Pediatric Flashcards
Developmental motor speech disorder
Disorder in which speech development is delayed or deviant, with no period of typical development
Spastic Cerebral palsy
- hypertonia
- primitive reflexes/ hyperreflexia
- spascticity, weakness, limited range
Most common time of cerebral palsy
spastic
Athetoid (dyskinetic) cerebral palsy
- abnormal, involuntary, variable movement
- fluctuaction between hyper- and hypotonia
Ataxic cerebral palsy
-balance, coordination, depth perception
-fine motor skills
shaking with deliberate actions
Posterior fossa tumor
sometimes brings dysarthria
Down syndrome
- hypotonia
- developmental delays and atypical development
- reduced ROM of jaw, lips, tongue
TBI
- speech often co-occurring with language, cognitive, and social impairments
- associated with dysarthria
Syndromes related to CAS
- galactosemia
- Fragile X
- Velocardiofacial syndrome
- Rhett syndrome
-FOXP2 mutation, possibly
Speech hallmarks of CAS
- inconsistent errors
- lengthened and disrupted coartic transitions
- inappropriate prosody, esp. in relation to lexical or phrasal stress
Is there a validated list of features for diagnosis?
no (ASHA, 2007)
Weakness/ incoordination in speeh musculature
dysarthria
problems with involuntary motor control (e.g. chewing)
dysarthria
inconsistent articulatory errors
CAS
Errors increase with complexity and length
CAS
disrupted rate, rythm and stress
CAS and Dysarthria
Impaired control of pitch and loudness
Dysarthria
Atypical voice quality
dysarthria
CAS and difficulty with ddk
only with pataka
Dysarthria and difficulty with ddk
papapa and pataka
Treatment goals of CAS
- increase consistency
- increase accuracy
- expand phonemic inventory
Systems approach (Pennington)
- for kids w/ dysarthria secondary to cerebral palsy
- intensive
- stabilizing phonatory and respiratory effort and control, speech rate and phrase length, or syllables/breath
- efficacy in kids w/ dysarthria 5-11 and 12-18
LSVT Loud
- intensive
- neuroplasticity-prinicipled
- adults w/ parkinsons, extended to kids with CP
- targets healthy vocal loudness and how loudness feels
Speech systems intelligibility treatment (SSIT)
- motor learning principles
- targets improved function and coordination of speech subsystems
- from sustained vowels to spoken language
- shown to improve loudness and intelligibility for kids with CP`
start with small stimulus for high performance, then increase, varying rate, intonation, loudness
CAS
Core vocabulary treatment
- CAS
- increased consistentcy
- goal is child’s best production from list of 50 functional words developed by family
- no focus on expanding phonemic inventory
Modified core vocab treatment
- adds stimulability training
- presents sounds in isolation with an associated gesture
- parent word list includes target sounds
Dynamic Temporal and Tactile Cueing (DTTC)
- CAS
- integral stimulation method
- sequences of sounds rather than a single sound
- increases complexity up to phrases
- clinician constantly adds or fades auditorry, visual, tactile cues
Prompts for restructuring oral muscular phonetic targets (PROMPT)
- Tactile facilitation method
- motor programming skills
- physical input about place, manner, degree, etc
- various clinical populations, but only emerging evidence
Linguistic approaches
- CAS
- linguistic and phonological components of speech and flexible, functional communication
- speech sounds and groups of sounds with similar patterns of error
- intended to complement motoric approaches
Biofeedback
- knowledge of performance
- mirror, webcams, ultrasounds, etc
