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MSD

Exam 4 Study Guide

TermDefinition
The _____________ for apraxia of speech (used for both adults and children) is based on the assumption that salient features of the reduced motor programming deficits in apraxia of speech are most salient in connected speech. motor speech examination (MSE)
The MSE assesses individuals with AOS based on three factors which directly tap into the motor programming deficit and are crucial to treatment: linguistic load, length and phonetic complexity of the utterance, temporal relationship between the stimulus and the response
What is the purpose of the MSE? To provide the clinician a framework and defining the strengths and weakness of the client.
Treatment should begin at a point where the client is successful and gradually increase ________ and _______________ linguistic load; utterance length and phonetic complexity while maintaining client success in motor programming.
The final factor to be manipulated by the clinician is the _____________ between the presentation of a stimulus (i.e., utterance) by the clinician and the response by the client. temporal delay
A central feature of the treatment of apraxia of speech is _________. imitation
So in creating a hierarchy of difficulty for treatment, we need to take into account ___________, __________, __________, _______________________ linguistic load, utterance length, temporal delay, and amount and kind of cueing
The linguistic demands hierarchy from easiest to hardest: Conversation Picture description Narrative
Each level of the hierarchy of linguistic load is evaluated based on Efficiency (rate of communicating information) Syntactical complexity Prosody Word Finding
When evaluating length and complexity, use ____________ format. imitative
simultaneous production with cueing speakers say the utterance with the clinician, but only after tactile and visual cues are provided
simultaneous production with cueing the speaker is allowed to stay in the initial articulatory configuration for a second or two before production in order to take full advantage of proprioceptive feedback
simultaneous production speakers say the utterance with the clinician; rate is slowed as needed to improve accuracy
immediate repetition speakers imitate the production of the clinician immediately after they see and hear it.
repetition with delay the clinician imposes a 2-4-second delay between modeling the utterance and requesting a response from the speaker
spontaneous production the utterance is produced in response to a question
Identifying cueing strategies is critical to treatment success and is important for four reasons Provides a starting point for speech in terms of the type and amount of cueing needed for the client to be successful Prognostic in nature- if cueing helps, there is potential for change
Identifying cueing strategies is critical to treatment success and is important for four reasons The less the amount of cueing needed, the better the prognosis for an individual The greater the delay between the model of the clinician and a correct response by the client, the better the prognosis
_________________ is the term used to indicate a subset of children who exhibit speech sound disorders due to difficulty formulating and executing motor plans for speech. childhood apraxia of speech (CAS)
Characteristics of CAS contain the following categories: speech and nonspeech characteristics; specific articulatory characteristics, particular movement characteristics, prosodic characteristics, and the influence of context on performance.
Such impairment leads to the current consensus-based core CAS features: Inconsistent errors on consonants and vowels in repeated productions of syllables or words;Lengthened and disrupted coarticulatory transitions between sounds and syllables Inappropriate prosody especially in the realization of lexical or phrasal stress
Acquired apraxia of speech is a motor speech disorder that is typically caused by ________. stroke
4 precursors to treatment for those with AOS (2) Trust (The adult or child needs to trust the clinician) - can be fostered by initial success and trust leads to increased motivation;Active participation (in treatment requires focused attention);
4 precursors to treatment for those with AOS (2) Conscious versus automatic processing; Processing capacity (is more constrained for individuals with apraxia of speech) and demands (when choosing stimuli for treatment.)
_________ and ________ practice are terms commonly used to describe practice. massed; distributed
In __________, a set of movements (such as CV or CVC) is practiced many times without intervening stimuli; practice occurs all at once. massed practice
Massed practice tends to facilitate motor __________ (accuracy of movement within the training session), but tends to hinder motor _________ (retention and generalization of the movement. performance; learning
In _____________, periods of rest or varying movements (different syllables) are used within a session. distributed practice
___________ results in slower learning, but learning is better generalized and retained. distributed practice
____________ (clinician provided information about the speaker’s performance) has been shown to facilitate motor learning. augmented feedback
Cognitive motor researchers have shown that providing different kinds of feedback - knowledge of _______ and knowledge of _________ - makes a difference in treatment outcomes. results; performance
Knowledge of ______ refers to giving the child or adult feedback about whether the movement sequence was correct (“That was right!). results
Knowledge of ___________ involves giving the speaker specific information regarding what was right or wrong about the movement (“Close your jaw a little” or “Good - you got your lips together!”) performance
Knowledge of ___________ leads to better movement skill during the session, but negatively influences motor learning. performance
Conversely, use of knowledge of ________ facilitates motor learning, but may cause speakers with apraxia to take longer to achieve movement accuracy, adding to frustration. results
How one provides feedback should be considered. This can be done _______ (on every trial) or ________. blocked; randomly
For example, providing feedback _________ and less _________ produces better motor learning than giving feedback after _______ trial for simple tasks. randomly; frequently; every
Research supports that for more complex motor tasks, _______ feedback enhances motor learning. This implies for the complex task of speech motor learning. frequent
We use _______ to guide our feedback frequency. We provide immediate feedback early in treatment or when the apraxia is severe. severity
As performance improves, we begin to provide _____ specific feedback more _______, adding a little _____. less; randomly, delay
Tactile cues The clinician uses tactile cues to show the client how the movements should be made and provides tactile stimulation for location.
Simultaneous production The clinician says the target utterance while the client watches and listens. Then the clinician and client say the utterance together, simultaneously, while the client continues to watch the clinician.
Mimed production The clinician says the utterance while the client watches and listens.The client then imitates the utterance immediately after the clinician.
Mimed production In this step, the auditory cue is faded, but the clinician continues to mime the movement, while the client produces it.
Immediate repetition The client imitates the clinician’s utterance, without auditory or visual cues during the client’s production.
Successive repetition The client imitates the clinician’s utterance, with several successive productions made by the client.
Delayed repetition The client imitates the clinician’s production, but must wait 1 to 5 seconds between hearing the utterance and producing it.
Reading The clinician presents written stimuli, followed by the client’s oral reading, with no auditory or visual cues from the clinician.
Answering questions The clinicians elicits the target utterance by asking a question.
Role playing The clinician elicits the target utterance by engaging in role playing.
______________ are often a discriminating feature of CAS. vowel distortions
The most important aspect of motor learning is that it requires __________. experience
____________ uses prosodic cues and stress patterns as a major facilitator to improve both speech production and prosody. This method has been used with speakers with dysarthria and apraxia. contrastive stress
______________ evaluates a child’s performance on untrained items that are somehow related to trained items, to determine whether more widespread change is occurring. response generalization
_________________ assesses performance on untrained materials, people, or settings, and environments. Such change is necessary to meet the overall goals of intervention. stimulus generalization
Created by: ryanriggs_90