Communication Sciences and Disorders Cumulative Capstone Final

WHO-ICF

World Health Organization’s International Classification of Functioning Disability & Health

What does the WHO-ICF (World Health Organization International Classification of Functioning Disability & Health) provide?

It provides professionals with a standardized language and way of classifying functioning and disability in a relationship

What are the sections of the WHO-ICF?

There are two sections of the WHO-ICF: health condition and contextual factors

Ethnicity

A social group with shared history, nationalities and traditions, such as “kinship, family, rituals, good, preferences and celebrations”

True or False: Surgical intervention for cleft palate takes place prior to repair of cleft lip, which is completed as the infant/child ages

False

When can cleft lip/palate be identified and how?

identified around 12 weeks gestation age via ultrasound

True or false: cleft lip/palate can be identified around 12 weeks gestation age via ultrasound

True

Identify the categories of manner of sound production that tend to be disordered in children with cleft lip and palate

stops and fricatives

Feeding disorders can occur in infants with cleft lip/palate. Issues can include:

• Nasal regurgitation during feeding

• Reduced ability to create suction to express milk from the nipple

• Increased intake of air during feeding

__ typically does NOT include cleft of the lip

Incomplete cleft of the palate

Due to issues that occur with jaw growth in cleft palate, this type of malocclusion occurs most frequently

Class III malocclusion (underbite)

What class malocclusion is underbite?

Class III malocclusion

What class malocclusion is overbite?

Class II malocclusion

What is Class III malocclusion?

Underbite

What is class II malocclusion?

overbite

True or false: The terms rehabilitation and habilitation are synonyms and can be used interchangeably

False

True or false: Currently, there are over 2,000 speech-language pathologists in the state of FL who have received certification in Listening and Spoken Language from the A.G. Bell Academy

False

Identify the characteristics that can be seen in stuttering

Prolongations of sounds, repetitions of sounds, repetitions of syllables

From the following choices, identify motor speech disorders: dysarthria, apraxia, dysphagia, laryngectomy

dysarthria and apraxia

Identify the systems that can be disrupted in dysarthria of speech

articulation, resonance, phonation, respiration

___ dysarthria typically results from bilateral upper motor neuron disease

spastic

__ dysarthria is typically seen in Parkinson’s Disease

Hypokinetic

True or False: The term dysphagia refers to a motor speech disorder

False

True or False: A patient who has undergone a total laryngectomy is likely to experience impaired articulation

False

True or False: Patients with apraxia of speech typically have significant muscle weakness of the lips and the tongue

False

True or False: Symptoms of an acquired stuttering disorder typically begin in early childhood

false

What speech disorder is the disruption in the function or coordination of the systems/muscles of speech production?

Dysarthria

Dysarthria

A speech disorder that is the disruption in the function or coordination of the systems/muscles of speech production

Individuals who only have dysarthria do not have a __ impairment

language

Medical conditions associated with acquired speech disorders

amyotrophic lateral sclerosis (ALS), Parkinson’s Disease, Multiple Sclerosis, Huntington’s Disease, Stroke (CVA), Traumatic Brain Injury

What type of disorders are dysarthria and apraxia?

motor speech disorders

Can dysarthria co-occur with other speech and language disorders?

Yes

When does dysarthria usually co-occur with other speech and language disorders?

This frequently occurs when a stroke is the etiology for the communication impairment

dysarthria

disruption in the function or coordination of the muscles of speech production

What is the disruption in the function or coordination of the muscles of speech production?

dysarthria

What does dysarthria result from?

Can result from an impairment of respiration, phonation, articulation, resonance and/or prosody

What age ranges does dysarthria occur in?

can occur in both adults and children

Dysarthria is frequently seen in children with __

cerebral palsy

When dysarthria is frequently seen in children with cerebral palsy, is this case typically considered to be a congenital disorder or an acquired one?

congenital

What is dysarthria typically caused by?

impaired motor neuron function because there is typically impairment in the function of the muscles of speech due to disruption or impairment of the nerves that innervate those muscles

Different types of dysarthria result from…

damage to different locations within the nervous system

Upper motor neurons

originate in the brain and travel to the brainstem or the spinal cord; they interact/communicate with lower motor neurons

Lower motor neurons

originate in the spinal cord and innervate glands and muscles (including skeletal muscles) throughout the body

Which neural bases originate in the brain and travel to the brainstem, and interact/communicate with lower motor neurons?

Upper motor neurons

Which neural bases originate in the spinal cord and innervate glands and muscles (including skeletal muscles) throughout the body?

lower motor neurons

Types of Dysarthria

Spastic, Flaccid, Ataxic, Hypokinetic, Hyperkinetic, Mixed

Spastic, Flaccid, Ataxic, Hypokinetic, Hyperkinetic and Mixed are

types of dysarthria

What does spastic dysarthria result from?

results from bilateral upper motor neuron

What do upper motor neurons inhibit?

when properly functioning, it inhibits muscle contraction

What happens when bilateral upper motor neuron damage is present?

The muscles become stiff and their range of motion (ROM) is reduced

What does it mean when speech muscles are spastic?

Sluggish, slow, labored movements of the articulators

When spasticity is present, muscles respond better at attempts at __ movement, rather than rapid movement

muscles respond better at attempts at slow movement, rather than rapid movement

Why do attempts to produce rapid speech create greater problems for individuals with spastic dysarthria?

When spasticity is present, muscles respond better at attempts at slow movement, rather than rapid movement

What does flaccid dysarthria result from?

lower motor neuron damage/disease and muscle weakness (not spasticity)

What is the rate of speech in flaccid dysarthria?

slow

What is the movement of articulators in flaccid dysarthria?

imprecise

Why is there imprecise/impaired phoneme production in flaccid dysarthria?

the muscle weakness causes imprecision in the movements of articulators

What causes hypernasality in flaccid dysarthria?

weakness of velopharyngeal closure

Hypernasality may be present in varying degrees due to weakness of velopharyngeal closure. Depending upon the degree of impairment, intervention with __ may be required to improve palatal closure

a palatal prosthesis or with a palatal lift surgery

In Flaccid Dysarthria, ___ is reduced

phrase length

In flaccid dysarthria, there may be an impairment of the voice due to possible

impaired movement of the true vocal fold(s)

Ataxic Dysarthria results from

lesions/disease of the cerebellum (this portion of the brain is responsible for coordination)

Which portion of the brain is responsible for coordination?

cerebellum

What is the cerebellum responsible for?

coordination

Ataxic movements

discoordinated in any part of the body

Ataxic dysarthria is characterized by

somewhat irregular, discoordinated speech

Prosody of speech in ataxic dysarthria

usually impaired with too little or too much stress on a syllable or word

monopitch

reduced pitch variability

Reduced pitch variability

monopitch

Vocal quality in ataxic dysarthria can be impaired with

vocal harshness evident along with reduced pitch variability (monopitch)

Ataxic dysarthria treatment

includes targeting precision of articulatory movements and improving the timing of articulation

Hypokinetic dysarthria results from

damage/disease to what is called the extrapyramidal system in the brain

This type of dysarthria results from damage/disease to what is called the extrapyramidal system in the brain

hypokinetic dysarthria

The basal ganglia is a part of the __ system

extrapyramidal system

Extrapyramidal system

a system of nerve fibers located deep within the brain that are responsible for involuntary/automatic control of muscles, including control of muscle tone, balance, posture and movement

What is a system of nerve fibers located deep within the brain that are responsible for involuntary / automatic control of muscles, including muscle tone, balance, posture and movement

extrapyramidal system

Parkinson’s disease

one of the most common types of extrapyramidal disorders that results from lack of dopamine

What is hypokinetic dysarthria characterized by?

slow, imprecise articulation

Why is vocal intensity reduced in hypokinetic dysarthria?

due to reduction in coordination of respiration and phonation

How intonation is impacted in hypokinetic dysarthria

intonation is impaired (speech is monotone)

In hypokinetic dysarthria, speech output tends to

come in short bursts

What does hyperkinetic dysarthria have in common with hypokinetic dysarthria?

they’re both caused by a disorder of the extrapyramidal system

What does the term hyperkinetic mean?

too much movement

A slow form of hyperkinetic dysarthria is characterized by

slow involuntary movements of the speech mechanism

Hyperkinetic dysarthria with quick movements is characterized by

rapid jerks or tics of structures in the speech mechanism

Hyperkinetic dysarthria is seen in which disease?

Huntington’s

Mixed Dysarthria

This type of dysarthria results from damage to more than one portion of the neuromotor system and results in a variety of symptoms, a “mix”

Amyotrophic lateral sclerosis (ALS)

A disease that involves both upper and motor neurons

Individuals with Amyotrophic lateral sclerosis (ALS) typically have what type of dysarthria?

mixed dysarthria (in this case both spastic and flaccid dysarthria occur at the same time)

Why do individuals with Amyotorphic lateral sclerosis (ALS) have mixed dysarthria?

Mixed dysarthria results from damage to more than one portion of the neuromotor system and ALS is a disease of both upper and lower motor neurons

What type of disorder is apraxia?

motor planning

In apraxia, there typically isn’t any evidence of __ weakness

oral

Individuals with apraxia demonstrate difficulty in

planning for the movements required for speech

Apraxia of speech

the message sent from the brain to “tell” the articulators how to move is disrupted; this results in an impairment in motor planning for movements required for speech

What causes apraxia of speech?

a lesion in the left hemisphere of the brain in the area of the lateral premotor cortex and the anterior insula

Speech characteristics of

From the choices provided, which deficits can be seen in right-handed patients with a stroke in the right hemisphere of the brain?: Flat affect, aphasia, visual scanning deficits, impaired orientation

visual scanning and impaired orientation