Quiz 2

Question 1

Apraxia is a difficulty with

Answer 1

motor planning and programming

Question 2

How is CAS caused?

Answer 2

1) Known neuro impairment
2) Complex behavioral disorder
3) Idiopathically neurogenic

Question 3

3 Key features of CAS speech

Answer 3

1) Inconsistent sound errors
2) Lengthened and disrupted co-articulatory transitions between sounds and syllables
3) Inappropriate prosody (stress)

*all with CAS have these features, but it is not enough for diagnosis

Question 4

Suprasegmental definition

Answer 4

1) Rate
2) Pitch
3) Loudness

Also called prosodic feature, in phonetics, a speech feature such as stress, tone, or word juncture that accompanies or is added over consonants and vowels

Question 5

Motor speech development trajectory (Hodge, 2000)

Answer 5

Development in order

1) Respiration and phonation
2) Velopharyngeal and laryngeal control (can send air through either mouth or nose) —> oral nasal contrast
3) Mandible (up and down first in the vertical plane)
4) Lips (horizontal plane with lip rounding)
5) Tongue (position, front-back, high or low)
5+) Lax vowels, liquids, refinement of grading movements

Question 6

CAS Differential diagnosis Indicators (4 Things)

Answer 6

1) Difficulty planning/programming volitional movements for speech
2) Absence of neuromuscular deficits
3) Errors in prosody
4) DDK rates (AMRs and SMRs) are inconsistent

Question 7

Dysarthria differential diagnosis indicators (4 Things)

Answer 7

1) Paralysis, weakness, abnormal tone, incoordination of speech muscles
2) Phonation, respiration, resonance, and articulation difficulties
3) Speech movements impaired in force, timing, endurance, direction
4) Slurred speech, weakness, low volume ect.

Question 8

Phonological disorder

Answer 8

Phono disorders have patterns of rule-bound errors: fronting all velars, stopping of fricatives, reducing consonant clusters, etc.

Question 9

Articulation disorder

Answer 9

You will often see that the client has 1 (or a few) individual sound errors, but doesn’t necessarily have trouble with entire classes of sounds (eg all fricatives, all clusters, etc). Articulation disorders are a result of not understanding what to do with your mouth more than not understanding phonological rule

Question 10

Similarities between CAS and Phonological Disorders (6 Things)

Answer 10

1) Inventory constraints
2) Omissions in segments and structures
3) Segmental errors
4) Altered prosody
5) Increased errors with increased utterance length or complexity
6) Use of simple but not complex syllable and word shapes

Question 11

Features of AOS speech (6 features)

Answer 11

1) Articulatory groping
2) Inconsistent errors (vowels)
3) Blurring
4) Slower rate
5) Stress and intonation errors
6) Word retrieval (agrammatism)

Question 12

Definition of AOS

Answer 12

Neurologic MSD that reflects and impaired capacity to plan or program commands necessary for the positioning and sequencing of speech movements for volitional speech

Question 13

AOS damage typically in the _______ or ________ lobe.

Answer 13

Frontal or parietal lobe (in the perisylvian area near Broca’s)

Question 14

AOS has an impaired capacity for

Answer 14

Planning and programming volitional speech

Question 15

The motor plan is

Answer 15

What to do

• Higher level
• Goal oriented
• Specific movements of articulators

Question 16

The motor program is

Answer 16

How to do it

• Lower level
• Procedure specific
• Specific movement of each muscle

Question 17

Most common areas for lesion in AOS

Answer 17

1) Posterior frontal lobe
2) Parietal lobe
3) Insula
4) Basal ganglia

Question 18

OME results for AOS

Answer 18

1) Nonverbal oral apraxia (NVOA)
2) Non-speech DDKS (open and closing mouth)
3) Trouble following instructions

Question 19

Are people with AOS aware of their mistakes (possess awareness of sound errors)

Answer 19

Yes, and they self-correct

Question 20

Ideomotor apraxia (instructional)

Answer 20

Not sure of making volitional movements even when told to do so

Question 21

Ideational apraxia (kettle)

Answer 21

Movement errors and hesitations. Also errors are made and then self corrected.

Question 22

What might we use as an assessment task to determine CAS or AOS?

Answer 22

Repetition task

Question 23

Which is more impacted in AOS; volitional or automatic speech?

Answer 23

Volitional

Question 24

OME for AOS: will a person improve with a model or unison cues?

Answer 24

Yes

Question 25

What kind of aphasia often co-occurs with AOS

Answer 25

Broca’s aphasia

Question 26

OME results for AOS (4 things)

Answer 26

1) No weakness of face or oral musculature
2) Normal gag
3) NVOA = unable to smile, or pucker when requested
4) Breakdown of non-speech DDKs

Question 27

Do people with AOS have receptive language troubles

Answer 27

Yes then can; receptive language deficits, and trouble following directions is common.

Question 28

Apraxia Battery for Adults (ABA-2)

Answer 28

Standardized assessment for AOS

Question 29

NVOA stands for

Answer 29

Non verbal oral apraxia

volitional pucker and kiss

Question 30

CAS evaluation (criterion referenced)

Answer 30

Dynamic evaluation of motor speech skill (DEMSS)

Question 31

Other CAS assessment

Answer 31

Kaufman speech praxis text

Question 32

Non-speech clinical characteristics of apraxia (5 main ones)

Answer 32

1) NVOA
2) Hemiplegia/hemiparesis
3) Limb apraxia
4) Decreased sensation
5) Spasticity

Question 33

Syllabicity effects of apraxia

Answer 33

Fewer syllables are easier

Question 34

Production of stressed/unstressed syllables in apraxia

Answer 34

Stressed are easier to produce

Question 35

Is CAS due to neuromuscular deficits?

Answer 35

No

Question 36

Parent friendly CAS

Answer 36

There is a disruption between the message plan sent from the brain to the speech muscles

Question 37

Cas may occur with other neurologic disorders and/or with:

Answer 37

1) Expressive language impairments
2) Phonological disorders
3) Phonological awareness and literacy challenges
4) Social communication impairments
5) Fluency disorders

Question 38

Motor suprasegmental development trajectory (Hodge, 2000)

Answer 38

1) Contrast syllable, number, and stress
2) Introduce syllable shape
3) Diphthongs
4) Sequencing C & V across more than one plane
5) Elaboration / refinement of rate and rhythm

Question 39

Essential ax for CAS

Answer 39

Word shapes

v
cv
vc
cvcv

ect.

Question 40

Dynamic Evaluation of Motor Speech Skill (DEMSS)

Answer 40

• One part of a comprehensive assessment
• Criterion referenced
• Vowels, prosody, overall articulatory accuracy and consistency

Question 41

Madison Speech Assessment Protocol

Answer 41

• Very intensive
• 2 hour battery
• CAS differential diagnosis
• Utilizes speech disorder classification system

Question 42

Motor programs for CAS for treatment

Answer 42

PROMPT
Kaufman
Nuffield
Speech Motor Chaining
DTTC 
Drill (make is fun)

Question 43

Primary behavioral AOS treatment

Answer 43

Articulatory kinematic techniques

Question 44

Stages of motor learning

Answer 44

1) Cognitive: understanding the nature of the problem (make sure the client understands what they’re doing)
2) Associative: starting to practice and becoming automatic
3) Automatic: skills performed with little conscious effort

Question 45

Specificity principle

Answer 45

Make the tasks as similar to speech as possible

Question 46

Motor learning promotes plasticity which is facilitated by _____________. (three things)

Answer 46

1) Stimulus selection
2) Structure of practice
3) Nature of feedback

Question 47

Task hierarchy for motor learning

Answer 47

Begin with smallest task possible and move on at 80%

Question 48

Perfection approximation

Answer 48

Perfect practice makes perfect

Question 49

Distributed practice

Answer 49

More sessions with less time per session leads to automaticity faster