quiz 6 strategies for unintelligibility

Question 1

comprehensibility

Answer 1

ability to be understand someone’s speech from the acoustic signal along with helpful factors, such as semantic context, knowing a topic, gestures, etc.

Question 2

intelligibility

Answer 2

ability to understand someone’s speech purely from the acoustic signal

Question 3

factors that improve comprehensibility

Answer 3

• semantic or syntactic context
• alphabet board supplementation
• gestures or illustrations
• providing a topic
• situational cues as to a communication style

Question 4

how to manage communication breakdowns

Answer 4

• will differ according to listener familiarity
• need to be very direct - ask them to repeat it once, if they you don’t get it say to use alphabet board
• if repetition doesn’t work, ask speaker to say it in a different way or use the alphabet board
• when a breakdown occurs, tell the speaker what you were able to understand

Question 5

shift communication modes

Answer 5

• be flexible
• requires cognitive abilities
• awareness of listener familiarity and personal effectiveness

Question 6

making use of residual communication

Answer 6

• use whatever you have and supplement
• prosody can aid communication even if you are unintelligible - cueing for a question

Question 7

teaching familiarization to client’s main conversational partner

Answer 7

• trying to get the listener to get a different acoustic map
• train by recording a passage, play it for listener, and have them read along to calibrate them to the speech
• to validate, do sentence intelligibility test before and after training
• for severe unintelligibility, poor motor control, one conversation partner

Question 8

alphabet board supplentation

Answer 8

• requires fine motor control, cognitive status, and literacy
• rigid rate control strategy that forces cognitive effort and breaks between words
• tell listener to point to the first letter of each word before they say the word, like this
• cues listener to what the next word is going to be, can improve intelligibility up to 25%
• when training, score accuracy of pointing to the first letter before they say the word and putting a pause between each word
• transfer goal: when conversing with a family member
• assess maintenance by assessing use at beginning of session without cueing
• for someone with good fine motor skills, 80% intelligibility in words, 50% in connected speech

Question 9

reduced rate with stretched speech

Answer 9

• for ataxic dysarthria
• slowing rate but stretching words together, no breaks between words

Question 10

clear speech

Answer 10

• increases articulatory precision via greater articulatory pressure and vowel space
• decreases rate, primarily by increasing vowel duration
• cue by saying to overenunciate or speak as though someone didn’t get what you said the first time
• would be appropriate for someone with mild-mod dysarthria looking to tune up their skills
• requires some degree of cognition

Question 11

increased vocal effort

Answer 11

• maximizes motor recruitment across all physiological systems
• opens mouth more, tighter vocal fold squeeze, bigger breath and pressure build up, increased velopharyngeal closure
• for patients with breathy/weak voices with mild-mod reduced intelligbility

Question 12

goal for increased vocal effort

Answer 12

• the client will utilize the strategy of increased vocal effort in randomized tasks of conversation, reading, and functional phrases in 80% of 100 opportunities independently

Question 13

goal for clear speech

Answer 13

• the client will utilize the strategy of overenunciation for clear speech in randomzied tasks of conversation, reading, and functional phrases with the clinician in 80% of 100 trials independently.

Question 14

goal for reduced speaking rate

Answer 14

• the client will utilize stretched speech as a rate control strategy in randomized tasks of conversation, reading, and functional phrases with the clinician in 80% of 100 opportunities independently