Phonology Dysarthria & Cp

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Dysarthria

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a neuromuscular impairment as a result of brain damage (disease or head injury) that may affect respiration, articulation, voice, and fluency. Speech may be slow, weak, imprecise, or uncoordinated

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A primary factor in distinguishing apraxia from dysarthria is the presence or absence of

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the presence or absence of vegetative impairments. Vegetative deficits are more severe in dysarthric children. Like apraxia this is more difficult to assess in very young children, as they may not be able to participate in adult oriented assessment tasks.

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Characteristics of Dysarthria

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Decreased strength and coordination of speech musculature
Difficulty with involuntary motor control for chewing, swallowing, etc.
Articulation errors are consistent
Errors are generally distortions
Less precision in connected speech
Not situational
No significant difference between receptive and expressive language
Rate, rhythm, and stress related to type of dysarthria
Monotone voice; difficulty with pitch and loudness
Voice quality may be hoarse, harsh, hypernasal, etc.

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FLACCID DYSARTHRIA

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Produced by injury to the lower motor neurons (cranial nerves) involved in speech. The effects depend upon which cranial nerves are damaged.

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SPASTIC DYSARTHRIA

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Produced by upper motor neuron lesions with damage to the direct activation pathway. Damage leads to increased tone and spasticity. Reflexes are diminished at first and then hyperactive.

is associated with impaired movement patterns, not weakness to individual muscles. It is usually associated with all components of the speech system.

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ATAXIC DYSARTHRIA

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This is associated with damage to the cerebellar circut, which controls smooth movement and coordination.

Damage leads to incoordination and reduced muscle tone.

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ATAXIC DYSARTHRIA can affect the

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It can affect the respiratory, phonatory, resonatory and articualtion levels of speech, but it’s most evident in articulation and prosody.

It is typically a bilateral or generalized cerebelar lesion.

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HYPOKINETIC DYSARTHRIA

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A lesion to the basal ganglia can result in hypokinetic dysarthria.

Damage results in failure to inhibit involuntary movement (“too little movement”).

Voice, articulation and prosody are most affected.


This is from a lesion to the basal ganglia as well.

It is primarily associated with involuntary movement (“too much movement”) and it may be unilateral or bilateral damage.

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Parkinson’s Disease

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is the prototype [of Hypokinetic Dysarthria), but not the only disease associated with hypokinetic dysarthria.

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MIXED DYSARTHRIA

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are common.

The characteristics depend on whether the upper or lower motor neurons remain most intact. For example, if the upper motor neurons remain intact initially, the voice will sound harsh. However, if the lower motor neurons are more affected than the voice may sound breathy.

It can result from more than one neurologic events or the occurance of two or more diseases such as a stroke and Parkinson’s Disease.

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Amyotropic Lateral Sclerosis

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is a degenerative disease that results in a mixed dysarthria. There are both upper and lower motor neuron signs and thus is classically associated with mixed spastic-flaccid dysarthria.

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CEREBRAL PALSY

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palsy is a group of chronic disorders impairing control of movement that appear in the first few years of life and generally do not worsen over time. These disorders are caused by faulty development of or damage to motor areas in the brain that disrupts the brain's ability to control movement and posture

A nonprogressive, congenital neuromotor disorder in children causing communication problems.

Results in dysarthria

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Speech and language disorders are common in people with Cerebral Palsy. The incidence of dysarthria is estimated to range

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is estimated to range from 31% to 88%.

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Speech problems are associated with

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with poor respiratory control, laryngeal and velopharyngeal dysfunction as well as oral articulation disorders that are due to restricted movement in the oral-facial muscles.

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CAUSES of Cerebral Palsy

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may be congenital or acquired after birth. Congenital causes include brain injury or malformation due to:
Infection
Intrauterine hypoxia (low blood oxygen)
Problems with the placenta
Genetic abnormalities

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Some of the causes of cerebral palsy that have been identified through research are preventable or treatable, including:

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Head injury
Jaundice
Rh incompatibility
Rubella (German measles)
Brain tissue may not develop correctly during pregnancy. The growing fetus may experience a lack of oxygen or nutrients.
Child sustains a head injury or brain infection.
Mother's and child's blood types are not compatible.
Mother has rubella while pregnant.
Stroke or bleeding occurs in the baby's brain during development or after birth.
Child is deprived of oxygen during or after birth.
There are abnormalities of the umbilical cord or placenta, or the placenta separates too early from the wall of the uterus.
Child has meningitis , encephalitis , seizures, or head injury.
Child has genetic/metabolic abnormalities.

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Some people with cerebral palsy are also affected by other medical disorders, such as

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are also affected by other medical disorders, such as seizures or intellectual disability . But cerebral palsy does not always cause intellectual disability.
Although its symptoms may change over time, cerebral palsy by definition is not progressive. If a patient shows increased impairment, the problem may be something other than cerebral palsy.

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Symptoms of cerebral palsy vary widely and may include difficulty with

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may include difficulty with fine motor tasks (such as writing or using scissors), difficulty maintaining balance or walking, and involuntary movements. The symptoms differ from person-to-person and may change over time.

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Cerebral palsy first shows up in children aged

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first shows up in children aged three years or younger. Symptoms vary depending on what areas of the brain are affected. Some children may have severe disabilities. Although symptoms may change as the child grows older, the child's condition is unlikely to worsen

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Characteristics of Cerebral Palsy

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Late to turn over, sit up, smile, or walk
Trouble writing, buttoning a button, or other fine motor activities
Difficulty walking or standing
Tight, spastic muscles

Weak muscles
Poor balance
Speech problems
Tremors
Unintentional body movements
Difficulty swallowing
Drooling

Seizures
Intellectual disability
Learning disabilities
Vision or hearing problems
Failure-to-thrive
Decreased ability to feel pain or identify items by touch

Problems with bowel and bladder control
Breathing problems if food or water has accidentally entered the lungs
Skin breakdown
Low bone density and fractures

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Speech disorders are highly prevalent among children with

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are highly prevalent among children with cerebral palsy and vary according to the nature and timing of the brain injury.
Overall, one in two children with cerebral palsy have some form of speech problem.

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spastic cerebral palsy

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causes stiffness and movement difficulties

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athetoid cerebral palsy

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leads to involuntary and uncontrolled movements

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ataxic cerebral palsy

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causes a disturbed sense of balance and depth perception

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hypotonic cerebral palsy

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causes musculature that is limp, and can move only a little or not at all.

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Speech impairments in spastic dysarthria involves four major abnormalities of voluntary movement:

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spasticity, weakness, limited range of motion and slowness of movement

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Speech mechanism impairment in athetosis involves a disorder in the regulation of

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involves a disorder in the regulation of breathing patterns, laryngeal dysfunction (monopitch, low, weak and breathy voice quality). It is also associated with articulatory dysfunction (large range of jaw movements), inappropriate positioning of the tongue, instability of velar elevation.

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Athetoid dysarthria is caused by disruption of the

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is caused by disruption of the internal sensorimotor feedback system for appropriate motor commands, which leads to the generation of faulty movements that are perceived by others as involuntary

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Ataxic dysarthria is uncommon in cerebral palsy. The speech characteristics are:

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imprecise consonants, irregular articulatory breakdown, distorted vowels, excess and equal stress, prolonged phonemes, slow rate, monopitch, monoloudness and harsh voice.

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Overall language delay is associated with problems of

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is associated with problems of mental retardation, hearing impairment and learned helplessness

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Children with cerebral palsy are at risk of

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are at risk of learned helplessness and becoming passive communicators, initiating little communication

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Early intervention with this clientele often targets situations in which children communicate with others, so that they learn that they

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so that they learn that they can control people and objects in their environment through this communication, including making choices, decisions and mistakes

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There is no treatment to cure cerebral palsy. The brain damage cannot be corrected. Therapy aims to help the child

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aims to help the child reach his or her full potential. Children with CP grow to adulthood and may be able to work and live independently.

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Cerebral palsy doesn't always cause

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palsy doesn't always cause profound disabilities.   While one child with severe cerebral palsy might be unable to walk and need extensive, lifelong care, another with mild cerebral palsy might be only slightly awkward and require no special assistance. Supportive treatments, medications, and surgery can help many individuals improve their motor skills and ability to communicate with the world.

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Sign language (hand and body movements) or special boards (with pictures, words, or letters on them).

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People who do not speak clearly can learn to communicate better using these tools.
Computers to increase the volume of a voice that is very faint.
Specialized computer programs. Some programs help improve speech through practicing lessons. Other programs are designed to allow a person who does not speak at all to communicate through objects or symbols.

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“augmentative and alternative communication systems (AAC)”

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MACHINES give a voice through a machine or computer and from a text source, such as a keyboard or preprogrammed answers.  Such computers can aid the cerebral palsy sufferer with severe speech disorders and can give them a larger range of communication possibilities.

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Other AACs include

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include symbol charts with prewritten words that the cerebral palsy patient can point to, either with their hands, or a device.  Using these charts can aid the cerebral palsy victim in communicating with people outside.

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Speech therapy may not only be important in making speech better, but also in developing the muscles of the face in order to

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in order to eat, breathe, and control side effects like drooling as well.  The speech therapy consists of working on communication techniques involving speaking, charts, or even sign language.  Cerebral palsy patients who are able to speak can improve their speech with long-term speech therapy.