Speech Sound disorders

apraxia of speech

a motor speech disorder which impacts the abilityto execute purposeful speech movements

dysarthria

*a motor speech disorder associated with muscle paralysis, weakness or incoordination.

*Affects different subsystems of speech

*causes - stroke, tbi, parkinsons, MLS

Subsystems affected by dysarthria

Respiration•

Phonation•

Resonance•

Articulation•

Prosody

articulation

the ability to produce the sound with the use of the articulators

phonological processes

*way to simplify speech; patterns children follow to simplify speech

*Phonology - the study of the sound system of language including speech sounds, speech patterns, and the rules that apply to them.

acquired disorders of speech

*Usually pertains to the adult population, but not always...•

*Results from neurological damage to the systems and structures that affect speech production•

*Motor Speech Disorders - Dysarthria, Apraxia•

*The Cranial Nerves

types of dysarthria

Flaccid•

Spastic•

Mixed•

Ataxic•

Hypokinetic•

Hyperkinetic

deficits due to dysarthria

*Imprecise speech

*Vowel distortions

*Hypernasality or hyponasality

*Atypical pitch/voice quality

*Voice tremors

*Audible inhalation

*Reduced loudness

*Shortened phrases

*Variable speech rate

*Atypical stress patterns

*Abnormal muscle tone

*Involuntary nonspeech tremors

Essential components of dysarthria assessment

*orofacial exam

*diadochokinetic rates

*speech samples- describing pictures, talking about a hobby, reading, etc.

* helps identify - strength, speed, ROM, coordination, symmetry, tone, function

acquired apraxia of speech

*Motor speech disorder impactsone's ability to complete volitional speech tasks

*NOT related to muscle weakness

*Motor programming impairment

*caused by Stroke, TBI, neurodegenerative condition

*impacts artivulation/ prosody

characteristics of AOS

*Articulation errors with more consonant errors than vowel errors• *Voiced phonemes produced without voice•

*Stress across syllables•

*Sounds and/or syllables may be elongated•

*Speech rate slow overall•

*Sound and syllable repetitions•

*Diadochokinetic speech tasks may reveal deficiencies•

*Automatic speech utterances- may be intact•

*Struggle behaviors (groping)•

*AOS can improve, remain stable, or worsen

Assessment of AOS

*orofacial exam, diadochokinetic rate, and speech samples• *Evaluate: Automatic speech, spontaneous speech, oral reading

Clients with AOS exhibit more errors in...

spontaneous speech and oral reading tasks and

Clients with AOS exhibit less errors in...

automatic speech tasks, automatic speech tasks, and overlearned phrases

Factors that affect intelligibility

*Frequency and types of errors

*Listener's familiarity with speaker*Contextual clues

*Face to face contact

*Nonverbal communication

*The environment

Calculating intelligibility

Transcribe the speech sample and calculate the percentage of words understood.

stimulability

*A client's ability to produce a correct production of an erred phoneme

*Assessment of stimulability provides prognostic information

*Ability to stimulate erred sounds is based on a working knowledge of speech mechanics

childhood apraxia of speech

*organic disorder not a functionl disorder•

*difficulty sequencing sounds, syllables, and words for speech; DESPITE normal muscle function (i.e., no weakness)•

3 features of CAS

1. Inconsistency of errors

2. Lengthened and disrupted coarticulatory transitions

3. inappropriate prosody

characteristics of CAS

*Non-speech behaviors- ex. Mild delays in motor development• *Speech behaviors - ex. Vowel errors , groping•

*Prosodic - ex. Equal stress•

*Speech perception - usually reduced• Language characteristics; ex. Gap between receptive and expressive language skills• *Metalinguistic - ex. Reduced phonological awareness