Motor Speech Assessment and Treatment Flashcards
Key evaluation tasks in Hyperkinetic dysarthria
Conversational speech
Paragraph reading
AMR
Vowel prolongations
Finger to nose test
Observation of involuntary movements
Finger to nose test assesses for what hyperkinetic movement disorder
Myoclonus
How are observations helpful in assessing hyperkinetic movement disorder? How will they each present?
- Chorea—relatively quick, unpredictable, coordinated movements of the limbs, head, face, mouth, and neck; sometimes having a dance-like quality.
- Myoclonus—Distinguished by brief contractions of a single muscle or body part. These contractions may occur singly, in a repeating irregular pattern, or rhythmically. Unlike tics, myoclonic contractions cannot be consciously suppressed.
- Tic disorders—Motor or vocal behaviors that can be con- trolled voluntarily until the compulsive desire to perform the behavior becomes overwhelming. Motor tics include eye blinks, shoulder shrugs, and head jerks. Vocal tics include grunting, humming, and barking noises.
- Essential tremor—A benign action tremor that usually affects the hands, arms, or head. Essential tremor results in essential voice tremor when it affects the vocal folds.
- Dystonia—Characterized by sustained, involuntary contractions of muscles in one or more body parts; these contractions often come and go in a waxing and waning pattern. Dystonic movements are usually slower and more prolonged than those seen in chorea.
What are two ways you can treat hyperkinetic
Behavioral intervention
Medical intervention
What are behavioral interventions for hunnington’s disease hyperkinetic
- early stages treatment will work on prosody
- Middle stages will target prosody and respiration: rate, rhythmic breathing and relaxation, speaking on exhalation
- Progressive dementia stages will work with caregivers, implementing AAC, target yes/no, basic eye gaze, and alphabet boards
What are 4 simple sequence cues caregivers can use when the pt’s message isn’t understood
- Tell the pt you didnt understand
- Look for cues to help you understand the message
- Ask the pt to repeat, the same way
- Ask pt to say it a different way
What are 4 behavioral treatments for dystonia hyperkinetic
- sensory trick (for temporary relief)
- Bite blocks
- easy onset of phonation
Behavioral treatments for tic disorder
- habit reversal training
- relaxation therapy + other procedures
- Exposure response prevention
- Comprehensive behavioral intervention for tics
What are medical interventions used for hyperkinetic
-Pharmacologic interventions- Botox
-Deep brain stimulation
What are some examples of sensory tics that can treat dystonia hyperkinetic
Belching
A mint
Singing
Yawning
Sucking in cheeks
What are the three treatment approaches used in hypokinetic
Pharmacologic
Surgical
Behavioral
What is the most widely used treatment approach for hypokinetic?
Pharmacologic intervention: L-dopa
What are two general surgery types used to treat hypokinetic
Deep brain stimulation
Ablation procedures
What type of articulation therapies are used for hypokinetic
Rate reduction exercises
Stretching tasks
Traditional articulation approaches
Identify a few phonatory treatments that can be used with hypokinetic
-pushing and pulling procedure
-Hard glottal attack
-voice amplifiers
-instrumental biofeedback
-Lee silverman voice treatment
Key evaluation tasks in assessing hypokinetic
Conversational speech
paragraph reading
AMR task
Vowel prolongations
Key evaluation tasks in assessing ataxic
AMR
Conversational speech
Paragraph reading
Repeating sentences with numerous multisyllabic words
Prosodic treatment for ataxic dysarthria should focus on:
Slow rate to improve intelligibility and incorporating more typical stress and intonation into utterances
Articulation treatment for ataxic dysarthria consists of what?
Traditional exercises
Should respiration treatment for ataxic target strengthening of respiration system?
No
Concentrate on controlling airflow more accurately since uncoordinated movements cause speech on residual air
Do breath control enhancement tasks
Key evaluation tasks in Unilateral UMN dysarthria
Medical record review
Conversational speech
Paragraph reading
AMR
Vowel prolongation
When treating unilateral upper motor neuron, what is the focus/goal
Focus on treating co-occurring, dominant disorder first
Key evaluation tasks for assessing spastic
Conversational speech
Paragraph reading
AMR
Vowel prolongation
Phonation treatment for spastic should be…
Relaxation exercises to reduce stiffness
What types of articulation treatments are used in spastic dysarthria
Traditional exercises
Stretching exercises
Prosodic treatment for spastic focuses on
Stress and intonational exercises