Motor Speech Disorders (Ch. 18) Flashcards
Impaired production of speech due to disturbances in the muscular control of the speech mechanism
Dysarthria
Dysarthria is caused by damage/injury in what systems?
CNS or PNS
In contrast to children with SSD, children with dysarthria will show not only articulatory system difficulties but what additional types of impairments?
Respiratory
Phonatory
Resonance
Dysarthria characterized by slow-labored articulation, hypernasal emission and hoarse-breathy phonation
Flaccid Dysarthria
Dysarthria characterized by imprecise consonants, monotone pitch and loudness, harsh quality, poor prosody and decreased rate of speech
Spastic Dysarthria
T/F: Children with Cerebral Palsy have an acquired dysarthria.
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.)
Cerebral palsy is a set of progressive disorders that cause severe motor disturbances in children.
False. Cerebral palsy is non-progressive. It causes motor disturbances that remain static.
A neurological childhood speech sound disorder in which the precision and consistency of movements underlying speech are impaired in the absence of neuromuscular deficits.
Childhood Apraxia of Speech (CAS)
CAS may occur as a result of known neurological impairment or it can be _______________.
idiopathic
T/F: Like children with dysarthria, children with CAS show significant neurological differences.
False. There are no identified neurological differences specific to children with CAS.
What are the underlying deficits in CAS?
Motor planning deficit
Sensorimotor integration deficit
Linguistic processing deficit
Parents of children with CAS report that their children were what type of babies?
Quiet
Perception of speech sounds that differ acoustically, yet are classified as part of the same phonemic category
Categorical Perception
What linguistic aspects of speech are impaired in CAS?
Suprasegmentals
Categorical Perception
Aspects of speech that exceed the level of individual segments, i.e., rhythm, stress, intonation and pitch.
Suprasegmentals
What are some observable characteristics of CAS, as identified by SLPs? (3)
- Inconsistent errors on consonants and vowels in repeated productions
- lengthened and disrupted coarticulatory transitions between sounds and syllables
- inappropriate prosody, especially in the realization of lexical or phrasal stress.
Non-speech tasks that reveal sound sequencing difficulties in children with CAS
Diadochokinetic (DDK) tasks
What is the core feature that helps us distinguish CAS from other SSDs?
Inconsistency of Errors
What question should an SLP ask and answer when looking at a child with disordered speech?
“What is the relative contribution of the disorder to the child’s overall communicative performance?”
What type of articulatory characteristics do we see with CAS?
Omissions substitutions Distortions Additions Voicing Errors Errors related to complexity of articulatory adjustment Independent PI>Relational PI Vowel Errors
What type of expressive speech would pose fewer difficulties for a child with CAS?
Shorter words Single words Shorter utterances Slower rate Visual, auditory model presented
T/F: Receptive language skills are relatively better than expressive language in CAS.
True.
However, receptive language proficiency may vary according to task complexity (word vs. sentence, short vs. long, etc.)
Children with CAS are at risk for difficulties with ____________ and ____________ awareness.
Phonologic;
Phonemic
The ability to reflect on and manipulate the sound structure of a language as distinct from its meaning
Phonologic awareness
The ability to hear, identify, and manipulate individual sounds in spoken words
Phonemic awareness
The problem with CAS diagnosis is that many CAS characteristics _______________ with other disorders.
Overlap
For a child with CAS, what are the first 4 areas we look at for treatment planning?
Neuromuscular
Structural-Functional
Physiological
Motor Speech
For a child with CAS, what are the last 4 areas we look at for treatment planning?
Articulation testing and phonologic analysis of speech errors
Consistency analysis of errors
Prosody
Hearing Screening
T/F: Children are often apraxic with no other diagnoses.
False. A child is rarely ever just apraxic. There are almost always other factors contributing to the child’s communication disorder.
What type of therapy makes sense to incorporate when treating motor speech disorders?
Motor Learning
How do children with phonologic delay differ from children with CAS?
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.
Why is it important to incorporate phonologic awareness skills into your speech therapy with children with CAS?
Phonological awareness can help strengthen the UR that drive articulation. These skills can also be used as visual cues for sequencing.
What are some signs/symptoms of CAS that we might see in a very young child?
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
What are some signs/symptoms of CAS that we might see in an older child?
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
What “other” potential problems might be present in a child with CAS?
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
What is one of the first things that should be ruled out when suspecting CAS?
Hearing Impairment -
An audiologist should perform a hearing evaluation.
What are the 4 main areas assessed in an Oral-Motor Assessment?
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)
T/F: CAS is a developmental disorder that children eventually outgrow.
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.
What is the difference between a communication delay and a communication disorder?
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.
