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CETP Review > Motor Speech > Flashcards

Motor Speech Flashcards

1
Q

Main features of apraxia (5)

A
  • Difficulty transitioning between sounds (turning voice on and off)
  • Issues with prosody
  • Articulatory groping
  • Difficulty with initiation
  • Increased sound errors with increase in length
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1
Q

Apraxia of speech is due to a defecit in:
a) programming
b) planning
c) execution
d) all of the above
e) a and b only
d) a and c only

A

e) programming and planning

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2
Q

Main features of dysarthria

A

Abnormality in strength, speed, range, steadiness, and tone of movement required for speech

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3
Q

What is oral apraxia?

A

Difficulty planning volitional movement of oral structures for non-speech tasks

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4
Q

Ideomotor apraxia

A

Unable to follow commands or imitate gestures

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5
Q

Ideational apraxia

A

Able to do individual tasks but can’t plan out a longer sequence/action (e.g.

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6
Q

What is the most common cause of AOS?

A

Degenerative disease + stroke

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7
Q

If a person with AOS complained of chewing/swallowing difficulties, what should you do?

A

Assess for dysarthria

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8
Q

Protocol for AOS when it comes to potential aphasia

A

All AOS patients should be considered aphasic until comprehensive language ax has been completed because AOS frequently occurs with Broca’s

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9
Q

AOS is nearly always the result of abnormality in the _____ cerebral
hemisphere

A

Left (dominant)

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10
Q

T/F: Dysarthria is often associated with aphasia

A

False - AOS is very often associated wth aphasia but Dysarthria is NOT

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11
Q

Differential dx of dysarthria and AOS

A

Dysarthria vs AOS
- All speech systems vs. artic + prosody
- Consistent errors vs. inconsistent
- More distortions (makes speech easier) vs. more substitutions (making it harder)
- Weakness vs. no change in strength/tone
- Keeps rhythm of SMRs but reduced range/speed/force vs. trouble with the rhythm/sequence

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12
Q

Ataxic dysarthria and AOS SIMILARITIES

A
  • Poor motor control/coordination
  • Irregular artic errors
  • Most prominent difficulties are with articulation and prosody
  • Oral mec findings can be normal
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13
Q

Differential dx of ataxic dysarthria and AOS

A
  • AMRs worse in ataxic while SMRs worse in AOS
  • Don’t usually grope to correct vs. do
  • Substitutions not as frequent in ataxic compared to AOS
  • Dysarthria doesn’t improve with automaticity while AOS can
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14
Q

What are some tx goals for RESTORATION when confronted with MSDs?

A
  • Increase maximum phonation time
  • Strengthen muscles of exhalation
  • Increase intelligibility
  • Increase participation/comm. effectiveness
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15
Q

What are some tx goals for COMPENSATION when confronted with MSDs?

A
  • Use extra effort to increase loudness
  • Use palatal lift/nasal obturator
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16
Q

What are some tx goals for SUPPLEMENTATION when confronted with MSDs?

A
  • Alphabet board to indicate first letter of word
  • AAC device when natural speech profoundly affected
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17
Q

Flaccid dysarthrias come from an injury to the:
a) Upper Motor Neuron
b) Lower Motor Neuron
c) Both

A

B) Lower Motor Neuron

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18
Q

Why do bilateral UMN lesions cause spastic dysarthria?

A

UMN sends the signal to muscles to relax; when impaired, it’s not giving that signal and so ++ stretch reflex, ++tonicity

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19
Q

In spastic dysarthria, the bias of the muscle tone in the larynx is usually toward
a) hyperadduction
b) hypoadduction

A

a) hyperadduction

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20
Q

Perceptual voice/speech characteristics of spastic dysarthria

A
  • Slow, deliberate pace
  • Equal + excess stress; monotone
  • Strained/strangled vocal quality
  • Hypernasal
  • Imprecise artic (sluggish tongue mvmt)
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21
Q

What does a person with PD having mixed spastic-ataxic dysarthria indicate?

A

Either they don’t have PD or they have something else going on as well because PD shouldn’t be associated with ataxia

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22
Q

What kinds of dysarthrias could we expect from ALS?

A

++ Flaccid
++ Spastic
(often mixed of the two)

23
Q

What kinds of dysarthrias could we expect from MS?

A

+ Flaccid (sometimes present but not nec. typical)
++ Spastic
++ Ataxic
+ Hypokinetic
+ Hyperkinetic
+ UUMN

24
Q

What is Sound Production Treatment used for? What is it?

A

Apraxia of Speech

https://www.youtube.com/watch?v=DdA1_PADaHw

  1. Target sound/word/minimal pair/phrase; model and ask for repetition
  2. Written letter + reminder; repeat 1
  3. Watch me, listen to me, and then say it with me w/ max number of attempts
  4. Provide specific placement cues
  5. Reduce step (e.g. sound instead of word)
  6. If wrong, move on to next target
25
Q

Ataxic dysarthria is caused by damage to the ____ system

A

Cerebellar

26
Q

Which type of dysarthria is described as giving the impression of “druken speech”?

A

Ataxic dysarthria

27
Q

Which type of dysarthria is associated with festination of gait?

A

Hypokinetic (trait of Parkinson’s)

28
Q

Which is the only type of dysarthria where a fast rate of speech can be observed?

A

Hypokinetic

29
Q

T/F: pushing, pulling, and other effortful closure techniques to enhance vocal fold adduction are usually beneficial for spastic dysarthria

A

False - hyperadduction is generally already a problem for someone with spastic dysarthria

30
Q

Vigorous nonspeech exercise is generally contraindicated in _______.

A

Rapidly degenerative disease and
myasthenia gravis.

31
Q

Traditional approaches to articulation therapy with dysarthria + apraxia pts

A
  • Integral stimulation
  • Phonetic placement cues
  • Phonetic derivation
  • Exaggeration
  • Minimal pairs/contrastive drills
  • Referential tasks
32
Q

What types of dysarthria would be contraindicated for a hand tapping to control rate?

A

Hypokinetic PD patients –> accelerate the rate
Ataxic –> most likely too uncoordinated

33
Q

T/F: Working on prosody can have beneficial effects on rate control

A

True

34
Q

Spasticity is associated with a lesion to what site, probably?

A

UMN

35
Q

A strained/strangled vocal quality is associated with what lesion site? What cranial nerve?

A

UMN
Vagus nerve

36
Q

Variable range is associated with what dysarthrias?

A

Ataxic
Hyperkinetic

37
Q

Reduced range of movement associated with what dysarthrias?

A

Flaccid
Spastic
Hypokinetic

38
Q

Increased rate is associated with what dysarthria?

A

Hypokinetic

39
Q

Tongue fasciculations, slow and slurred DDKs and a breathy vocal quality are all signs of what type of dysarthria?

A

Flaccid

40
Q

True/False: Those who can easily imitate productions have a better prognosis

A

True

41
Q

T/F: In patients with progressive dysarthria, listeners’ perceptions are more accurate than the patients’

A

True - not as sensitive to early changes; able to offer more accurate ax of communication effectiveness

42
Q

Patient has:
- Reduced palatal movement
- Reduced pharyngeal wall movement
- Incomplete glottal closure

Signs of what dysarthria?

A

Flaccid

43
Q

Patient has:
- Reduced lip and jaw amplitude
- Lip rigidity
- Bowed vocal folds

Signs of what dysarthria?

A

Hypokinetic

44
Q

Patient has:
- Reduced inhalatory/exhalatory volume
- Slow velopharyngeal movement
- Reduced tongue strength
- Incomplete lingual artic. contact

Signs of what dysarthria?

A

Spastic

45
Q

T/F: The UMN is contained within the CNS?

A

True

46
Q

Individual client factors that may influence compensatory strategies

A

o Presence + severity of co-occurring conditions
o Presence + severity of motor impairment
o Awareness of communication limitations
o Capacity to repair breakdowns
o Patient and care partner preference (capacity for support)

47
Q

Populations with weak respiratory support

A

Flaccid dysarthria
Hypokinetic dysarthria
Children with spastic CP

48
Q

Which dysarthria is associated with Pseudobulbar Palsy?

A

Spastic

49
Q

Lombard effect

A

involuntary tendency to increase vocal effort when speaking in loud noise

50
Q

Why should we not assume that reduced air pressure in dysarthria is caused by respiratory weakness/incoordination?

A

Could be caused by
- Velopharyngeal mechanism
- Impairment in larynx
- Insufficient articulatory closure

51
Q

Why does sustained vowel not reflect breath support?

A
  • Pts inhale a greater amount
  • Reflects max lung capacity
  • Does not represent demands of speaking for 4-5 seconds at a conversational loudness and quality
52
Q

Lack of vocal flexibility (pitch variation) seen in what dysarthria?

A

Generally associated with hypokinetic (PD) but can be found in all types

53
Q
A
54
Q

Dysarthrias associated with LMN lesion?

A

Flaccid dysarthria

CETP Review (11 decks)

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