Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Motor Test 2
Motor speech Disorders CH 3-5, 13
| Question | Answer |
|---|---|
| What subsystems are deficits found for Dysarthria? | All subsystems |
| What subsystems are deficits found for aphasia? | None, subsystem functioning is normal |
| Aphasia results from | Tumors, trauma, CVA |
| Site of lesion for Dysarthria | PNS, CNS, or both |
| Site of lesion for Aphasia | cortical r cerebral hemisphere language areas |
| speech and language features of dysarthria | slow, strained and labored speech, and distortions |
| speech and language features of aphasia | slow strained and labored speech and exhibits substitutions, omissions, additions |
| Does dysarthria have word finding difficulties | no word finding difficulties |
| Does aphasia have word finding deficits | exhibits word finding deficits |
| what modalities are impaired by aphasia | Listening, speaking, reading and writing |
| what modalities are impaired by dysarthria | speaking |
| what areas do speakers with dysarthria NOT have difficulties with | understanding verbal and written language |
| Dysarthria results from | tumors, trauma, CVA, ALS, MS etc |
| What features OF DYSARTHRIA differentiate it from aphasia? | no difficulties understanding verbal and written language, no word retrieval difficulties, exhibit distortions, site of lesion in the PNS CNS or both, can result from ALS, MS etc, deficits in all subsystems |
| What features of APHASIA differentiate it from dysarthria? | deficits can occur in all 4 modalities, word retrieval difficulties, substitutions/omissions/additions, lesion in the cortical or cerebral hemisphere language areas (typically Left), subsystem functioning is typically normal |
| what features are the SAME between AOS and aphasia? | unilateral lesion to L hem, respiration, phonation, and resonance are normal, free of neuromuscular impairment (paresis, spasticity, involuntary movement) |
| what features of AOS differentiate it from aphasia? | all 4 modalities are intact, etiology is predominately stroke, prosody NOT normal, right hemiparesis more common, speech sound distortions are more common, groping is present, artic hesitancy, errors approximate target, errors increase with complexity |
| what features of APHASIA differentiate it from apraxia of speech? | difficulties in all modalities, normal prosody, stroke is main cause, effortless articulation, unaware of errors, errors farther from target, increasing complexity has little effect on errors |
| Language of confusion results from... | TBI and right hemisphere lesions |
| Especially with TBI, language of confusion can co-occur with... | Dysarthria |
| If a speaker with a TBI exhibits Dysarthria, it typically resolves after | 1 year |
| differentiation between dysarthria and language of confusion should focus on | nature of the lesion (traumatic), location of the lesion, and uniqueness of the deficits (cognitive) |
| TBI occurs as a result of... | sudden onset that can be focal or diffuse |
| focal lesions are | less complex and fewer in number |
| highest frequency of TBI occurs in | males 15-24 years old |
| majorities of TBIs and Right hemisphere lesions are from | falls or MVA |
| damage from TBI occurs at | site of impact, area opposite of the impact as a result of countercoup action, near bony prominences inside the skull that shear and lacerate the brain |
| damage from TBI result in problems with | speech (dysarthria &/or AOS), language, swallowing, cognition, behavior, personality, motor control, vision and hearing |
| communication deficits from TBI include | similar language problems as in aphasia (anomia, comprehension problems), deficits in pragmatics, difficulties with discourse including lack of cohesion in conversation resulting in rambling pattern of speech |
| Right hemisphere lesions are more closely aligned with | TBI than aphasia |
| 5 major deficits of right hemisphere lesion | left neglect, denial of illness or motor difficulties, impaired judgement and self-monitoring, reduced motivation, visual perceptual deficits (visual tracking during reading) |
| what is the same about AOS and Dysarthria? | neurologic speech disorder |
| AOS is a MSD resulting from a deficit in | the motor programming domain of expressive communication |
| Dysarthria is a MSD resulting from a deficit in | the execution domain of expressive communication |
| In AOS, programming deficits do not exist for... | automatic or involuntary tasks so certain speech/non speech tasks will not be impaired |
| For dysarthria, during the physical exam abnormalities in...will be noted | movement, rate, precision, coordination, and strength in both speech and non speech tasks |
| Site of lesion for AOS | left cerebral hemisphere- parietal, frontal, and related subcortical circuits |
| site of lesion for Dysarthria | can vary depending on the type |
| which MSD has more consistent errors | dysarthria |
| which MSD will increase errors with increasing length and linguistic complexity | AOS |
| Prosody and articulation only are impaired for what MSD | AOS |
| Variable phonemic errors are found in | AOS |
| prosody, articulation, respiration, phonation, and nasal resonance are impaired for | dysarthria |
| Developmental dysarthria has a presence of... where phonological disorders do not | neurological diagnosis and site of lesion |
| what systems are impaired with developmental dysarthria? | respiratory, phonatory, or resonance systems |
| what systems are impaired in phonological disorders | no systems are directly impaired |
| what errors are present with developmental dysarthria? | distortions |
| what errors are present with phonological disorders? | substitutions or omissions |
| inconsistent errors on consonants and vowels in repeated productions of syllables/words for children is consistent with what DX | CAS |
| consistent errors, even when the same word is repeated in isolation and when errors phoneme is produced in connected speech in children is consistent with what DX | phonological disorders |
| lengthened and disrupted coarticulatory transitions between sounds and syllables is a feature of what developmental disorder | CAS |
| inappropriate prosody (lexical or phrasal stress) is a feature of what developmental disorder | CAS |
| a greater number of omissions (phoneme and diphthongs) are observed with what childhood disorder | CAS |
| Children with ____ have no difficulty transitioning between sounds | phonological disorders |
| it is not wise to make a CAS diagnosis for children under the age of--- | 3 |
| Main focus on therapy if phonological processes or speech apraxic behaviors are not present | language simulation |
| what DX's- may have difficulty understanding written and verbal language | aphasia, dementia, and language of confusion |
| what DX may have slow strained and labored speech | aphasia and dysarthria |
| what dx may have presence of circumlocutions when speaking | dementia |
| what dx is associated with use of non-intended words that can be or may not be semantically related | aphasia |
| what dx has a site of lesion that can occur within the PNS | dysarthria |
| what disorders commonly occurs with non verbal or oral apraxia | AOS and aphasia |
| diffuse or focal lesions may be present with | language of confusion (TBI or R Hem Stroke) |
| cognitive deficits (episodic mem, attention, orientation, problem solving, visiospatial skills) are consistent with what disorders | dementia and language of confusion, (possibly aphasia) |
| presence of a neuromuscular condition such as rigidity, spasticity or paresis | dysarthria |
| presence of anomias are associated with what disorders | aphasia and dementia, posible TBI depending on lesion site |
| impaired judgement and self monitoring is associated with what disorders | R Hem Stroke, TBI (possible), and dementia |
| for children with a limited verbal expression, what would need to be identified to confirm a DX od developmental dysarthria? | a neurological condition |
| what DX in children may lead to limited verbalization of speech | delayed language, CAS, and developmental dysarthria |
| static or isometric exercise | muscle length and joint position do not change, leads to greater strength than dynamic or isotonic exercise |
| isotonic exercise | muscle tension remains the same while muscle length changes |
| dynamic exercise | leads to increase speed of contraction, greater maximum velocity of shortening muscle fibers, beneficial for speech because they mimic the muscle contraction needed for speech production |
| task specific exercise | to improve speech production, use speech production task exercises (continuous positive airway pressure) |
| overload | involves muscle being stimulated beyond a given level to achieve hypertrophy of muscles and recruitment of more motor units, leads to increase in strength, endurance, and power in muscle functioning, (NOT FOR SPEECH) |
| How much strength does one need for speech production? | about 15% of total force |
| Principles of Neuroplasticity | body activity competes for representation in brain, alteration in brain representation MAY be limited to the specific function being trained, brain reorganization will only occur with extensive prolonged practice, |
| explain the principle of neuroplasticity: body part activity competes for representation in the brain | use it or lose it/ use it and improve it |
| explain the principle of neuroplasticity: alteration in brain representation MAY be limited to the specific function being trained | non speech exercise may not help speech to improve |
| explain the principle of neuroplasticity: influence of training on neural reorganization may be linked to time | reorganization may occur more earlier in the disease process |
| explain the principle of neuroplasticity: relevant speech tasks may include plasticity to a greater extent than non relevant activity | practice slowing speaking rate to improve intelligibility compared to working on producing repetitive productions of non sense syllables |
| what factors influence acquisition and retention of a motor skill? | 1. randomized practice 2. feedback on every trial for improved acquisition and summary for retention 3. generalization (retention) of learning improves with variable practice, acquisition is greater with non variable practice |
| to make informed choices regarding treatment options, what factors should a therapist consider? | 1. empirical evidence from published research 2. experimental evidence from personal clinical experience 3. physiological rationale based on understanding of normal process of the body 4. values of the client 5. system features (economic, legal, & culture |
| what is a narrative review? | informal reviews- methods used for collecting and interpreting information are frequently not specified- written by one or more researchers |
| systematic reviews include what | 1. study inclusion/exclusion parameters 2. specify databases of search 3. time frame for search of evidence 4. specifics on how studies were evaluated for quality 5. who sponsored the review |
| what is the importance of having practice guidelines for either assessment or treatment of a disorder? | practice guidelines are developed by a panel of experts and sponsored by an org, based on a review of lit. on certain topics and offer explicit descriptions of how pt. should be evaluated and treated to reduce variability of service and improve quality |
| Phase 1 of outcome research | develop hypothesis that will be tested later, establish safety of treatment, small sample sizes |
| Phase 2 of outcome research | carried out if phase 1 is good, refine hypothesis, develop explanations of why the tx should be carried out, determine the ideal situation for this tx |
| Phase 3 of outcome research | treatment described in 1 & 2 is carried out, RCT - Multicenter RCT |
| Phase 4 of outcome research | single subject designs with multiple replications to test the effectiveness of the TX |
| Phase 5 of outcome research | exploration of efficiency cost effectiveness, cost benefits, cost utility, satisfaction measures to understand impact of TX on subjects lives |
| what are the 3 dimensions for measuring the 'strength' of evidence for a given assessment or tx procedure | quality, quantity, consistency of the evidence |
| Quality- dimension for measuring strength of evidence | overall rating of excellence across research studies, typically rated according to the research design features of objectivity, validity, reliability, rigor, open-mindedness, and thoroughness of reporting |
| Quantity- dimension for measuring strength of evidence | includes the number of studies and the size of the sample or effect size |
| consistency of the evidence- dimension for measuring strength of evidence | degree of similarity of findings across studies |
| what are the two levels of management decisions to consider when treating a client with dysarthria? | 1. decision regarding the goals of tx (severity of the function al limitation and the disability experienced) 2. decisions regarding the treatment approach to adopt (heavily dependent upon understanding the pattern of impairment |
| typical areas of focus for SEVERE dysarthria | family education in their role, AAC to maximize S/L development, increase participation of the person in their environment, make tx decisions based on cognitive, linguistic, and motor limitations, the literacy needs of the child |
| what information from assessment is used for planning treatment | nature of the impairment, identifying features that can be modified, identification of existing compensatory strategies, multiple approaches to intervention |
| as an aerodynamic pressure source, what is the goal of the respiratory system? | maintain a relatively stable sub glottal pressure (5-10 cm H20) |
| severe impairment of respiratory system | can adversely influence speech production to the extent that phonation may not be existent |
| less severe impairment of the respiratory system | can influence the functioning go all other subsystems because of the central role respiration plays as the aerodynamic energy source |
| what are the four areas to be focused on when evaluating the respiratory system? | air pressure (vary and control the pressure), lung volume (maintain pressure over time), airflow (control at the larynx), and respiratory shape (movement) |
| what else should be considered when evaluating the respiratory system | the nature of the utterance the person is trying to produce |
| how to measure air pressure | glass/water manometer, phonatory function analyzer, aerophone2, aerowin, phonatory aerodynamic system |
| how to measure lung volume | spirometer like the aerophone2 (normative volume falls between 3.5-5 liters, volume has to be VERY reduced before it has an affect on ability to speak) |
| how to measure airflow | have client phonate a vowel sound, flow volume (total act of air expelled during phonation of a word phrase or sentence), phonatory function analyzer, aerophone 2, aerowin, phonatory aerodynamic system |
| how to measure respiratory shape | pneumograph, inductotrace, magnetometers (research) |
| how might impairment in respiration influence speech intelligibility | loudness (too soft) and breath group lengths |
| how might impairment in respiration influence speaking rate | breath group length affects it |
| how might impairment in respiration influence naturalness | loudness (mono loudness or loudness decay) |
| what are the four typical respiratory movement impairments in individuals with dysarthria? | reduced vital capacity (below 60%), inconsistent lung volume, inappropriate lung volume, excessive lung volume |
| treatment for respiration focuses on what 3 main areas | establishing respiratory support, stabilizing respiratory patterns (eliminate maladaptive behaviors), and increase respiratory flexibility |
| what is involved in establishing respiratory support | helps the pt to generate the sub glottal pressure they need to develop inspiratory and expiratory respiratory drive for speech |
| what signs indicate a need for stabilizing respiratory patterns | may have the clavicular breathing or paradoxical breathing |
| who might benefit from stabilizing respiratory patterns? | initiates speaking at; too high/low lung volume, w/o initial inhalation, initiates breath groups with wrong amt of lung volume, utterances are too loud/soft, speaks into his/her residual volume (loudness decay, bad voice quality) |
| how would you stabilize respiratory support for a client with near normal inspiratory muscle function and weak expiratory muscles? | train them to breath in near 60% of VC prior to initiation of phonation to take advantage of passive respiratory muscle forces |
| what tools can be used as biofeedback for training targeted lung volumes | spirometer and the inductotracecan |
| when do you use inspiratory checking? | when the pt cant maintain the breath for the length of the utterance they are wanting to say |
| what is inspiratory checking? | take in too much air and through passive forces there is too much pressure and need to lower the pressure by slowing the contraction of the lungs by turning on the inspiratory muscles, will slow down the natural compression of letting the system fall |
| how would you increase respiratory flexibility? | heighten awareness of the breathing process, practice reading scripts where correct pause placement is marked, then practice pause use in conversation |
| when should you work on increasing respiratory flexibility (what pt signs) | stereotypic (limited variation) of breath group lengths, never pauses w/o taking a breath, unable to manage a quick inhalation needed to support short breath group utterances |
| what is Guillain barre syndrome | inflammatory disorder of the peripheral nerve charcterized by the rapid onset of weakness and often paralysis of the legs, arms, breathing muscles and face |
| what is friedreich ataxia? | one of a heterogeneous group of degenerative spinocerebellar disorders |
| what is Huntington's desease | hereditary degenerative disorder of the nervous system characterized by chorea, dementia, emotional instability, and a history of familial occurrence |
Created by:
clp26570
Popular Speech Therapy sets