Motor Speech Disorders Flashcards
Speech Motor Control
an individual’s control of muscular coordination involved with the production of speech
Motor Speech Disorder
impairment of speech production caused by defects of the neuromuscular system, the motor system or both
defects involve programing, planning and or execution of speech
cannot be explained by other disorders such as language, cognitive or phonological impairments
5 Domains of Language
Pragmatics, Phonology, Syntax, Semantics, Morphology
5 Sensory Domains
Pain, Temperature, Touch, Vibration, Proprioception
5 Domains Speech Sound Production
Respiration Phonation Resonation Articulation Prosody
Respiration (key structures, muscles/articulators)
Key Structures- Lungs
Muscles/Articulators- Respiratory Musculature
Phonation (key structures, muscles/articulators)
Key Structures- Larynx
Muscles/Articulators- Vocal folds
Resonation (key structures, muscles/articulators)
Key Structures- Velopharyngeal Port
Muscles/Articulators- Velum and Pharynx
Articulation (key structures, muscles/articulators)
Key Structures- Oral Cavity/Articulators
Muscles/Articulators- Mandible (jaw), lips, tongue, teeth
Prosody (key structures, muscles/articulators)
Key Structures- all others
Muscles/Articulators- impacted by all
Muscles can be….
paralyzed (unable to move) weak (inability to move adequately) spastic (too much tone, tight) flaccid (too little tone, loose, flabby) uncoordinated
muscle can…
- move to far or not far enough
- in the wrong direction
- move with too much or too little strength
- move at the wrong time in sequence or stop moving
Disorders of Motor Planning/Programing
inability to group/sequence the relevant muscles with respect to one another in order to plan or program movement
Disorders of Execution
deficiency or inefficiency in basic physiological or movement characteristics of the muscles such as tone, speech and or range
Apraxia of Speech (AOS)
AOS is the inability to transform a linguistic representation into appropriate coordinated muscular movements of the articulators
- disorder of motor planning/programming
- planning: process that defines/sequences of articulation goals prior to their occurrence
- programming: process for establishing and preparing the flow of motor information across muscles for speech production and specifying timing and force required for all movements
AOS Characteristics
- effortful, slow speech w/increased pauses b/w syllables and sounds
- prolonged duration of speech sounds
- distortion of the speech sounds
- reduced prosody (pitch, duration, loudness b/w stress, and unstressed syllables)
- groping
- absence of muscular weakness
- increased difficulty as the utterance length advances
- inconsistent errors
- no weakness
AOS Etiologies
- damage is most usually near Broca’s area
- damage may be to the perisylvian area
Dysarthria
- “slurred speech”
- disruption in the execution of speech muscle movements
- execution: process responsible for activating relevant muscles during the movements used in speech production
- involves all speech production domains
- results from damage to the to the CNS or PNS
- will always show some degree of weakness, slowness, incoordination, or alteration of muscle tone
Dysarthria Etiologies
- developmental
- recovering
- stable
- degenerative
- exacerbating and remitting
Cerebellum
- center for coordination of smooth, accurate, voluntary movements
- doesnt initiate motor action
- serves in regulation of force, speed, range, timing, and direction of movement originating from the pyramidal system
- gait, limb coordination and balance will be impacted
- movements will be slow in starting and in accomplishing there objective
Cerebellum
- repetitive motions will be slow and irregular
- alternating movements will be irregular
- hypotonicity and flaccidity of muscles is frequently present
- gait may be broad based w/impairment in equilibrium
- intention tremors
- intention tremors may be present in speech; laryngeal musculature may also be impacted
Etiologies of Cerebellar Damage
- tumor
- CVA
- demyelinating disease (MS)
- inherited degenerative disease
- encephalitis
- alcohol toxicity
- cancer
- vascular lesions
Flaccid Dysarthria
Perceptual Characteristics: Hypernasality, CI, Breathiness, Mono pitch, Nasal emission
Localization: LMN (stroke in brainstem
Etiologies: tumor, MG, stroke, virus
Neuromuscular Conditions: Flaccid paralysis, weakness, hypotonia, muscle atrophy, fasciculations
Ataxic Dysarthria
Perceptual Characteristics: CI, Excess & Equal stress, Irregular articulatory breakdown (IAB), Distorted vowels, harsh voice quality, prolonged phonemes & intervals
Localization: Cerebellum
Etiologies: CVA, tumor, trauma, congenital
Neuromuscular Conditions: inaccurate movements, slow movements, low tone
Spastic Dysarthria
Perceptual Characteristics: CI, Mono pitch, Reduced stress, harsh voice quality (strained strangle) mono loudness
Localization: UMN (stroke in cortex)
Etiologies: tumor, CVA, trauma, infection
Neuromuscular Conditions: spastic paralysis, weakness, limited ROM, slowness of movements
Spastic-Flaccid Dysarthria
Perceptual Characteristics: CI, Hypernasality, Harsh voice, Slow rate, Mono pitch
Localization: UMN & LMN
Etiologies: CVA, trauma, ALS
Neuromuscular Conditions: weakness, slow movements, limited ROM
Spastic-Ataxic-Hypokinetic
Perceptual Characteristics: Reduced stress, mono pitch, mono loudness, CI, Slow rate
Localization: UMN, Cerebellum, EPS
Etiologies: Wilson’s Disease
Neuromuscular Conditions: intention tremors, rigidity, spasticity, slow movements
Unilateral UMN Dysarthria
Perceptual Characteristics: CI, Slow AMR’s, Harsh voice, Impersice AMR’s, irregular AMR’s
Localization: UMN (sometimes EPS)
Etiologies: CVA, trauma
Neuromuscular Conditions: unilateral weakness, spasticity
Spastic-Ataxic-Flaccid
Perceptual Characteristics: Impaired loudness control, Harsh voice, Imprecise articulation, Imprecise emphasis, Decreased vital capacity
Localization: variable UMN, Cerebellum, LMN
Etiologies: MS
Neuromuscular Conditions: variable spasticity, weakness, slow movement, limited ROM, inaccurate movements
