Assessment & Diagnosis Of Childhood Motor Speech Disorders

Front 1

What are typical symptoms for childhood motor speech disorder?

Back 1

1-Quiet baby; ltd sounds
2-Babbling undifferentiated
3-Says a new word, then never repeats
4-Few attempts to imitate sounds/words
5-Limited vocab for age-level
6-Poor intelligibility
7-Uses gestures & vowel sounds
8-Understands, but frustrated at not being understood

Front 2

What information would be included on a case history for Developmental Speech Delay and CAS?

Back 2

0-Hearing screening
1-Medical history
2-Developmental history
3-Family history
4-Communication skills
5-Psychosocial skills
6-Neuromuscular observation
7-Motor speech exam
8-Intelligibility/comprehensibility

Front 3

What characteristics of gait may indicate neural system involvement?

Back 3

1-Ataxic (cerebellar damage): wide-stance, veering, discoordinated
2-Spastic (UMN): pelvice tilted to one side; discoordinated; slightly adducted foot

Front 4

What are symptoms of low tone?

What pathway is involved?

Back 4

1-open mouth
2-droopy eyes & facial muscles
3-not weakness, paralysis, or atrophy

Indirect Activation Pathway

Front 5

Weak muscular strength indicates involvement of which pathway and tracts?

Back 5

Direct Activation Pathway:
1-Cortex
2-Cortico bulbar
3-Cortico spinal

Front 6

What are indicators of adventitious movement (involuntary, sporadic movements) and their possible anatomical correlates?

Back 6

1-Fasciculations (LMN)
2-Spasms (descending tracts)
3-Myoclonus (jerking of limb): reticular formation & cerebellum
4-Tremors (resting): Basal ganglia
5-Tremors (intention): Cerebellum

Front 7

What are indicators of pathological reflexes?

Back 7

1-Babinski: extension of big toe & fanning of toes
2-Snout: puckering movement when upper lip tapped
3-Sucking: in direction of stimulus
4-Jaw jerk (corticobulbar disease)

Front 8

Neuromuscular difficulties is indicative of dysarthria or apraxia?

Back 8

Dysarthria

Front 9

What observations of cranial nerve function are performed during the structural-functional exam?

Back 9

CN V-jaw weakness, atrophy, groping; /pa/ syllable

CN VII-repetitive /pa/: lip movement

CN IX, X, XII: cough & throat clearing; observation of palatal movement w/sustained phonation; presence of hyper/hypo nasality

CN XII: tongue movement; food movement; repetition of /ta/ & /ka/

Front 10

What are the five parameters for evaluation of each structure?

Back 10

1-Range of motion
2-Speed
3-Strength
4-Ability to vary muscle tension
5-Coordination

Front 11

What is oral apraxia?

Back 11

Inability to volitionally plan & execute intended non-speech movement; even when sufficient range, speed, stength, etc. are present

Front 12

What are methods to assess if respiration is adequate for speech?

Back 12

1-Spirometer
2-Blow 5 cm of water for 5 sec
3-Blow a tissue across table

Front 13

Laryngeal function is correlated with which cranial nerve?

Back 13

CN X

Front 14

Laryngeal function assesses which parameters?

Back 14

1-Speech volume
2-Vocal quality (breathy, harsh, strained)
3-Fluctuations in phonation
4-Sridor
5-Good laryneal adduction during cough
6-Maximum phonation during sustained /a/

Front 15

Laryngeal difficulties are indicative of CAS or Dysarthria?

Back 15

Dysarthria

Front 16

What standardized tests should be given for motor speech disorders?

Back 16

1-articulation
2-receptive language
3-CAS (gold standard not yet available)
4-phonological awareness - co-occuring problem?

Front 17

What is intelligibility vs. comprehensibility of speech?

Back 17

1-Intelligibility: degree to which acoustic signal can be understood

2-comprehensibility: includes facial expression, body language, environmental cues

Front 18

What is the best measure for measuring severe SSD?

Back 18

Percent Consonants Correct (SSD)

Front 19

Comprehensibility measures what?

Back 19

Percent of words understood; each word worth 0, 1, or 2 points; using all environmental cues