Neurogenic Communication Disorders Flashcards
Speech based disorders
Apraxia of speech
Dysarthria
Childhood apraxia of speech
Language based disorders
Aphasia
Cognitive linguistic impairment
Language of confusion
Language of general intellectual impairment
Dysarthria
Group of speech disorders resulting from disturbances in muscular control that causes weakness, slowness, and incoordination of the speech mechanism because of CNS and/or PNS dysfunction
Involvement of respiration, phonation, resonation, articulation, and prosody
Types of dysarthria
Spastic Flaccid Hypo kinetic Hyperkinetic Ataxic Unilateral upper motor neuron Mixed
Assessment for dysarthria
The assessment of intelligibility of dysarthric speakers
Frenchay dysarthria assessment
Trigeminal nerve
S- jaw, face, mouth, any feeling in lips, gums, mouth
M- jaw, soft palate, masseur muscle
Facial
S- taste anterior 2/3, mucous mem of soft palate and pharynx
M- face muscles, lips, smile, pucker, close eyes, wrinkle forehead
Glossopharyngeal
S- taste posterior 1/3, mucous mem of the pharynx, middle ear, and mouth
M- pharynx
Vagus
S- mucous mem of pharynx, larynx, soft palate, tongue, lungs
M- pharynx and larynx
Hypoglossal
M- intrinsic m of tongue
The WHO model
Body structure
Body function
Activity/participation
Contextual factors
Motor execution
Processing responsible for activating relevant muscles during the movements used in speech production
Motor planning
Refers to the process that defines and sequences articulatory goals prior to their occurrence
Motor programming
Establish and prepare flow of motor info across muscles for speech production and specifying the timing and force required for the movements
Categorizing neurogenic speech disorders
I - age of onset - acquired or congenital
II - status - acute or chronic
III - course of the disorder - static v progressive v exacerbating
IV - site of lesion - CNS v PNS, bilateral v unilateral, diffuse v focal
V - neurologic diagnosis - VITAMIN D
Causes of neurogenic communication disorders
V - vascular accident I - infectious process T - traumatic insults A - allergic/anoxic reaction M - metabolic disorder I - idiopathic disorder N - neoplasm D - degenerative disease
Spastic dysarthria
Excessive muscle tone Strained/strangled voice quality Hypernasality Slow rate mono pitch/low pitch short phrases
Flaccid dysarthria
Hypotonia Hypoactive reflexes Hypernasality Breathy voice quality/mono loudness/mono pitch Short phrases
Hyperkinetic dysarthria
Variable muscle tone Sudden/irregular respiratory patterns Sudden changes in pitch, loudness and voice quality Inappropriate phrasing Damage to basal ganglia Huntingtons disease
Ataxic dysarthria
Incoordination Tremors Hypotonia Irregular respiratory patterns Breathy voice, irregular loudness and pitch SOL- cerebellum
Unilateral upper motor neuron
Unilateral facial or tongue weakness
Harsh voice quality, reduced loudness
SOL- unilateral damage to motor cortex
Apraxia of speech
Impairment of the capacity to program the positioning of speech muscles and the sequencing of muscle movements for the volitional production of phonemes
Not result of weakness or discoordination
Articulation and prosody affected
Inconsistent errors
Assessment for apraxia
Apraxia battery for adults- look for problems with coordinating and planning
Aphasia
A language disorder that is acquired sometime after an individual has developed language competence and results from injury to language centers of the brain
Sterotopy
True words used in a unit
Ischemic strokes
Blockage of blood flow to cerebral cortex
Thrombosis- gradual bird up of plaque in artery and eventually closes it off
Embolism- traveling blood clot and lodges itself itself in a particular part of artery
Hemorrhagic stroke
Vessel or artery rupture and excessive amounts of blood enter the brain
TIA
Transient ischemic attack
Arteries that nourish cerebral cortex essential for speech and language production
Left and middle cerebral arteries
Anterior aphasias
Nonfluent
Expressive language problems
Posterior aphasias
Fluent
Receptive language problems
Brocas aphasia
Frontal lobe
Fair-good comprehension
Nonfluent
Agrammatic, difficulty with repetitions, word finding
Global aphasia
Diffuse in lobes
Poor comprehension
Nonfluent
Expressive problems, anomia
Wernickes aphasia
Temporal lobe
Poor comprehension
Fluent
Meaningless jargon, limited awareness of their issue, word rep, neologisms
Conduction aphasia
Arcuate fasciculus
Fair-good comprehension
Fluent
Imitation problems, naming difficulties, normal prosody and artic
Anomic
Multiple potential lesion sites
Fair to good comprehension
Fluent
Word finding problems
Controllable factors of stroke
High blood pressure Arterial fibrillation High cholesterol Diabetes Atherosclerosis Circulation problems Tobacco and smoking Alcohol use Physical inactivity Obesity
Uncontrollable stroke factors
Age Gender Race Family history Pervious stoke or TIA fibromuscular dysplasia Patent foramen ovule
Aphasia tests
Western aphasia battery (WAB)
Boston diagnostic aphasia examination (BDAE)
Functional outcomes testing
Communication abilities of daily living
ASHA functional assessment of communication skills for adults
General treatment objectives for AOS
Voluntary control of articulatory postures
Voluntary control of sequential articulator movements
Promote slower, more deliberate speech
Reduce struggle and groping behaviors
General treatment objectives for dysarthria
Oral motor development
Adequate orofacial postures
Integration of orofacial reflexes
Improve orofacial muscle tone and strength
Articulation errors for dysarthria and apraxia
Dysarthria- distortions and omissions
Apraxia- substitutions, repititions, additions, transpositions, prolongations, omissions, and distortions
Right hemisphere dysfunction
Left hemi neglect Prosopagnosia Pragmatics Wordy expression Lack of awareness of problems Abstract thinking
Traumatic brain injury
Personality changes
Widespread language comprehension and expression issues
Dementia
Memory impairment
Impairment of cognitive skills
Hypokinetic dysarthria
Slow movement, rigidity, tremors Shallow breaths Reduced loudness Reduced precision of articulators and range of motion Rapid bursts of speech, long pauses Damage to basal ganglia Parkinson's disease
Tests for TBI
Glasgow coma scale
Rancho Los amigos levels of cognitive function
