Week 2 (Models and Frameworks)

Question 1

Speech can be produced at rates of up to ______ syllables (or _____ phonetic segments) per second. Faster than any other discrete motor performance.

Answer 1

6-‐‐9 syllables (or 20-‐‐30 phonetic segments) per second

Question 2

Speech involves more __________ than any other human mechanical activity

Answer 2

motor fibers

Question 3

Speech must generate what?

Answer 3

an acoustic signal that is understood by other listeners as a linguistic message and affective message

Question 4

In infancy, _________ is one of infant’s first ventures into speech motor control
– Separate neural control systems for _______ and _________.

Answer 4

babbling; speech and other oromotor functions

Question 5

Explain development of speech motor control system through childhood, adulthood, advancing age

Answer 5

The speech motor control system continues to develop and mature into childhood (think motor plans/programs)
Adulthood is then focused on the maintenance and deployment of well established processes of speech motor control
• But with advancing age speech changes in precision, fluency, voice quality and communicative effectiveness

Question 6

Define and explain what it includes: theory

Answer 6

– Overall conception that encompasses the known facts in a parsimonious way
– Typically includes a set of assumptions and a number of principles from which hypotheses can be derived

Question 7

Define and explain: model

Answer 7

Simplified description of a complex system or process. – Always an abstraction or simplification.
– Modeling helps the scientist to identify important parameters
or elements of a system that is too complicated to be comprehended in its complete, natural form

Question 8

5 general types of models of speech production

Answer 8

neural, articulatory, vocal tract, functional, motor control

Question 9

Define: neural model

Answer 9

Accounts for nervous system processes that control speaking; may specify neural structures, control circuits, information flow, other neural
variables.

Question 10

Define: articulatory model

Answer 10

Describes articulatory positions, movements, or configurations; typically specifies individual articulators (tongue, lips, jaw, velum)

Question 11

Define: vocal tract model

Answer 11

Focuses on the shaping of the vocal tract for the production of speech; does not necessarily specify actions of individual articulators

Question 12

Define: functional model

Answer 12

Accounts for the ways in which various types of information regulate speech production; variables may be linguistic (syllables, phonemes, etc), control signals (feedforward or feedback) or generally defined in terms of
movement sequence.

Question 13

Define: motor control model

Answer 13

Describes the motor processes of the activation of muscles for the production of speech; usually expressed in motor terms, such as specification of muscle synergies or kinematic descriptions of movement.

Question 14

3 critical issues facing speech production models

Answer 14

Serial order problem, degrees of freedom problem, context sensitivity problem

Question 15

3 questions asked by serial order problem

Answer 15

– How are elements strung together?
– What are the elements of control? • Is it the Phoneme, syllable, word?
– Do the elements cohere in a larger structure (e.g. stress grouping?)

Question 16

Define and explain: degrees of freedom problem

Answer 16

The speech system has potential for a large number of degrees of freedom.
– 70 different muscular degrees of freedom in production of speech
– Tongue, lips, jaw, velum, larynx and respiratory system possess
several possible types of movement (range, direction, speech and temporal combinations)
– Excessive degrees of freedom can allow a great degree of flexibility
– On the other hand, too many presents a challenge
• Expend a great deal of computational effort to manage a large number of degrees of freedom or somehow reduce them.

Question 17

Define and explain: context-sensitivity problem

Answer 17

– The production of a sound varies with the context in which it is produced.
– Coarticulation
• At any one time the speech system shows adjustments for more than one segment
• Example – /s/ in soup produced with rounding of lips – /s/ in seep is not produced with such rounding and may even
be associated with lip retraction

Question 18

Define and explain: Schmidt (1988) model of motor programming

Answer 18

In order to deal with storage and novelty problems Schmidt proposed
Generalized motor program (GMP)
• Based on notion of schema and uses recall memory to produce movement and recognition memory to evaluate response correctness
• GMP is a motor program for a class of action stored in memory with certain parameters that define the ultimate goal
• GMP has not been directly related to speech

Question 19

Keele and Summers (1976) theory of motor programming

Answer 19

Motor programs might be generated by stringing together smaller
individually programmed units of behavior so the string is controlled by a single unit of one larger program (over time)
• Example: shifting gears in a car

Question 20

Define: Levelt and Wheeldon (1994) model of motor programming

Answer 20

Translating acquisition of sequencing to the process involves in phonetic encoding

Question 21

Define: mental syllabary (Levelt & Wheeldon- 1994)

Answer 21

Mechanism for translating the abstract phonological representation into a context-‐‐dependent phonetic representation
– Retrieved from a sensorimotor store

Question 22

Define: gestural score (LEvelt and Wheeldon- 1994)

Answer 22

Think of musical score – One score for each of the five subsystems involved in articulation
(glottal, velar, tongue body and tip and lips) – One gestural score needed for /p/ (close lips, voiceless, burst of air)
– The gestural scores are abstract and specify the tasks to be performed, not the actual motor programs

Question 23

Define and explain: Van der Mewre (1997) model of motor programming

Answer 23

• Need to work from a sound theoretical framework based on normal process of speech, language production for both research and management of communication disorders.
• This framework portrays the transformation of the speech code from one form to another as seen from a brain behavior perspective.
• This framework incorporates ideas from many other models/frameworks into a framework with real clinical relevance

Question 24

Define and explain: speech

Answer 24

…the externalized expression of language – “the motor-‐‐afferent mechanisms that direct and regulate speech
movements” (Netsell, 1982)

Question 25

4 facts about the "Intent to communicate verbally" domain

Answer 25

Intention or readiness to commence intentional behavior • Regulated by fronto-‐‐limbic circuits • Closely linked with affective input • Originates in internal biological or cognitive needs of a person or in the external demands exerted by the environment

Question 26

Errors in the intent to communicate verbally domain include

Answer 26

Absence or reduction in amount of verbal communication

Question 27

2 facts about the linguistic-symbolic planning domain

Answer 27

Non-‐‐motor in nature • Semantic, syntactic, lexical, morphological, and phonological planning based on linguistic rules of a given language

Question 28

Errors in the linguistic-symbolic planning domain include

Answer 28

Errors consistent with “aphasia”

Question 29

5 facts about the motor-planning domain

Answer 29

* “Highest” level of the motor hierarchy * Formulating the strategy of action by specifying motor goals * Gradual transformation of symbolic units (phonemes) to a code that can be handled by a motor system * Articulator specific, not muscle-‐‐specific * Cannot be disentangled from motor programming “clinically”

Question 30

Errors in the motor planning domain include:

Answer 30

* Slow, struggling speech with distortion and even apparent substitutions * Slowed temporal flow of speech

Question 31

3 facts about the motor-programming domain

Answer 31

“Strategies prescribe the general nature of plans and tactics give them particular specifications in space and time.” • Programs specify muscle tone, movement direction, force, range, and rate as well as mechanical stiffness of the joints • Muscle-‐‐specific

Question 32

1 fact about the sensation domain

Answer 32

The hierarchy of plans and programs is transformed into non-‐‐learned automatic (reflex) motor adjustments

Question 33

2 types of corrective and predictive sensorimotor actions

Answer 33

feedback and feedforward

Question 34

3 types of feedback

Answer 34

proprioceptive, auditory, tactile

Question 35

Define: proprioceptive feedback

Answer 35

sense of what the muscle itself is doing faster than exteroceptive feedback

Question 36

Define: auditory feedback

Answer 36

exteroceptive provides information about completion of speech movements and may play a roll in speech timing

Question 37

Define: tactile feedback

Answer 37

exteroceptive; tactile-‐‐kinesthetic information with muscle movements

Question 38

4 contextual factors that highly influence feedback

Answer 38

voluntary v. involuntary speech • motor complexity of the utterance • familiar vs. unfamiliar utterances • rate of speech

Question 39

PCND Chart- Conceptualization

Answer 39

Components: Cognitively and affectively generated thoughts, feelings, and emotions, plus a desire to express them to achieve a goal Neural Substrate: Widespread Disorders affecting speech: general cognitive impairment (dementia, psychosis, confusion)

Question 40

PCND Chart: Linguistic Planning

Answer 40

Components: Highly interactive semantic and syntactic processing ultimately taking a phonologic form Neural Substrate: left hemisphere perisylvian cortex, with less specific contributions from subcortical structures (thalamus and basal ganglia) Disorders affecting speech: Aphasia

Question 41

PCND Chart: Motor planning or programming

Answer 41

Components: Formulation and retrieval of motor commands for production of phonetic segments and syllables at particular rates and with particular patterns of stress and prosody, based on acoustic (and other modality) goals and feedback Neural substrate: 1. Dominant hemisphere --> somatosensory cortex, premotor cortex (Broca's area), supplementary motor cortex, motor cortex, insula 2. control circuits --> 3. Limbic system --> 4. right hemisphere --> 5. Thalamus and reticular formation --> Disorders affecting speech: apraxia of speech, dysarthrias (apraxia of speech), altered affect of prosody (aprosodia), dysarthrias

Question 42

PCND Chart: Performance

Answer 42

Components: motor execution Neural substrate: LMN's (as controlled by direct and indirect activation pathways, control circuits, and feedback) Disorders affecting speech: dysarthrias

Question 43

PCND Chart: Feedback

Answer 43

Components: multimodality feedback to the above components Neural substrate: Peripheral and central sensory pathways Disorders affecting speech: dysarthrias and peripheral sensory - based speech disturbances

Question 44

Why do we care about these models and frameworks>

Answer 44

Understanding them is integral to proper assessment and management of your patients with motor speech disorders

Question 45

Define and explain: perceptual methods

Answer 45

Gold standard for clinical differential diagnosis, judgments of severity, and many decisions about management Unfortunately: 1. Subject to unreliability among clinicians 2. they can be difficult to quantify 3. they cannot directly test hypotheses about the pathophysiology underlying perceived speech abnormalities But also "in the hands (ears, eyes, and hands) of experienced clinicians, the auditory-perceptual classification of MSD's is a valid and essential diagnostic and clinical decision-making tool

Question 46

Define: Instrumental methods

Answer 46

Not widely used in management of MSD's | Lacking standards and normative data

Question 47

Define: acoustic methods

Answer 47

can visually display and numerically quantify frequency, intensity, and temporal components of the speech signal

Question 48

Define: physiologic methods, 3 examples

Answer 48

move "upstream" towards the sources of activity that generate and control speech Ex: electromyography, kinematic measures, and aerodynamic measures

Question 49

Define: visual imaging methods, 3 examples

Answer 49

These instruments saddle the boundary between perceptual and physiologic measures, because although the visual images can be quantitatively analyzed, the instrumentally provided image usually is interpreted by way of non-quantified perceptual judgments by the clinician doing the examination Ex: videofluoroscopy, nasoendoscopy, laryngoscopy, videostroboscopy

Question 50

Duffy said: The evaluation of anyone with a suspected MSD begins with a __________. Any instrumental assessment that may follow is motivated and directed by the results of the perceptual assessment. If descriptive or diagnostic errors are made at this perceptual entry point, whatever follows may be misguided and misleading to both diagnosis and management.

Answer 50

perceptually based speech assessment

Question 51

Duffy said: The usefulness of ___________ has been established. The degree to which other methods contribute to, modify, or contradict that usefulness is not yet entirely clear. This does not minimize the contribution of instrumental methods to the description, understanding, and quantification of MSDs, but it does argue that _____________. It also argues for requiring an adequate description of salient perceptual speech characteristics in any research that examines the acoustic or physiologic attributes of MSDs. The likelihood that any such research can be replicated, generalized to clinical populations, or meaningfully interpreted by clinicians or other researchers is greatly diminished or nullified without perceptual description.

Answer 51

perceptually based differential diagnosis, relative to its contribution to localization and diagnosis of neurologic disease; perceptually based methods should be the foundation of clinical practice

Question 52

Duffy said: The standard for judging the functional outcome of management of MSDs is most often based on auditory-perceptual judgments of speech and its ______, _____, and ______.

Answer 52

intelligibility, comprehensibility and efficiency

Question 53

3 ways auditory-perceptual clinical assessment works: 3 signs? 3 things they result from abnormalities in? 4 types of control abnormalities?

Answer 53

Signs such as hypernasality, consonant imprecision Result from movement abnormalities in range, velocity or direction Most likely resulting from control abnormalities specifically: strength, tone, timing, coordination

Question 54

Continued: 5 ways auditory-perceptual clinical assessment works

Answer 54

Patient has hypernasality Because of involvement of soft palate Appears range and force of movement are reduced Hypothesize that the main reason is weakness You may even be able to hypothesize the lesion site

Question 55

2 steps of perceptual-auditory evaluation

Answer 55

1. Listen systematically to all signs | 2. Create hypothesis about the label of best fit

Question 56

4 things to look at first in PAE:

Answer 56

strength, tone, timing, coordination

Question 57

4 things to look at second in PAE

Answer 57

range, velocity, direction, force

Question 58

After looking at those 8 things you can see what?

Answer 58

signs of speech abnormallity

Question 59

5 categories of deviant speech characteristics

Answer 59

respiratory/laryngeal, resonance, articulation, prosody, other

Question 60

4 types of respiratory/laryngeal deviant speech characteristics.

Answer 60

Respiration: Forced insp/exp, audible inspiration, inhalatory stridor Pitch: pitch level, pitch breaks, monopitch, voice tremor, laryngeal myoclonus, diplophonia Loudness: monoloudness, excess loudness variation, loudness decay, overall loudness Vocal quality: Harsh voice, hoarse (wet); breathy (continuous vs. transient), voice stoppages, flutter

Question 61

4 types of resonance deviant speech characteristics

Answer 61

hypernasality, hyponasality, nasal emission, weak pressure consonants

Question 62

7 types of articulatory deviant speech characteristics

Answer 62

Imprecise consonants, prolonged phonemes, repeated phonemes, irregular articulatory breakdowns, distorted vowels, distorted articulatory groping, increased errors with increase rate

Question 63

10 types of prosody deviant speech characteristics

Answer 63

Rate, short phrases, increase rate segments, increased rate overall, reduced stress, variable rate, inappropriate silences, short rushes of speech, excess and equal stress, syllable segmentation

Question 64

7 types of other deviant speech characteristics

Answer 64

Slow AMRs, fast AMRs, irregular AMRs, poorly sequenced SMRs, vocal tics, palilalia, coprolalia