Week 4 Flashcards
speech tasks for motor speech exam
vowel prolongation (most basic)
sequential motion rates
alternating motion rates
contextual speech
speech stress testing
assessing motor speech planning/programming capacity (complex)
-if client struggles with 1st task, it will become more apparent in next sessions
vowel prolongation
-we need to see good breath support and sustaining a vowel for 9 seconds
-good phonation and vocal quality
sequential motion rates (SMR)
sustain puh, ta, ka for as long as you can
-stimuli: buttercup if they cannot do above stimuli
-looking for articulatory coordination (bilabial, alveolar, velar)
alternating motion rates (AMRs)
such as papapa then tatata
-5-7 reps per second
contextual speech
provide context and have them talk about it
-look for intelligibility
-reading a standard passage such as Grandfather or Rainbow
speech stress testing
to see if they are fatigued and will affect speech
speech fatigue: intelligibility decreases, hyper nasal, quieter, shorter utterances, and more breath support
-mainly used if LMN weakness is unexplained
assessing motor speech planning/programming capacity
assess presence of verbal apraxia
kids: Kaufmann test
adults: aphasia battery
-start at word level and then increase capacity of verbal utterances
French Dysarthria Assessment
rate ability of each parameter using a 9 point scale and 5 descriptors
Components of motor speech examination
-linguistic load (conversation, picture description, narrative)
-as complexity increases, performance decreases
-length and phonetic complexity of utterance
-temporal relationship between stimulus and response ex: apraxia of speech benefits from visual and auditory models (can remember motor planning and correct their production, however, dysarthria patients cannot)
Kaufman speech praxis test
assisting in identification and treatment of childhood apraxia of speech
-measures imitative responses to the clinician
apraxia battery for adults
diadochokinetic rates for one, tow, and three syllable combinations
-imitation of words of increasing length
-latency and utterance time for naming of pictured multisyllabic words
-articulatory adequacy during 3 consecutive repetitions of polysyllabic words
intelligibility
understanding acoustic signal (degree to which a listener understands speech
comprehensibility
adds in context, gestures
efficiency
how fast relative to amount understood
aphasia
can present as deficits in listening, speaking, reading, and/or writing
-can result in receptive language deficits
-word retrieval problems whereas, dysarthria will have no substitution errors
-mild dysarthria may present with aphasia in acute phase
dementia
deficits of intellect may appear/be confused
-language impairments but may occur later in progression of disease
-memory impairments (cognition) impact ability to make self understood
-reasoning and judgment may show impairment
Apraxia of speech (AOS)
deficit of motor programming involving speech production tasks but not automatic or involuntary tasks
verbal apraxia
issues with voluntary tasks (asking them directly for imitation or intention)
ex: can you repeat “pa, pa, pa”
oral apraxia
in pure form of oral apraxia, patients have trouble with voluntary oral tasks (chewing, smiling)
-involuntary tasks are intact
ex: if you tell them a joke and then spread their lips, but can’t when you directly ask them
flaccid etiology
trauma, surgery LMN (head/neck), myasthenia gravis
-insult to final common pathway
flaccid symptoms
paralysis, hyporeflexia atrophy, fasciculation, quick fatigue
flaccid distinct speech
focal, asymmetrical, or not enough (whole system weak- hyper nasal and/or breathy and/or short phrases and/or quiet and/or reduced stress), diplophonia, nasal emission
spastic etiology
bilateral cerebral UMN (pyramidal and extrapyramidal tracts)
stroke
brainstem tumor
TBI
cerebral anoxia (lack of oxygen)
meningitis (affecting cortex)
spastic symptoms
emotional liability
hyperreflexia
spasticity
