eccentric Control Activities

Question 29

● Static surface to dynamic surface
● Reaching activities

Answer 29

Midrange Control Activities

Question 30

● Passive to active
● Static to Dynamic
● Reaching/Pointing activities
● Assist back and side

Answer 30

Rotational Control Activities

Question 31

Encourage core control

Answer 31

Standing/walking activities

Question 32

● Lack of muscle coordination
● Compensatory: wide base of support;
hyperextension of knee
● Disturbed reciprocal innervation

Answer 32

Ataxia

Question 33

Postural tone of ataxia

Answer 33

● Low but not excessively low
● Lack of co-activation proximally

Question 34

Principles of treatment for ataxia

Answer 34

● Increase Postural Tone
○ Sustained postural control
○ Grading of movement
● Facilitate Active adaptation to movement
● Regulate Balance Reactions
● Facilitate Selectivity of Movement

Question 35

Activities for ataxia

Answer 35

1. Balance
2. Postural control
3. Dynamic evaluation activities

Question 36

Organizational Guideline

Answer 36

Avoid negative responses
Work from least to most sensitive
Extra-Oral to Intra-Oral
Work the mouth and tongue ‘be verbally explicit

Question 37

Oral Motor Techniques

Answer 37

1. Exercises
2. Cues
3. Stimulation

Question 38

Articulation drills

Answer 38

• target
• frequency
• starting point

Question 39

Respiratory treatment

Answer 39

1. Limited breath support
2. Ine cient use of breath support
3. Speaking in short phrases

Question 40

adjust the sitting, yung postural support niya for breathing or you could actually do inspiratory/expiratory muscle training na targeting lung capacity.

Answer 40

Limited breath support

Question 41

Maximum inhalation, you want to train the
muscles how to expand and contract well -
para makakuha ng madaming air -
Maintaining phonation, meaning exhalation naman. Exhalation control.

Answer 41

Inefficient use of breath support

Question 42

teach the patient how to
speak in short phrases

Answer 42

Speaking in short phrases

Question 43

Phonatory Treatment targets

Answer 43

● Coordinating respiration and phonation
● Increasing loudness
Improving quality
Improving pitch

Question 44

Goal of improving respiratory/laryngeal function

Answer 44

achieve and maintain adequate subglottal pressure to produce and sustain voice

Question 45

Approaches to Improve Respiratory/Laryngeal Function

Answer 45

Activities that encourage use of speech like patterns and that provide feedback as to how much subglottal pressure is being produced, and for how long

Question 46

Resonatory treatment

Answer 46

non-speech and Speech Exercises
Pharyngeal Flap
Prosthesis

Question 47

Prosody treatment

Answer 47

Speaking rate
Lexical stress
Sentence stress
Phrase groupings