Motor Speech Disorders (Ch. 18)

Question 1

Impaired production of speech due to disturbances in the muscular control of the speech mechanism

Answer 1

Dysarthria

Question 2

Dysarthria is caused by damage/injury in what systems?

Answer 2

CNS or PNS

Question 3

In contrast to children with SSD, children with dysarthria will show not only articulatory system difficulties but what additional types of impairments?

Answer 3

Respiratory
Phonatory
Resonance

Question 4

Dysarthria characterized by slow-labored articulation, hypernasal emission and hoarse-breathy phonation

Answer 4

Flaccid Dysarthria

Question 5

Dysarthria characterized by imprecise consonants, monotone pitch and loudness, harsh quality, poor prosody and decreased rate of speech

Answer 5

Spastic Dysarthria

Question 6

T/F: Children with Cerebral Palsy have an acquired dysarthria.

Answer 6

False. Children with cerebral palsy sustain damage to the CNS prior to any typical development period. (the lesion occurs just prior to or at birth.)

Question 7

Cerebral palsy is a set of progressive disorders that cause severe motor disturbances in children.

Answer 7

False. Cerebral palsy is non-progressive. It causes motor disturbances that remain static.

Question 8

A neurological childhood speech sound disorder in which the precision and consistency of movements underlying speech are impaired in the absence of neuromuscular deficits.

Answer 8

Childhood Apraxia of Speech (CAS)

Question 9

CAS may occur as a result of known neurological impairment or it can be _______________.

Answer 9

idiopathic

Question 10

T/F: Like children with dysarthria, children with CAS show significant neurological differences.

Answer 10

False. There are no identified neurological differences specific to children with CAS.

Question 11

What are the underlying deficits in CAS?

Answer 11

Motor planning deficit
Sensorimotor integration deficit
Linguistic processing deficit

Question 12

Parents of children with CAS report that their children were what type of babies?

Answer 12

Quiet

Question 13

Perception of speech sounds that differ acoustically, yet are classified as part of the same phonemic category

Answer 13

Categorical Perception

Question 14

What linguistic aspects of speech are impaired in CAS?

Answer 14

Suprasegmentals

Categorical Perception

Question 15

Aspects of speech that exceed the level of individual segments, i.e., rhythm, stress, intonation and pitch.

Answer 15

Suprasegmentals

Question 16

What are some observable characteristics of CAS, as identified by SLPs? (3)

Answer 16

1. Inconsistent errors on consonants and vowels in repeated productions
2. lengthened and disrupted coarticulatory transitions between sounds and syllables
3. inappropriate prosody, especially in the realization of lexical or phrasal stress.

Question 17

Non-speech tasks that reveal sound sequencing difficulties in children with CAS

Answer 17

Diadochokinetic (DDK) tasks

Question 18

What is the core feature that helps us distinguish CAS from other SSDs?

Answer 18

Inconsistency of Errors

Question 19

What question should an SLP ask and answer when looking at a child with disordered speech?

Answer 19

“What is the relative contribution of the disorder to the child’s overall communicative performance?”

Question 20

What type of articulatory characteristics do we see with CAS?

Answer 20

Omissions
substitutions 
Distortions
Additions
Voicing Errors
Errors related to complexity of articulatory adjustment
Independent PI>Relational PI
Vowel Errors

Question 21

What type of expressive speech would pose fewer difficulties for a child with CAS?

Answer 21

Shorter words
Single words  
Shorter utterances 
Slower rate
Visual, auditory model presented

Question 22

T/F: Receptive language skills are relatively better than expressive language in CAS.

Answer 22

True.

However, receptive language proficiency may vary according to task complexity (word vs. sentence, short vs. long, etc.)

Question 23

Children with CAS are at risk for difficulties with ____________ and ____________ awareness.

Answer 23

Phonologic;

Phonemic

Question 24

The ability to reflect on and manipulate the sound structure of a language as distinct from its meaning

Answer 24

Phonologic awareness

Question 25

The ability to hear, identify, and manipulate individual sounds in spoken words

Answer 25

Phonemic awareness

Question 26

The problem with CAS diagnosis is that many CAS characteristics _______________ with other disorders.

Answer 26

Overlap

Question 27

For a child with CAS, what are the first 4 areas we look at for treatment planning?

Answer 27

Neuromuscular
Structural-Functional

Physiological

Motor Speech

Question 28

For a child with CAS, what are the last 4 areas we look at for treatment planning?

Answer 28

Articulation testing and phonologic analysis of speech errors

Consistency analysis of errors

Prosody

Hearing Screening

Question 29

T/F: Children are often apraxic with no other diagnoses.

Answer 29

False. A child is rarely ever just apraxic. There are almost always other factors contributing to the child’s communication disorder.

Question 30

What type of therapy makes sense to incorporate when treating motor speech disorders?

Answer 30

Motor Learning

Question 31

How do children with phonologic delay differ from children with CAS?

Answer 31

PD: Consistent errors, no vowel errors, normal prosody, improvement with phonological contrasts.
CAS: Inconsistent errors, vowel errors, impaired prosody, improvement with slowing down and visual cues.

Question 32

Why is it important to incorporate phonologic awareness skills into your speech therapy with children with CAS?

Answer 32

Phonological awareness can help strengthen the UR that drive articulation. These skills can also be used as visual cues for sequencing.

Question 33

What are some signs/symptoms of CAS that we might see in a very young child?

Answer 33

Does not coo or babble as an infant
First words come late and are missing sounds
Small inventory of sounds
Problems combining sounds; long pauses between
Simplifies words with substitutions or omissions
Problems eating

Question 34

What are some signs/symptoms of CAS that we might see in an older child?

Answer 34

Inconsistent errors 
Receptive better than expressive speech
Imitated speech clearer than spontaneous
Groping
Longer words and phrases more difficult 
Anxiety intensifies difficulties 
Is hard to understand
Sounds choppy, monotonous, unnatural stress/intonation

Question 35

What “other” potential problems might be present in a child with CAS?

Answer 35

Delayed language
Word order and word recall difficulty
Difficulties with fine motor movement/coordination
Orally hypersensitive or hyposensitive
Problems learning to read, spell, and write

Question 36

What is one of the first things that should be ruled out when suspecting CAS?

Answer 36

Hearing Impairment -

An audiologist should perform a hearing evaluation.

Question 37

What are the 4 main areas assessed in an Oral-Motor Assessment?

Answer 37

checking for signs of weakness or low muscle tone

seeing how well the child can coordinate the movement of the mouth (tongue movement, puckering, etc.)

evaluating the coordination and sequencing of muscle movements through diadochokinetic tasks

examining rote abilities (licking a lollipop, pretending to lick a lollipop)

Question 38

T/F: CAS is a developmental disorder that children eventually outgrow.

Answer 38

False. In CAS, children do not follow typical patterns and will not make progress without treatment. There is no cure, but with appropriate, intensive intervention, significant progress can be made.

Question 39

What is the difference between a communication delay and a communication disorder?

Answer 39

A delay means that a child is learning to speak following a predictable and prescribed pattern, but at a much slower rate than typical peers.

A disorder means that speech or language is developing in an unusual or abnormal way.