Richard Garcia is a 55 year-old patient who suffered from a moderate brainstem stroke that primarily affected his swallowing and speech. The stroke damaged the patients descending pyramidal and extrapyramidal bilaterally component. This is evidenced by his spastic dysarthria. Mr. Garcia primary concern is his speech. He states his speech is slow and his tongue has reduced range of movement. The patient spastic dysarthria characteristics major areas of concern include the following: low pitch, slow rate of speech, imprecise consonants (mild), strained-strangled vocal quality (mild) monoloudness and monopitch. Subtle hypernasality was observed but was not readily evident.
Etiology
According to Duffy (2013) dysarthria is the collective term …show more content…
The second goal is the patient will increase rate of speech of articulation placement by performing oral motor exercises 3 out of 5 times over 3 sessions with moderate assistance provided. For the first goal, the clinician will be utilizing the intelligibility drill technique within therapy. This technique is used to inform the patient about the adequacy of the speech being provided. Yorkston, Beukelman, Strand, and Bell (1998) stated intelligibility drills provide useful framework for treatment of articulation disorders for a number of reasons. First, they do not require specific instructions about how to produce the sounds. Rather they depend on the speaker’s ability to compensate for the motor impairment and to find ways to produce a perceptually acceptable sound. Ince and Rosenberg (1973) described a study which two speakers with dysarthria were asked to spontaneously produce one sentence at a time. Following the production, the experimenters gave the speakers general feedback by indicating to the speakers whether the production was “clear or “unclear”. Over a period of 38 sessions, the proportion of intelligible sentences increased from 1.8% to 100% for one speaker and 5% to 100% for the other. From the evidences gathered, the clinician will implement this strategy within the session. The clinician will drill the patient on a word list that contains words with vowels, words in the initial consonants and words in the final consonants. The second goal, is to increase the rate of speech of the patient by utilizing oral motor exercise. Freed (2000) states in one case study, a patient with spastic dysarthria reported difficulty with making the articulatory contact needed to produce a /l/ in conversational speech. Shortly after
Etiology
According to Duffy (2013) dysarthria is the collective term …show more content…
The second goal is the patient will increase rate of speech of articulation placement by performing oral motor exercises 3 out of 5 times over 3 sessions with moderate assistance provided. For the first goal, the clinician will be utilizing the intelligibility drill technique within therapy. This technique is used to inform the patient about the adequacy of the speech being provided. Yorkston, Beukelman, Strand, and Bell (1998) stated intelligibility drills provide useful framework for treatment of articulation disorders for a number of reasons. First, they do not require specific instructions about how to produce the sounds. Rather they depend on the speaker’s ability to compensate for the motor impairment and to find ways to produce a perceptually acceptable sound. Ince and Rosenberg (1973) described a study which two speakers with dysarthria were asked to spontaneously produce one sentence at a time. Following the production, the experimenters gave the speakers general feedback by indicating to the speakers whether the production was “clear or “unclear”. Over a period of 38 sessions, the proportion of intelligible sentences increased from 1.8% to 100% for one speaker and 5% to 100% for the other. From the evidences gathered, the clinician will implement this strategy within the session. The clinician will drill the patient on a word list that contains words with vowels, words in the initial consonants and words in the final consonants. The second goal, is to increase the rate of speech of the patient by utilizing oral motor exercise. Freed (2000) states in one case study, a patient with spastic dysarthria reported difficulty with making the articulatory contact needed to produce a /l/ in conversational speech. Shortly after