managing apraxia

Question 1

What usually co-occurs with apraxia?

Answer 1

aphasia

Question 2

Is it better to work on Apraxia first before language sometimes?

Answer 2

No! It is better to work on language first

Question 3

T/F: All canidates are good for Apraxia therapy

Answer 3

F

Question 4

Which medicines are prescribed for apraxia?

Answer 4

NONE (maybe one for underlying disorder)

Question 5

Which prosthetic mnagemtns are best for apraxia?

Answer 5

Palatal lift in rare cases
pacing devices (metronome/finger tapping)
AAC devices

Question 6

Are DAFs good for apraxia?

Answer 6

not typically, espeically for Broca’s

Question 7

T/F: progression of systematic intensive drill is beneficial for Apraxia

Answer 7

True

Question 8

What is important for motor learning for apraxia?

Answer 8

9
Drill (one on one)
Patients need self monitoring
beginning at sound/syllable/word level? - listen and watch me approach
use automatic speech to begin with (counting etc)
feeback (mirrors)
Use speech tasks
intensive practice multiple repetitions of stimuli
begin with consistent practive move to variable
reduce rate

Question 9

When do nonspeech tasks help with AOS?

Answer 9

If the px cannot make syllables or sounds.

Question 10

What to do if patient is mute?

Answer 10

FOcuse on vegetative actions cough laugh humming singing

Question 11

If a client is at the multi-sllable level what treatment approaches do you use?

Answer 11

Focus on rythm, stress, intonation and artic (pacing board/finger tapping/metronome
Use phonetic and stree contrtrasts

Question 12

What are some treatment programs for AOs?

Answer 12

Rosenbecks Eight step continuum
Sound Production Treatment (SPT)-Wambaugh
Prompts for Restructuring Oral Muscular Phonetic Targets (PROMPTS)
MIT
Multiple Input Phoneme Therapy (MIPT)
Volentary Control of Involentary Utterances (VCIU)
Biofeedback (not alone)

Question 13

Rosenbek’s eight step continuum

Answer 13

1- Integral Stimulation (at the same time)
2- Same as step 1 but clients responce is delayed and clinician mimes
3 Intergral stim followed by unsupported imitation
4Intergral stimulation with sev. succestive unsupported responces
5 written stim ONLY – client production
6 Written stim and production 10secs AFTER
7 - Responce elicited by a question
8 - produced in role play situation

Question 14

Sound production treatment

Answer 14

Uses rosenbeks heiarchy but focus on minimal pairs

Question 15

Prompts for resturcturing oral muscular phonetic targets (PROMPTS)

Answer 15

**develped for children but now for adults too!!
**USED FOR SEVERE AOS
Tactile kinesthetic input - highly structured finger placement on face/neck and tell them the articulatory placement

Question 16

Who is a good canidate for MIT?

Answer 16

good verbal comprehension, limited spontaneous verbal output, good self monitoring
Brocas with AOS

Question 17

How does MIT bascially work?

Answer 17

Hand tapping rythms, moving to humming and tapping with clinician, adding words, phrases and gradual fading of music
focus on pitch tempo and rythem
move on to spoken song then speech

Question 18

Biofeedback techniques

Answer 18

EMG for relaxation
Electromagnetic articulography (tonge positions)

Question 19

What do you do for a severe apraxia (speechless techniques)

Answer 19

-automatic speech tasks
carrier phrases
singing familiar songs
initiation of phonation- sighing, yawning, coughing
pair gestures with sound/words (waving ok sign finger to lips /sh/

Question 20

techiques for soung syllable and word levels

Answer 20

work on nonsense words
Isolated sounds then shape into words (hum then prolong this to ma… then add final consonant
Key word technique - use words correctly gain control over speech.. use the initial sound of this word to lead to another one
cueing strats (placement cues)

Question 21

Multiple Input Phoneme Therapy (MIPT)

Answer 21

Used with severely aphasic and apraxic
aid during struggle to speech
identiry most frequently occuring stereotype *such as go-go and use this as target of treatment