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Hagge MSD Final > Chapter 13 > Flashcards

Chapter 13 Flashcards

1
Q

What is apraxia of speech (AOS)?

A
  • neurologic speech disorder
  • impaired ability to plan or program sensorimotor commands needed for directing movements that result in phonetically and prosodically normal speech
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2
Q

T/F AOS is synonymous with Broca’s or non fluent aphasia

A

false; people with broca;s or nonfluent aphasia OFTEN have an accompanying AOS

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3
Q

T/F All sound level errors made by persons with aphasia are manifestations of AOS

A

false

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4
Q

T/F Ideomotor apraxia is the loss of ability to carry out motor plan for movements

A

true; AOS, limb apraxia, and nonverbal oral apraxia are subtypes of this form of apraxia

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5
Q

Where is the brain damage located for someone with AOS?

A

left frontal lobe, especially if damage is near Broca’s area

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6
Q

Where is the motor speech programmer located in the brain?

A

left cerebral hemisphere, especially parietal-frontal

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7
Q

Describe what nonverbal (nonspeech) oral apraxia (NVOA) is

A

the inability to imitate or follow commands to perform volitional movements of speech structures (cough, blow, click tongue)

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8
Q

NVOA cannot be attributed to… (3 things)

A

poor a/c
sensory deficits
neuromuscular deficits

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9
Q

T/F someone with NVOA is able to do voluntary, but not involuntary movements

A

false; can do involuntary, not voluntary

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10
Q

What is the most common etiology for AOS?

A

left hemisphere stroke

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11
Q

T/F a patient with AOS will usually complain of chewing or swallowing difficulties

A

false

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12
Q

What should someone with AOS also be screened for?

A

aphasia

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13
Q

T/F If no dysarthria is present, then chewing/swallowing functions may be entirely normal

A

true

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14
Q

Name 3 perceptually salient characteristics of AOS

A

consonant and vowel distortions
slow overall rate
prosodic abnormalities

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15
Q

Describe the hierarchy of difficulty for phonemes from easiest to most difficult

A

easiest- vowels, semivowels /r/ and /l/, glides, nasals
more difficult- plosives, fricatives, affricates
most difficult- clusters of consonants

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16
Q

T/F there will be fewer errors in producing singe words, and more errors in production of phrases and sentences

A

true

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17
Q

What assessment could be used to measure intelligibility?

A

Word Intelligibility test, ABA

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18
Q

What are some major goals of treatment?

A
  • help with reorganization of internal circuits for motor planning for speech
  • help patient be able to access stored patterns and sequences for speech
  • emphasize movement and coordination of articulators in meaningful speech tasks
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19
Q

Name the two broad avenues of treatment

A

Intrasystemic reorganization and intersystemic reorganization

20
Q

integral stimulation

A

ask patient to watch, listen and do it with you

21
Q

Multiple input phoneme therapy

A
  • for severely apraxic patient
  • begin with patient’s stereotype
  • repetitions of stereotypey become varients of stereotypy and move up a hierarchy
22
Q

Sound production treatment

A
  • aka minimal contrast treatment
  • uses repetition, integral stimulation, modeling, phonetic placement cues, feedback to facilitate consonant production
  • determine stimuli based on error patterns
23
Q

Voluntary control of involuntary utterances (Helm-Estabrook)

A
  • for patient with nonfluent aphasia, moderate preserved comprehension
  • identify any real words used
  • use word in an oral reading task
  • create list of words used involuntary, even those based on errors
24
Q

Melodic intonation therapy

A
  • exploits melodic abilities of right hemisphere in nonfluent aphasic persons (severe)
  • incorporates integral stimulation, repetition, gradual fading of cues, enforced delays
  • need relatively preserved comprehension and self-monitoring skills
25
Q

How can you help with apraxia of phonation (muteness)

A
  • shape from a yawn, grunt, or cough
  • quick push on abdomen while mouth is open
  • providing tactile cues to surface of larynx with clinician’s hand
  • pairing symbolic gesture with word
26
Q

What is anarthria?

A

speechlessness due to severe loss of neuromuscular control over speech

27
Q

T/F Individuals with anarthria do not speak because they don’t want to speak

A

false; because they cannot speak

28
Q

T/F flaccid dysarthria almost always leads to anarthria

A

false; flaccid dysarthria alone seldom leads to anarthria

29
Q

What type of dysarthrias are the most likely reasons for anarthria?

A

spastic and hypokinetic

30
Q

Unilateral or bilateral involvement for anarthria?

A

bilateral

31
Q

Locked-in syndrome (brain-stem stroke)

A
  • mute and quadriplegic; preserved consciousness and vertical eye movements
  • severe dysphagia
32
Q

Biopercular syndrome

A
  • rare disorder

- bilateral damage to lower part of heminspheres

33
Q

Cerebellar mutism

A
  • primarily in children
  • almost always after surgery/transient
  • surgery in the posterior fossa
34
Q

T/F Apraxia of speech and mutism seldom lasts longer than a few days when caused by a stroke

A

true; they also tend to have NVOA

35
Q

T/F Aphasia and mutism persisting even in persons with global aphasia is uncommon

A

true

36
Q

Describe what a coma is

A
  • “state of unarousable unresponsiveness”
  • absence of sleep/wake cycles on EEG
  • voluntary behavior is absent (eyes remain closed)
  • reflects a failure of the RAS, cortex, and absence of functions above brainstem level
  • usually secondary to TBI and vascular events
37
Q

Describe what being in a vegetative state means

A
  • “wakeful awareness”
  • no purposeful behavior
  • do not interact meaningfully with environment
  • muteness is consistent with a severely reduced level of arousal and cognition
  • follows an initial period of coma after TBI
38
Q

T/F recovery from vegetative state is considered unlikely when it persists longer than 3 weeks after trauma

A

false; 3 months after trauma

39
Q

define minimally conscious state

A
  • much more common than a vegetative state
  • persons show a degree of awareness/responsiveness
  • usually bedbound, incontinent, and require tube feeding
40
Q

8 step continuum

A
  • uses integral stimulation

- hierarchy that begins with most support and fades cues as time goes on

41
Q

Inter-systemic reorganization

A
  • use of non speech activities to facilitate speech

- pairing speech training with gestural cues, rate/rhythm cues, and vibro-tactile stimulation

42
Q

PROMPT

A

A multi sensory approach in which visual, auditory, tactile, and movement cues are given

43
Q

Kaufman Speech to Language Protocol

A
  • bottom up style of teaching and learning by beginning with easier, shorter approximations of a word and gradually advancing to more difficult approximations of the word as the child’s motor coordination improves
  • CAS
44
Q

Lee Silverman Voice Treatment

A
  • targets respiration and phonation
  • teaches patients with PD to improve functional intelligible oral communication by increasing vocal loudness, accomplished through phonatory effort tasks and respiratory support
45
Q

Horn therapy

A
  • oral/motor placement therapy
  • 12 horns that progress in a hierarchy from least to most complex
  • assists in improving speech clarity by targeting muscle-based systems while increasing sentence length
46
Q

Therapeutic singing

A

-addresses decreased respiratory and coordination of breath and decreased rate of speech, intelligibility, breath control, and vocal output

Hagge MSD Final (3 decks)

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