Motor speech Flashcards
What is not a common etiology of motor speech disorders?
Parkinson’s disease
What is a common etiology of motor speech disorders?
Huntington’s disease, seizure disorders, and brainstem stroke
Nonverbal oral apraxia is associated with a lesion in the
frontal and central opercula (the operculum is a brain structure next to the insula that is involved in sensory, motor, autonomic, and cognitive processing); it plays a role in behavioral planning and motor functioning
What is the etiology of dysarthrias?
issue to the peripheral or central nervous system
What is the etiology of flaccid dysarthria?
lower motor neuron damage, especially to muscles and/or CNs involved in speech
How does flaccid dysarthria affect articulation?
weak and imprecise consonants
How does flaccid dysarthria affect respiration?
reduced subglottal air pressure and short phrases
How does flaccid dysarthria affect phonation?
harsh, monopitch and monoloudness, short phrases, breathy; you can hear them breathing;
How does flaccid dysarthria affect resonance?
hypernasality; air coming out of the nose
What is the neuromotor basis of flaccid dysarthria?
hypotonia and weakness
What is the etiology of ataxic dysarthria?
damage to the cerebellum
What is the neuromotor basis of ataxic dysarthria?
incoordination
How does ataxic dysarthria affect articulation?
imprecise consonants, vowel distortion,
How does ataxic dysarthria affect prosody?
long time between words and syllables; slow rate of speech; excessive and even stress
How does ataxic dysarthria affect resonance?
hyponasality (not a prominent feature)
How does ataxic dysarthria affect phonation?
monopitch; monoloudness; harshness
How does ataxic dysarthria affect respiration?
paradoxical breathing
Regarding articulation, all dysarthria types result in
imprecise consonants
Regarding phonation, all dysarthria types result in
monopitch and monoloudness
Which dysarthria types do not cause vowel distortions?
flaccid and hypokinetic
Regarding prosody, which dysarthria types do not cause excess and equal stress?
flaccid and hypokinetic
Which dysarthria types do not cause a slow rate of speech?
flaccid and hypokinetic
Which dysarthria types cause hypernasality?
flaccid, unilateral upper motor neuron, spastic, mixed, hyperkinetic
Which dysarthria type causes hyponasality?
ataxic
Which dysarthria types cause mild hypernasality?
hypokinetic
Which dysarthria type does not cause someone to produce short phrases?
ataxic; flaccid
What is the neuromotor basis for hyperkinetic dysarthria?
abnormal movements
What is the neuromotor basis for hypokinetic dysarthria?
reduced range of motion and reduced movements
What is the neuromotor basis for unilateral upper motor neuron dysarthria?
weakness and spasticity, just like spastic dysarthria
What are speech characteristics of someone with hyperkinetic dysarthria?
prolonged phonemes, silences are inappropriate, variable rate, voice stoppage or voice breaks
What diseases cause hyperkinetic dysarthria?
huntington’s disease and dystonia
What is the site of lesion for hyperkinetic dysarthria and hypokinetic dysarthria?
extrapyramidal tract (deals with indirect motor movement by refining major motor movements)
What disease causes hypokinetic dysarthria?
Parkinson’s disease
What are the speech characteristics of someone with hypokinetic dysarthria?
monopitch, monoloudness, reduced loudness, and rapid rate
What is a characteristic found in all severities of AOS?
increased variability of articulatory characteristics
What is multiple input phoneme therapy?
a treatment approach designed for clients to gain or regain volitional motor control through clinician cues and client stimuli
Intracranial arteritis is never a possible cause for
hypokinetic dysarthria
The use of breathy onsets during speech is useful for what type of dysarthria?
spastic; it oftens results in a harsh voice, uncontrollable subglottic air pressure, and spasms occurring in the larynx
People who exhibit ________ struggle to make nonspeech sounds and cannot move the muscles of the throat, soft palate, and tongue for nonspeech purposes
oral apraxia
What are the etiologies of dysarthria?
trauma to the brain (e.g., skull fracture or neck injury), nonprogressive neurological conditions (e.g., stroke, TBI), progressive neurological conditions (e.g., ALS, MS), penetrating injury, toxins
What parts of the brain are damaged in apraxia of speech?
insula, pathways connecting the parietal lobe to the frontal lobe, lateral prefrontal cortex, and internal capsule
What is a prosthetic device for people with ataxic dysarthria?
neck brace or cervical collar since people with ataxic dysarthria may have head tremors so the neck brace will stabilize their head
What is a common etiology of Apraxia of speech?
vascular lesions
What is the most effective treatment for Apraxia of Speech?
behavioral treatment where speech movements are prioritized as well as speech rate. A pacing board or a metronome can be used to help slow down speech rate
What is sound production treatment?
a treatment used with people with apraxia of speech that focuses on minimal contrast between words (e.g., shock and sock)
When treating dysarthria, to modify respiration, an SLP should
use instrumentation (e.g., air pressure manometer) to help them build subglottal air pressure; help them prolong vowels; teach them how to control their breathing; change their postures; change how their breathing habits; shape production of longer phrases and sentences
When treating dysarthria, to modify phonation, an SLP should use
biofeedback to shape the desired loudness of one’s voice; train the client to use portable amplification systems; tell aphonic clients to use an artificial larynx or other techniques
When treating dysathria, to modify resonance, an SLP should use
a nose clip or a nasal obdurator (to reduce the flow of air when you speak; making it sound less hypernasal); a nasometer or a nasoendoscope to measure airflow through the nose; teach them to open their mouth wide to increase oral resonance and vocal intensity
When treating dysarthria, to modify articulation, an SLP should
teach the client how to achieve their best posture; use a bite block to position jaw; use phonetic placement cues; slower rate and minimal contrast pairs; teaching self-monitoring and compensatory strategies/skills
When treating dysarthria to modify speech rate, an SLP should
use delayed auditory feedback, pacing board, metronomie, hand tapping
When treating dysarthria to modify prosody, an SLP should
teach appropriate intonation and reduce speech rate
When treating dysarthria to modify pitch, an SLP should
use modeling and differential feedback
When treating dysarthria to modify vocal intensity, an SLP should
modeling; increased laryngeal adduction; wider mouth opening; differentially reinforcing greater inhalation
What are the causes of dysarthria?
trauma; toxic-metabolic causes (e.g., exposure to drugs); infectious disease (e.g., TB or AIDS); nonprogressive neurological damage (e.g., stroke, TBI); degenerative disease (PD or HD)
Which dysarthria types do not affect respiration?
mixed dysarthria and unilateral upper motor neuron
What is the neuromotor basis for unilateral upper motor neuron dysarthria?
weakness and spasticity caused by a a stroke, multiple sclerosis, or neurosurgical trauma
What are the neuromotor bases for mixed dysarthria?
flaccid-spastic and ataxic spastic caused by MS, ALS, Friedriech’s Ataxia, and Wilson’s disease
What are the differences between flaccid-spastic and ataxic-spastic dysarthria?
flaccid-spastic is associated with monopitch and monoloudness whereas ataxic-spastic is associated with inappropriate loudness levels. Flaccid-spastic dysarthria is associated with a slow rate of speech, distorted vowels, breathiness, audible inspiration, nasal emisson, inappropriate silences, and strangled voice quality; no articulatory breakdowns, and is most commonly resulted from ALS. Ataxic-spastic dysarthria is associated with no slow rate of speech and articulatory breakdowns and most commonly results from MS. Hypernasality is present in both
What do flaccid-spastic and ataxic-spastic have in common?
imprecise articulation and harsh voice quality
Regarding respiration issues, how do the following dysarthria types differ: flaccid, ataxic, hyperkinetic, and hypokinetic?
flaccid: reduced subglottal pressure, short phrases
Ataxic: paradoxical breathing
Hypokinetic: reduced vital capacity; breath quickly and irregularly
Hyperkinetic: forced inhalation and exhalation and you can hear them while they breathe
Regarding phonation issues, which types have monopitch and monoloudness?
flaccid, ataxic, hypokinetic, flaccid-spastic
Regarding phonation issues, which types do not have monopitch and monoloudness?
spastic, ataxic-spastic, unilateral upper-motor neuron, hyperkinetic
Regarding phonation issues, how do these types of dysarthria differ?
spastic: strained-strangled and pitch breaks, low pitch, continuously breathy voice, and short phrases
UUMN: Strained voice; harshness; wet voice; breathy voice
Hyperkinetic: voice stoppage, voice tremor, voice noise, harsh voice, and loudness variation
Ataxic-spastic: inappropriate pitch levels, harsh voice quality
What is the difference between tics and chorea?
tics: Rapid, involuntary, and quick stereotyped movements
Chorea: random, involuntary movements of the body
Both movement disorders are associated with hyperkinetic dysarthria
What is the difference between dystonia and tics?
tics: rapid, involuntary, and quick stereotyped movements; dystonia: contraction of antagnostic muscles that cause abnormal posture such as spastic torticollis and blepharospasm
Which dysarthria types are caused by a stroke?
flaccid; flaccid-spastic; unilateral upper motor neuron; ataxic
When treating resonance issues, an SLP can use
a CPAP or a nasal clip or a nasal obdurator for hypernasality
When treating vocal intensity, an SLP can use
LSVT; modeling, shaping, and differently reinforcing greater inhalation; increased laryngeal adduction, and wider mouth opening
When treating Apraxia of Speech, you should focus on
improving speech movements; helping the client speak faster and improve articulation accuracy.
What is the neuromotor basis for hypokinetic dysarthria?
reduced range of motion, reduced movement, and rigidity
What is the neuromotor basis for hyperkinetic dysarthria?
abnormal, extra movements
What is the neuromotor basis for ataxic dysarthria?
incoordination
What is the neuromotor for flaccid dysarthria?
weakness and hypotonia
