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SLP 2a > Motor Speech > Flashcards

Motor Speech Flashcards

1
Q

What is the difference between AOS and dysarthria

A

Dysarthria- motor execution

AOS- motor planning

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2
Q

What do the lower motor neurons do?

A

They are the final common pathway
Carry impulses to muscle fibres
Include cranial nerves for speech
Damage to LMN would result in flaccid weakness

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3
Q

What do upper motor neurons do?

A

Include corticospinal and corticobulbar tracts

Damage results in spasticity

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4
Q

What aspects are used to describe dysarthric speech

A

Physiological- are the muscles moving
Neurological - where is it damaged
Acoustic- what effect does it have on the sound signal?
Perceptual- how does it sound

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5
Q

Name the 5 types of dysarthria

A 
Flaccid 
Spastic 
Ataxic 
Hypokinetic 
Hyperkinetic
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6
Q

Name some features of flaccid dysarthria

A

Weakness
Lower motor neurons affected
Phonatory incompetence (breathiness, soft voice)
Resonatory incompetence (hypernasality, imprecise consonants)
Phonatory prosodic insufficiency (harsh voice, monoloudness, monopitch)

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7
Q

Features of spastic dysarthria

A
  • prosodic excess (excess stress, slow rate)
  • articulatory resonatory incompetence (imprecise consonants, hypernasal)
  • phonatory stenosis (strained, harsh, low voice)
  • prosodic insufficiency (monopitch, monoloudness)
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8
Q

Features of ataxic dysarthria

A

Articulatory inaccuracy (imprecise articulation, irregular breakdowns)
Prosodic excess (excess stress, slow rate)
Phonatory prosodic insuffiency (monoloudness, monopitch, harsh voice)
Mainly occurs with degenerative diseases

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9
Q

Features of hypokinetic dysarthria

A 
Prosodic insufficiency (monoloudness, monopitch, low volume, increased rate)
Often in Parkinson’s disease
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10
Q

Features of hyperkinetic

A

Unpredictable involuntary movements

  • respiration- sudden inspiration
  • phonation- strained quality
  • resonance - hypernasal
  • Articulation- imprecise
  • prosody- variable rate
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11
Q

What is unilateral UMN dysarthria

A 
Occurs in single lesion strokes 
Lower facial and tongue weakness 
Imprecise consonants 
Harsh voice, slow rate
Drooling from affected side
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12
Q

Features of AOS

A 
Occurs with dominant hemisphere damage 
Distorted articulation 
Slow effortful speech 
Groping 
Difficulty initiating
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13
Q

What features do you look for when completing an observation of a dysarthric client

A 
Speech mechanisms (speed, range of movement, symmetry, tone, precision)
Assess - respiration
-phonation
- articulation
- resonance
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14
Q

How do you assess respiration

A 
Posture normal?
Sufficient breath support?
Adequate loudness?
Assess maximum exhalation of /s/
Alternating loudness on /s/
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15
Q

How do you assess phonation

A

Pitch level appropriate?
Voice quality normal?
Maximum phonation on /a/
Alternating pitch on /a/

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16
Q

How do you assess resonance

A

Is nasality normal?
Is there nasal emission?
Observe for symmetrical palatial elevation

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17
Q

Assessing articulation

A

Are consonants and vowels precise
Length of phoneme normal?
Irregular articulatory breakdowns?

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18
Q

How do you assess mvmt of oral structures

A

Frenchay
Observe lips, jaw, face, tongue

Diadochokinetic (DDK) rates

  • /p/ /t/ /k/ as fast possible (altering rates of motion)
  • /p-t-k/ as fast as possible (sequential rates of motion)
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19
Q

Name a scale used to rate severity of speech

A

Frenchay- 9point scale

Dysarthria profile- 5 point scale

20
Q

Name some assessment tasks for AOS

A 
Spontaneous vs repetition
Automatic vs propositional (automatic better)
AMR vs SMR
(AMR better)
Length complexity
21
Q

What instrument measures muscle contraction.

A

Electromyography

22
Q

What can be used to visualise oral structures

A

Ultrasounds/ videofluoroscopys

23
Q

How do you measure respiratory volume

A

Spirometry

24
Q

What records mvmt of articulators during speech

A

Electromagnetic articulograph

25
Q

What is the difference between intelligibility and comprehensibility

A

Intelligibility- understanding acoustic signal

Comprehensibility - the same plus other information (eg gesture) that may contribute to understanding

26
Q

How can you assess and quantify intelligibility

A

Visual analogue scale
% correct item identification by listener
ASSIDS ( identify word from set of options)
Transcription by listener
Frenchay intelligibility section

27
Q

How can you assess a clients functional communication

A

Interview
Dysarthria impact profile
Communicative effectiveness survey (4 point scale)

28
Q

What is the purpose of management of motor speech

A

Maximise-
Effectiveness of communication
Efficiency of communication
Naturalness of communication

29
Q

What are the different approaches to management for motor speech

A 
Medical
Prosthetic
AAC
Counselling 
Behavioural
30
Q

What are the two aspects to medical management of motor speech

A

Pharmacological - (medication eg in Parkinson’s, Botox injections)
Surgical -( thyroplasty for VF paralysis, deep brain stimulation but can worsen dysarthria)

31
Q

Name some examples of prosthetic management

A

Palatal lift prosthesis
Voice amplifier
Pacing board
Delayed auditory feedback

32
Q

What is considered in candidacy for AAC

A 
Access (do they also have a physical impairment) 
Cognitive ability (attention, memory)
Motivation 
Carer support
Funding
33
Q

What does the speaker oriented approach aim to do

A

Reduce impairment

Compensate for impairment

34
Q

Management strategies for respiration

A

Direct- exhalation tasks, vowel prolongation, blowing into bottles

Compensation- postural adjustment, abdominal breathing, phrasing

35
Q

Management strategies for phonation

A

Direct- lee Silverman voice treatment

16 sessions/ 4 weeks, starting with /a/ working to connected speech, works on perception of loudness

36
Q

Management for resonance

A

Duffy 2013- non speech tasks eg blowing don’t help

Changing rate, overarticulation may help

37
Q

Management for articulation

A 
Integral stimulation (watch and listen imitation) 
Phonetic placement 
Contrastive tasks (minimal pairs) 
Intelligibility drills (help from listener) 
Over articulation (improve clarity)
Reduce rate (Duffy 2013 easiest to achieve)
38
Q

Management for prosody

A

Contrastive stress tasks
Phrasing
Loudness and pitch control

39
Q

What activities could you do to help AOS

A

Drill and repetition therapies

40
Q

What evidence is there for LSVT

A

Yorkston et al (2007) effective to increase intelligibility

41
Q

What evidence is there for Botox injections

A

Duffy and Yorkston (2003) improvement for spasmodic dysphonia

42
Q

Evidence for AOS therapy

A

Morgan et al (2018) positive outcome after 1 month with Nuffield and rapid syllable transition treatment

43
Q

Staging of dysarthria

A 
1- no detectable dysarthria 
2- dysarthria detectable 
3- reduced intelligibility 
4- need for speech supplementation
5- no useable speech
44
Q

What type of dysarthria is most common in Parkinson’s

A

Hypokinetic

45
Q

What type of dysarthria is most common in Huntington’s disease

A

Hyperkinetic (affects basal ganglia)

SLP 2a (2 decks)

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