Motor Speech Disorder Comps study guide

Cranial nerves for speech

V: trigeminal, jaw

VII: facial

IX: glossopharyngeal, larynx and pharynx

X: vagus nerve, velar elevation

XII: hypoglossal, tongue

Flaccid dysarthria

weakness, problem of neuromuscular execution, dependent on which CN is damaged, decreased speed range & accuracy of speech movements, impaired articulation, reduced loudness, breathy

location: lower motor neurons (peripheral nervous system

related conditions: ALS

Spastic Dysarthria

increased muscle tone, hard to move structures, decreased skilled movement and weakness, imprecision, slow and effortful, disorientated oral reflexs (sucking, snout, jaw jerk), spasticity

location: bilateral upper motor neurons

hyperkinetic dysarthria

involuntary movements, does not inhibit well enough = too much movement, excess loudness/stress, short phrases, variable rate, prolonged phonemes, tremor, imprecise articulation, decreased intelligibility

location: basal ganglia (Excess dopamine)

hypokinetic dysarthria

rigid, reduces movement too much - reduced inhibition, slowed rate, irregular prosody, monoptich and monoloudness, short phrases, imprecise articulation, hoarseness, roughness, breathiness, short rushes of speech

location: basal ganglia (dopamine depletion)

related conditions: parkinsons

ataxic dysarthria

uncoordinated, articulation and prosody are most affected, drunken quality, slowness and inaccuracy in the force, range, timing, and direction of speech movements

location: cerebellum or neural pathways * when drunken speech you need to call this*

UUMN dysarthria

mainly affects articulation, phonation and prosody. imprecise consonants, irregular breakdowns, slow rate, imprecise speech, reduced loudness (drooping on one side of lower face), weakness, incoordination, spasticity

location: unilateral upper motor neurons

apraxia

difficulty with motor planning for speech sounds, may say it right one time and wrong the other, leave sounds out, say sounds wrong way, groping- messages the brain is sending the muscles get mixed up. They know what they wat to say, but can't get their mouth to do it.

lesions flaccid dysarthria

LMN pathways

lesions spastic dysarthria

UMN, direct and indirect pathways

lesions hyperkinetic dysarthria

basal ganglia control center

lesions hypokinetic dysarthria

basal ganglia control center

lesions ataxic dysarthria

cerebellar control circuit

lesions UUMN dysarthria

UMN indirect or direct pathways (may be temporary)

lesions apraxia

left hemisphere

childhood apraxia of speech

goal of tx is to help say sounds, words and sentences more clearly

motor program approaches: motor learning principles -- need for repetitions fo speech movements to help child acquire skils

linguistic approach: focus on CAS as language learning disorder-- teach children how to make speech sounds & the rules for when sounds & sound sequence are used in language

combination approach: uses both motor and linguistic approaches

rhythmic (prosodic) approaches: such as MIT, use intonation patterns to improve functional speech production

motor program approaches (CAS)

motor learning principles -- need for repetitions fo speech movements to help child acquire skils

linguistic approach (CAS)

focus on CAS as language learning disorder-- teach children how to make speech sounds & the rules for when sounds & sound sequence are used in language

combination approach (CAS)

mix of both linguist and motor plann

rhythmic (prosodic) approaches (CAS)

such as MIT, use intonation patterns to improve functional speech production

Adult with apraxia

goal is to help individual achieve highest level of independent function for participation in daily living

sound production treatment (SPT): tx hierarchy that incorporates modeling and repetition of minimal-contrast word pairs to target problematic consonants

combined aphasia & apraxia of speech treatments (CAAST)

PROMPT: tactile method of tx based on touch, pressure, kinesthetic and proprioceptive cues. Requires specialized trainings

sound production treatment (SPT) (Adult apraxia)

tx hierarchy that incorporates modeling and repetition of minimal-contrast word pairs to target problematic consonants

PROMPT (Adult apraxia)

tactile method of tx based on touch, pressure, kinesthetic and proprioceptive cues. Requires specialized trainings

general issues regarding motor speech disorders

-Results revealed limited but growing efficacy data for acquired AOS. Myriad concerns about research design and quality of the evidence from tx studies.

-"There is some evidence to support tx of MSDs, though the quality & quantity of that info needs to be improved" (Management of MSDs slide 22).