Assessment of Motor Speech Disorders – Key Vocabulary

Vocabulary flashcards summarizing essential terms and definitions from the lecture on assessment of motor speech disorders. These cards cover diagnostic goals, key assessment tools, salient neuromuscular features, cranial nerve functions, prosodic elements, formal tests, and characteristic signs of various dysarthria types to aid exam preparation.

Motor Speech Disorder (MSD)

An impairment of speech production resulting from neurological damage affecting the motor‐planning, neuromuscular control, or execution of the speech musculature.

Dysarthria

A collective name for a group of MSDs caused by disturbances in muscular control of the speech mechanism due to CNS or PNS damage.

Apraxia of Speech (AOS)

A motor speech disorder marked by impaired capacity to plan/program sensorimotor commands for directing movements that result in phonetically and prosodically normal speech.

Assessment Goals

Determine presence and type of MSD, affected subsystems, functional impact, participation limits, prognosis, and treatment plan.

Case History

The portion of the evaluation in which personal, medical, and communication information is gathered to guide diagnosis and goal setting.

Perceptual Assessment

Clinician’s auditory‐perceptual judgments of speech used as the gold standard for diagnosis, severity rating, and treatment planning.

Instrumental Assessment

Use of acoustic, physiologic, or visual‐imaging tools to quantify speech characteristics and underlying pathophysiology.

Acoustic Measures

Instrumental assessments that analyze the sound signal (e.g., SPL meter, pitch analysis, nasometer).

Physiologic Measures

Instrumental assessments that record movement, muscle activity, or aerodynamics (e.g., EMG, spirometry, IOPI).

Visual Imaging

Direct visualization of speech structures in motion (e.g., videofluoroscopy, nasoendoscopy, videostroboscopy, FEES).

DAB Classification

System by Darley, Aronson & Brown that links perceptual speech features to presumed neuropathophysiology and lesion site.

Subsystems of Speech

Respiration, phonation, resonance, articulation, and prosody.

Maximum Phonation Time (MPT)

Duration a person can sustain a vowel on one breath; normal adult ≥9 s.

Alternating Motion Rate (AMR)

Rapid repetition of a single syllable (/p/, /t/, /k/) to assess speed and regularity of reciprocal movements.

Sequential Motion Rate (SMR)

Rapid repetition of a syllable sequence (/pʌtəkʌ/) to assess ability to sequence articulatory movements.

Speech Intelligibility

Degree to which a listener understands the acoustic signal produced by a speaker.

Comprehensibility

Overall understanding of spoken messages using both speech signal and contextual cues.

Efficiency (in MSD)

Rate at which intelligible speech conveys information.

Quality of Life (QOL) Measure

Patient‐reported outcome tool assessing the impact of MSD on daily activities and participation.

SLUMS / MoCA

Brief cognitive‐linguistic screenings often administered alongside motor speech evaluations.

Respiratory Assessment

Observation of posture, breathing pattern, phrase length, and ability to support speech with adequate breath.

Stridor

Audible wheeze on inspiration indicating possible airway obstruction or laryngeal pathology.

Sustained Vowel Norms

Typical vowel duration: young M ≈ 23–35 s; young F ≈ 15–27 s; elderly M ≈ 13–18 s; elderly F ≈ 10–15 s.

Pitch Glide

Ascending and descending pitch task used to evaluate laryngeal range and control.

Hypernasality

Excessive nasal resonance during non‐nasal sounds due to VP inadequacy.

Hyponasality

Reduced nasal resonance during nasal sounds, often from nasal obstruction.

Nasal Air Emission

Audible or visible escape of air through the nose during pressure consonants.

AMR Patterns – Spastic

Slow and regular repetitions characteristic of spastic dysarthria.

AMR Patterns – Ataxic

Irregular (slow or normal) repetitions typical of ataxic dysarthria.

AMR Patterns – Hypokinetic

Rapid, blurred repetitions characteristic of hypokinetic dysarthria.

Salient Neuromuscular Features

Symmetry, strength, speed, range, steadiness, tone, accuracy, and sensation.

Muscle Strength

Force generated by muscles; weakness suggests LMN involvement and flaccid dysarthria.

Speed of Movement

Rate at which speech structures move; usually reduced except in some hypokinetic or hyperkinetic cases.

Range of Motion (ROM)

Distance traveled by articulators; often reduced or variable in MSDs.

Steadiness

Absence of involuntary oscillations; disturbed by tremor or other hyperkinesias.

Tone

Muscle tension at rest; can be low (flaccid), high (spastic/hypokinetic), or variable (hyperkinetic).

Accuracy

Precision of speech movements integrating strength, speed, ROM, tone, and timing.

Oral Motor Examination (OME)

Structured evaluation of oral structures and movements at rest, in sustained postures, and in movement.

Facial Asymmetry

Unequal appearance or movement of facial structures indicating possible unilateral weakness.

Glottal Coup

Sharp glottal stop used to assess laryngeal adductor strength with minimal respiratory demand.

Cranial Nerve V (Trigeminal)

Nerve controlling jaw movement and facial sensation; damage causes jaw deviation to weak side.

Cranial Nerve VII (Facial)

Nerve controlling facial expression and lip movement; LMN lesion affects ipsilateral upper & lower face.

Cranial Nerve IX (Glossopharyngeal)

Supplies stylopharyngeus; difficult to test directly at bedside, contributes to gag reflex sensation.

Cranial Nerve X (Vagus)

Innervates velum, pharynx, larynx, and UES; lesions affect voice, resonance, swallow, cough.

Cranial Nerve XII (Hypoglossal)

Controls tongue muscles; tongue deviates toward weak side with LMN lesion.

UMN vs LMN Lesion – Tongue

UMN lesion → contralateral weakness; LMN lesion → ipsilateral weakness with atrophy/fasciculations.

Nonverbal Oral Apraxia

Impaired volitional movement of orofacial structures unrelated to weakness or comprehension deficits.

Maximum Performance Tasks

Stress tests (e.g., counting to 100) used to reveal fatigue‐related speech changes.

Frenchay Dysarthria Assessment

Standardized test combining OME with speech component ratings from syllables to conversation.

Apraxia Battery for Adults-2 (ABA-2)

Commercial test assessing limb/nonverbal apraxia and apraxia of speech across six subtests.

Assessment of Intelligibility of Dysarthric Speech (AIDS)

Formal tool that quantifies single‐word and sentence intelligibility and communication rate.

ICE (Intelligibility, Comprehensibility, Efficiency)

Tripartite framework for rating spoken communication outcomes in MSD.

ASHA Functional Communication Measure (FCM)

7-point scale documenting functional speech production outcomes (levels CN–CH).

Motor Speech Intelligibility Scale

10-point clinician rating from normal speech (10) to nonvocal communication (1).

Prolonged “Ah” Task

Sustained phonation used to examine respiratory support and laryngeal function.

Stress

Prosodic use of pitch, loudness, or duration to emphasize syllables/words.

Intonation

Pattern of pitch variation across an utterance conveying linguistic or emotional meaning.

Rate (Prosody)

Speed of speech output; may be fast, slow, or variable in MSDs.

Rhythm

Timing pattern of syllables and pauses; can become choppy in many dysarthrias.

Videofluoroscopy

Dynamic X-ray imaging of swallowing or speech movements for diagnostic analysis.

FEES (Fiberoptic Endoscopic Evaluation of Swallowing)

Endoscopic assessment of pharyngeal swallow and laryngeal function using a transnasal scope.

Nasometer

Instrument that measures acoustic energy from oral and nasal cavities to quantify nasalance.

Electromyography (EMG)

Physiologic recording of muscle electrical activity to assess neuromuscular function.

Spirometry

Measurement of lung volumes and airflow used in respiratory assessment.

IOPI (Iowa Oral Performance Instrument)

Device measuring tongue or lip strength and endurance via pressure sensors.

fMRI

Functional imaging technique detecting brain activity through blood oxygenation changes.

PET

Imaging that tracks metabolic activity with radioactive tracers, useful in neural function studies.

MEG

Technique measuring magnetic fields produced by neuronal activity for high-temporal-resolution brain mapping.

Transcranial Magnetic Stimulation (TMS)

Non-invasive brain stimulation/assessment method using magnetic fields to induce cortical activity.

AMR Expected Rate

Adult average ≈ 6 repetitions per second for /p/, /t/, /k/.

SMR Expected Rate

Adult average ≈ 5 repetitions per second for /pʌtəkʌ/ sequence.

Ataxic Speech Signs

Irregular AMRs, excess and equal stress, timing inaccuracy linked to cerebellar pathology.

Spastic Speech Signs

Strained‐strangled voice, slow AMRs, low pitch, hypernasality from bilateral UMN lesions.

Flaccid Speech Signs

Breathiness, nasal emission, imprecise consonants due to LMN weakness and low tone.

Hypokinetic Speech Signs

Monopitch, monoloudness, rapid AMRs, short rushes, often associated with Parkinson’s disease.

Hyperkinetic Speech Signs

Sudden involuntary movements causing variable loudness, pitch breaks, and unpredictable articulatory distortions.

Confirmatory Signs

Non-speech or ancillary findings (e.g., limb tremor, fasciculations) supporting MSD diagnosis.

Translator (in MSD context)

Familiar communication partner who restates an unintelligible speaker’s message to listeners.

Compensatory Strategy

Adaptive technique (e.g., slower rate, augmentative device) used by speakers to improve communication.

Listener Burden

Effort required by a listener to understand speech; increases with low intelligibility or efficiency.

Snout Reflex

Primitive reflex elicited by tapping the philtrum resulting in lip pout; may return with UMN disease.

Gag Reflex

Pharyngeal response to tactile stimulation; afferent IX, efferent mostly X.

Silent Aspiration

Entry of material into airway without cough or overt symptom, often due to sensory vagal deficit.

Mendelsohn Maneuver

Swallowing exercise increasing hyolaryngeal elevation to improve UES opening.

CTAR (Chin Tuck Against Resistance)

Exercise targeting suprahyoid strengthening to aid UES opening.

Shaker Exercise

Head-lifting exercise enhancing suprahyoid muscle strength for pharyngeal swallow improvement.

Ear Training

Clinician practice to improve perceptual discrimination and reliability in MSD assessment.