Treatment Of Motor Disorders

Front 1

Development of Management Plans: Factors to consider

Back 1

-overall goal
-specific tx approaches to achieve goals
-order of implementation, short-term objectives
-evaluation of tx effectiveness

Front 2

Strength Training

Back 2

-overload muscle
-isometric (resistance against stationary object) /isotonic (mvmt of structure to be strengthened)
-isotonic usually preferred- trains agility and ROM
-repetition needed- 5-10 reps/set, total of 1-2 min., work on each muscle group, resistance set at levels greater than needed for functional speech but less than maximum
-speech specific activities when strength sufficient for speech activities

Front 3

Strength Training Cautions

Back 3

-if progressive disorder, then exercise may be futile and/or fatigue pt. w/ little payoff
-tx approaches that reduce impairment, increase the physiological support for speech
-principle of peripheral dependencies
-little efficacy research to support (or refute) value of strength training

Front 4

AAC Systems

Back 4

All speakers use a 'system' of communication
-natural speech, facial expression, gestures
-supplemented by contextual information
Clients w/ MSDs may need additional components to their communication system
-low tech (alph. board, comm. bk)
-high tech (DV4 or other dynamic display device w/ voice synthesizer)
Both comm. partners need to be actively participating for optimal effectiveness

Front 5

Considerations for AAC Systems

Back 5

-selection- direct, indirect
-reliable way to get attention (bell, buzzer)
-motor response for yes/no
-messages needed to be communicated by the client
-determining appropriate system
-train individual to use the system
-train family/caregivers to use the system (model, coach, supervise)
-update and revise

Front 6

Interaction Enhancement Strateies- a universal approach for clients w/ MSDs, as all may benefit from this
SETTING

Back 6

-minimize background noise
-maximize visibility of the speakers face
-minimize distance between speaker and listener
have supplementary info for listener readily visible in written form (e.g.instructions for alph. board use)

Front 7

IES- SPEAKER

Back 7

-use posture thats optimal to support eye contact w/ listener
-id topic, use gestures, facial expressions to provide redundance and increase listeners ability to predict spoken utterances
-slow rate, stress important words
-learn how to "read" the listener
-increase ability to id and repair comm breakdowns (repeat, increase loudness, phonetic, semantic, syntactic revisions, elaboration, use of "back-up" system)
-top-down approach to speech production if appropriate for client
-semantics (use phonetically easier words, specific language vs figurative, short messages w/ content words vs longer sentences)
-syntax (basic SVO sentence structure easier to interpret than complex embedded structure)
-phonology (sounds, sound combinations that are visible and audible more understandable in degraded conditions, shorter sequences easier to produce and understand than longer ones)
-pragmatics (clear signals re: engaing in joint attn, eye gaze, head nods, facial expressions, body orientation, intiating, maintaining and shifting head topics, turn taking)
-have visible instructions for unfamiliar listeners

Front 8

IES- LISTENER

Back 8

-give speaker specific feedback when a word is not understood (hand gesture, facial expression)
-look for other cues from the speaker (facial expression, gestures)
-clarify the topic if needed
-be patient-expect slower speaking rates
-word questions to reduce utterance demands on the speaker when specific info is required
-will need to model, coach, supervise client and comm partners and provide practice in various settings