Motor speech: assessing dysarthria Flashcards
Primary function of respiration for speech? If there is damages, what does it affect?
- Provides subglottic air pressure for phonation
- Nerve damage leads to weak muscles w/difficulties moving air in and out of lungs→ short phrases, reduced loundness, and breathy voice
Primary function of phonation for speech production? If there is damage, what does it affect?
- Normal phonation= complete adduction of VFs and sufficient subglottic air pressure
- Neuromotor damage to the nerve that innervates VF→ flaccid dysarthria, spastic dysarthria, neuromotor damage to laryngeal muscles
Primary function of resonance for speech productions? If there is damage, what does it affect?
- Proper placement of oral or nasal tonality onto phonemes during speech accomplished by raising and lowering of velum
- Oral resonance- velum is raised and closes off nasal cavity
- Nasal resonance- velum is lowered and oral cavity is blocked by tongue and lips
- Damage to nerves innervating velar muscles may cause hypernasal quality
Primary function for articulation for speech production? If there is damage, what will it affect?
- Shapes the vocal air stream into phonemes
- Neuromotor damage to articulators may affect lips, tongue, jaw, velum, or vocal folds and results in articulation errors (imprecise consonants or distorted vowels)
Primary function of prosody for speech production? If there is damage, what will it affect?
- Melody of speech, using stress, and intonation to convey meaning
- Neuromotor damage can affect prosody→ monopitch, and monoloudness; involuntary movements can result in irregular pitch variations, loudness, and prolonged intervals
Standardized test for apraxia
Apraxia battery for adults-second edition
Standardized test for dysarthria
- Frenchay Dysarthria Assessment-2
- Assessment of intelligibility of Dysarthric speech
- Speech intelligibility test for windows
What 6 salient features should we assess?
- Muscle strength
- Speech of movement
- Range of motion
- Accuracy of movement
- Motor steadiness
- Muscle tone
Muscle strength
- Typical speech- requires adequate strength to perform speech production tasks
- Decreased muscle strength- can affect respiration, articulation, resonance, phonation, prosody
- Assessed by- asking the patient to press the tongue against tongue blade
Speed of movement
- Typical speech- requires very rapid muscle movements of tongue and vocal folds
- Reduced speech movement is a characteristic of most dysarthrias except hypokinetic dysarthria
- Assessed by- alternate motion rates (AMR) and sequential motion rates (SMR)
Range of movement
- Typical speech- requires range of movement of articulators
- Reduced ROM- may cause inability to open jar or completely adduct vocal folds
- Assessed by- asking patient to extend or hold articulators in various position
Accuracy of movement
- Typical speech- requires accurate movements of articulators
- Reduced accuracy of movement may cause- distorted consonants; hypernasality
- Assessed by- conversational speech; spoken paragraph reading
Motor steadiness
- Typical speech- ability to hold articulators still
- Reduced motor steadiness- tremors and large, inovoluntary movements
- Assessed by- asking patient to hold position of prolonged vowel
Muscle tone
- Typical speech- requires muscle ready for quick movements
- Reduced muscle tone may cause- weakness or paralysis; spasticity or rigidity
- Assessed by- listening to speech, looking at affected body parts
Specific tasks during oral mech exam
- face and jaw muscles at rest/during movement
- tongue at rest/during movement
- velum and pharynx at rest/during movement
- laryngeal function
- auditory perceptual evaluation
- phonatory respiratory system
- resonation system
- combined systems
- stress test