Motor Speech Disorders

motor speech disorders

motor speech disorders

neurological-based problems that affect speech production

congenital or acquired

upper motor neurons

central nervous system

lower motor neurons

peripheral nervous system

basal ganglia

subcortical structure responsible for

• control of movements

• learning

• habit

• cognition

• emotion

cerebellum

responsible for timing and balance

dysarthria

problem with execution of articulatory movements

consistent errors on repeated production

dysarthria lesions on

CNS or PNS

dysarthria affects

• articulation

• prosody

• respiration

• phonation

• resonance

dysarthria predominant speech erros

distortions & substitutions

apraxia of speech

problem with planning & programming articulatory movements

inconsistent errors on repeated productions

time, rate, and sequence

AoS lesions on

CNS (Broca’s area)

AoS affects

• articulation

• prosody

AoS predominante speech errors

substitutions & repetitions

flaccid dysarthria

lesion site - LMN (PNS)

weakness & low tone in muscles

spastic dysarthria

lesion site -bilateral damage to UPM (CNS)

spasticity & increased tone in muscles

unilateral upper motor neuron

lesion site - unilateral damage to UPM (CNS)

spasticity & increased tone in muscle

hyperkinetic

lesion site - basal ganglia or connections to CNS

involuntary movements

Huntington’s disease

hypokinetic

lesion site - basal ganglia or connections to CNS

reduced range & speed of motion

Parkinson’s disease

ataxic dysarthria

lesion site - cerebellum or connection to CNS

incoordination between muscle groups

mixed dysarthria

multiple lesion sistes

any combination of symptoms of the 6 dysarthria’s

cause and risk factors

neurological conditions

genetic factors

developmental issues

SLP role

screen

assess

diagnose

treat

4 goals of dysarthria assessment

• describe perceptual characteristic’s of individuals speech

• describe speech subsystems affected (articulation, respiration, etc)

• identify other systems/processes affected (swallowing, cognition, etc)

• assess the impact of the dysarthria and apraxia on speech intelligibility

goal of treatments

preserve or maintain function

restorative interventions

maximize intelligibility by addressing the function of speech subsystems

restorative approaches focus on improving

• speech intelligibility

• prosody and naturalness

• efficiency

compensatory interventions

maximize a person’s participation in activities by addressing function communication

compensatory approaches focus on

• increasing the speaker’s use of communication strategies

• improving listener skills and capacity

• altering the communication environment

Ideational Apraxia

difficulty in creating a motor plan & carrying out the sequence of actions to perform a multistep task

Ideomotor Apraxia

difficulty pantomiming or performing a gesture with a tool on command

difference between ideomotor & ideational apraxia

ideational apraxia cannot perform an action spontaneously while people with ideomotor apraxia can

limb apraxia

inability to sequence movements involving arms, legs, hands, or feet during an action

nonverbal oral apraxia

inability to sequence movements for nonverbal, volitional actions involving oral structures