Motor Speech Disorders 1

Front 1

Flaccid dysarthria

Back 1

Lower motor neuron, final common pathway, motor unit
Weakness, hypernasal speech, poor articulation, breathy voice

Front 2

Spastic dysarthria

Back 2

Bilateral upper motor neuron, direct and indirect activation pathways,
Spacticity, extremely poor articulation, strained voice, low pitched voice

Front 3

Ataxic dysarthria

Back 3

Cerebellar: cerebellar control circuit
Incoordination, irregular jerky speech, syllable repetitions

Front 4

Hypokinetic dysarthria

Back 4

Basal ganglia control circuit, extrapyramidal
Rigidity/reduced range of movement, weak voice, hesitations mixed with brief rushes of speech

Front 5

Hyperkinetic dysarthria

Back 5

Basal ganglia control ciruit, extrapyramidal
involuntary movement, irregular rate, pitch, loudness, frequent stopping, tics

Front 6

Unilateral upper motor neuron dysarthria

Back 6

Unilateral upper motor neuron
Weakness? incoordination

Front 7

Mixed dysarthria

Back 7

more than one

Front 8

Apraxia of Speech

Back 8

left (dominant) hemisphere
Motor programming

Front 9

Defining Motor Speech Disorders

Back 9

disorders of speech resulting from neurologic impairment affecting the motor programming or neuromuscular execution of speech

Front 10

Dysarthria

Back 10

resulting from disturbances in muscular control over the speech mechanism due to CNS or PNS damage

Front 11

Apraxia of Speech

Back 11

Neurogenic speech disorder, no weakness or slowness, impairment of capacity to program sensorimotor commands, for the positioning and movement of muscles and for volitional productions of speech
damage to Broca's area

Front 12

Characterize motor speech disorders by

Back 12

speech characteristics: which system is affected: respiration, phonation, resonance, articulation
severity
perceptual characteristics

Front 13

Developmental Dysarthria

Back 13

damage to immature nervous system, weakness, paralysis, incoordination of the speech musculature
weak, mushy garbled, imprecise speech

Front 14

Developmental Dysarthria Spastic CP

Back 14

Pyramidal tract, bilateral corticobulbar involvement,
Increased muscle tone, muscle rigidity, slow, stiff abrupt movements, slowed rate, possible hypernasality

Front 15

Developmental Dysarthria Ataxic CP

Back 15

Cerebellum
Unequal stress, loudness, and pitch, explosive speech quality

Front 16

Developmental Dysarthria Dyskinetic (athetoid) CP

Back 16

Basal ganglia: athetosis (involuntary, uncontrolled writhing movements) uncontrolled movements, slow and poor articulation, hypernasality

Front 17

Developmental Dysarthria Mixed CP

Back 17

more than one site and characteristic

Front 18

Childhood apraxia of speech

Back 18

Inconsistent errors on consonants and vowels in repeated productions of syllables or words, lengthened and disrupted transitions between sounds and syllables, inappropriate prosody, especially in relation to word and phrase stress

Front 19

Functional Articulation Disorder

Back 19

Need to learn place manner voicing characteristic to produce specific error sounds.

Front 20

Tx of Functional Articulation disorder

Back 20

Cue to get tongue in right place –lots of motor production practice in hierarchy so placement becomes automatic – break the motor habit of producing the sound in error, make correct production become the new habit

Front 21

Phonological Disorder

Back 21

Problem understanding rules of phonology/features of classes of phonemes.

Front 22

Tx of Phonological Disorder

Back 22

Teach patterns so rules can be learned/ features of phoneme classes will be acquired

Front 23

Dysarthria for children

Back 23

Neuromusclar deficits lead to weakness/incoordination of speech mechanism. (Duffy definition -abnormal neuromuscular execution that may affect speed, strength, range, timing, or accuracy of speech movements- Can affect respiration, phonation, resonance, articulation, and prosody)

Front 24

Tx for Dysarthria

Back 24

Treatment focuses on improving speech intelligibility by improving physiologic support for speech (such as improving vital capacity, increasing vocal fold adductors, improving strength of articulatory contacts or developing techniques to compensate for the impairment

Front 25

Goal of apraxia treatment

Back 25

Improve the individual’s ability to assemble, retrieve and execute motor plans for speech production

Front 26

Principles of apraxia tx

Back 26

emphasize: self-monitoring, functional communication, training on multisyllabic or multiword utterances at beginning of tx, slow-rate when modeling/introducing new movement patterns then increase rate

Front 27

Integral Stimulation therapy CAS

Back 27

Hierarchy of temporal delay, use of phonetic placement, tactile cueing, prosodic cueing used as necessary VISUAL and AUDITORY MODELS

Front 28

Multisensory Treatment

Back 28

Using visual, auditory, proprioceptive and tactile stimuli in order to teach the child the movement sequences for speech

Front 29

Tactile Methods

Back 29

Provide input to the child's face or articulators to cue them for the correct production.

Front 30

Visual Methods

Back 30

Use of hand signs, that provide information about the shape, placement, or movement of articulators

Front 31

Emphasis of CAS treatment

Back 31

well-controlled sequences of movement patterns required for accurate productions of continuous strings of phonemes

Front 32

Hierarchy to inaccurate verbal attempts

Back 32

1. sign plus full word
2. sign plus audible first sound/syllable
3. sign plus first sound position
4. sign only

Front 33

Factors to consider in CAS Tx

Back 33

age of the child
overall intelligibility/severity
the need for other types of comm
cognitive/receptive skills
co-occuring problems
attention span
tolerance for potential use of multisensory input
depends on what child can do

Front 34

Acquired dysarthria

Back 34

Individual may have developed some speech and language skills prior to the neurologic insult

Front 35

Nonspeech characteristics

Back 35

Sucking, chewing, swallowing, drooling, gagging, choking

Front 36

Spina Bifida

Back 36

incomplete fusion of the veterbral column
hydrocephalus: excess of cerebrospinal fluid, enlarged skull
Ataxic dysarthria

Front 37

Fragile X syndrome

Back 37

mutation of FMRI gene on X chromosome, dysarthria, dyspraxia, articulatory distortions and substitutions

Front 38

Down Syndrome

Back 38

Hypotonia, low pitch, hypernasality, breathiness, articulatory distortions, increased rate, reduced prosody, dysarthria floppy

Front 39

Prader Willi Syndrome

Back 39

Delayed motor development secondary to hypotonia, flaccid dysarthria, hypernasality, reduced intelligibility, articulation errrors

Front 40

Spastic Syndromes

Back 40

Low birth weight, hypoxia, ischemia (reduced cerebral blood flow)

Front 41

Spastic Hemiplegia

Back 41

arm and leg on one side of the body shows signs of claspknife spastic paresis, CN 9 involvement

Front 42

Spastic paraplegia

Back 42

affects only legs, speech and langue are alright

Front 43

Spastic diplegia

Back 43

All extermities are affected, respiratory muscles affected, severe dysarthria,

Front 44

Speech Impairments in Spastic syndromes

Back 44

stiff muscles, weakness, limited range of motion, slowness of movement, laryngeal, articulatory, and velopharyngeal function affected

Front 45

Dyskinetic syndromes: athetosis

Back 45

involuntary uncontrolled movements, abnormal movements in timing, directions and spatial characteristics, slow and writhing movements

Front 46

Dyskinetic Syndromes: dysphasia

Back 46

drooling, severity of the dyskinetic involvement of the limbs is correlated with the severity of the speech mechanism involvement

Front 47

Speech mechanisms impairment in athetosis

Back 47

respiration functions: respiration fast and irregular rate, belly breathing, laryngeal dysfunction

Front 48

Ataxic Syndromes

Back 48

hypotonia, action tremor, disorder of incoordination, cerebellar malformation, metabolic disturbances, birth trauma, genetic

Front 49

Treatment of dysrthria

Back 49

depends on type and severity of symptoms, evp, length of treatment

Front 50

Dysarthria treatment targets

Back 50

resonance, respiration, loudness, articulation, phonation, prosody,

Front 51

Causes of Cleft Palate

Back 51

Chromosomal disorders, genetic disorders, environmental teratogens, mechanical factors in utero such as Pierre Robin

Front 52

Clefts of the primary palate

Back 52

Anterior to incisive foramen, including the lip

Front 53

Cleft of the secondary palate

Back 53

posterior to the incisive foramen: hard palate and velum

Front 54

Incomplete primary cleft palate

Back 54

just a notch in the lip with alveolar ridge still intact

Front 55

Complete primary cleft palate

Back 55

cleft of primary palate all the way though incisive foramen, through entire lip and alveolus

Front 56

Incomplete secondary cleft palate

Back 56

can be bifid uvula only or further into the velum

Front 57

Complete secondary cleft palate

Back 57

Extends through uvula and velum and through hard palate, associated with syndrome

Front 58

Palatal fistula

Back 58

hole in palate can persist after repair: breakdown of repair

Front 59

Submucous cleft

Back 59

Congenital defect that affects underlying structures of the palate, not on the oral surface, bifid uvula

Front 60

Obligatory errors

Back 60

spontaneously correct once the cause of error is corrected. nasal emissions, hypernasality, nasal turbulence, weak consonants, distortions

Front 61

Compensatory errors

Back 61

NOT useful, glottal stops, nasal snorts, pharyngeal fricatives, pharyngeal stops, mid-dorsum palatal stops

Front 62

Insufficiency of VP closure

Back 62

velum does not make contact with the pharyngeal wall

Front 63

Incompetence in VP

Back 63

Poor movement caused by abnormal muscle insertion following repair, poor lateral pharyngeal wall movement

Front 64

Mislearning

Back 64

Faulty articulation, habituated speech patterns, lack of auditory feedback, conversion disorder

Front 65

VP dysfunction effects on speech

Back 65

Hypernasality, nasal air emission, weak or omitted consonants, short utterance length, compensatory and obligatory articulation errors