Chapter 12 Flashcards

1
Q

Definition of motor speech disorder

A

an impairment of speech production caused by defects of the neuromuscular system, the motor control system, or both

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2
Q

what defects of a motor speech disorder result in significant difficulties producing fluent, intelligible speech?

A

planning, programming, and executing speech systems

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3
Q

Definition of Systems of Speech Production

A

Systems of muscles which coordinate with other muscles within and across subsystems

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4
Q

four Systems of Speech Production

A

Articulatory System

Respiratory System

Resonatory System

Phonatory System

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5
Q

Definition of respiratory system

A

system that regulates the inhalation/exhalation cycle for passive breathing and for producing speech

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6
Q

what is the key structure of the respiratory system?

A

lungs

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7
Q

what muscles and Articulators are involved with the respiratory system?

A

respiratory and postural muscles

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8
Q

true or false: breath support is crucial for oxygen intake as well as for speech production

A

true - the duration of inhalation versus exhalation corresponds to a ratio of approximately 1:1, but in speech production this ratio ranges from about 1:6 to 1:9

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9
Q

Definition of Phonatory System

A

system that regulates the production of voice and the prosodic or intonational aspects of speech

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10
Q

what is the key structure of the Phonatory System?

A

larynx

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11
Q

what muscles and/or Articulators are involved with the Phonatory system?

A

vocal folds

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12
Q

Definition of glottis

A

the opening between the vocal folds

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13
Q

Definition of subglottal air pressure

A

air pressure that sets the vocal folds into cycles of vibration

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14
Q

true or false: voiceless consonants are produced without vocal fold vibration

A

true

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15
Q

phonatory system coordinates with the respiratory system to provide what?

A

the airflow needed for phonation

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16
Q

true or false: the phonatory system is essential for producing both voiced and voiceless sounds

A

true

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17
Q

how are voiced sounds produced?

A

vocal folds are brought close together (adduction) by various muscle groups so that the airflow causes them to vibrate

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18
Q

Definition of Resonatory System

A

system that regulates the resonation or vibration of the airflow as it moves from the pharynx into the oral and/or nasal cavities

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19
Q

what are the key structures of the Resonatory System?

A

velopharyngeal port and pharynx

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20
Q

what muscles and Articulators are involved with the Resonatory System?

A

velum and pharynx

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21
Q

Resonance refers to the effects of what?

A

the shape and size of the vocal tract on sound quality,

whether the nasal cavity is used as a vibrating chamber

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22
Q

Definition of velopharyngeal port

A

opening between the velum (soft palate) and the back of the pharyngeal wall

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23
Q

what is the velopharyngeal port responsible for?

A

sound quality/vocal resonance - whether the nasal cavity is used as a vibrating chamber

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24
Q

When the velum is ____, the velopharyngeal port is closed and air flows out through and resonates where?

A

raised; within only the oral cavity

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25
Q

When the velum is _____, the velopharyngeal port is open and air flows out through where?

A

lowered; both the oral and nasal cavities

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26
Q

when does nasality occur?

A

when the velum is lowered and the velopharyngeal port is open and air flows out through both the oral and nasal cavities

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27
Q

why is regulation of the velopharyngeal port important?

A

for producing the difference between oral and nasal sounds

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28
Q

Definition of Articulatory System

A

system that regulates the control of the articulators within the oral cavity to manipulate the outgoing airflow

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29
Q

what is the key structure of the Articulatory System?

A

oral cavity

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30
Q

what muscles and Articulators are involved with the Articulatory System?

A

jaw, lips, tongue

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31
Q

what is probably the most important articulator and why?

A

the tongue because of its flexibility and capacity for high-speed motion

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32
Q

four sections of the tongue

A

apex (tongue tip)

blade (front of tongue)

center (middle part)

dorsum (back of tongue)

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33
Q

true or false: consonants involve a constriction in the vocal tract

A

true

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34
Q

true or false: vowels involve a constriction in the vocal tract

A

false - little or no constriction of the vocal tract but a modulation of the shape of the oral cavity by the tongue, lips, or jaw

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35
Q

Definition of Diphthongs

A

a variety of vowels that involve a gliding movement in the production of the sound (ex. oy)

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36
Q

why does the actions of the articulatory system must work seamlessly with the other systems (respiratory, phonatory, and resonance)?

A

to produce well-articulated and fluent speech that unfolds overtime

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37
Q

true or false: given the complexity, only adults may experience failures in motor speech coordination

A

false - children and adults

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38
Q

two causes of breakdowns in the larger motor speech production system

A

the four individual systems are poorly coordinated

deficits in the coordination of the muscles and muscle groups within a specific system

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39
Q

Definition of Speech Motor Control

A

coordination of muscle activity across a wide range of muscle groups within the four systems of speech production

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40
Q

what does the coordination between the four systems of speech production involve to produce accurate and fluent articulation?

A

programming particular configurations of muscle activity into single motor units

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41
Q

Definition of Motor Planning

A

the processes that define and sequence articulatory goals prior to their occurrence (ex. lip closure, onset of voicing)

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42
Q

Definition of Motor Programming

A

the processes responsible for establishing and preparing the flow of motor information across muscles for speech production and specifying the timing and force required for the movements

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43
Q

Definition of Motor Execution

A

the processes responsible for activating relevant muscles during the movements used in speech production

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44
Q

true or false: motor planning and programming are aspects of motor control that occur before or during initiation of movement

A

false - only before

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45
Q

true or false: motor execution occurs at or after initiation of movement

A

true

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46
Q

Definition of Motor learning

A

the way in which practice or experience leads to relatively permanent changes in the capability for movement

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47
Q

true or false: Prevalence and Incidence rates for specific motor speech disorders are rare

A

true

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48
Q

how are motor speech disorders classified?

A

etiology, manifestation, severity

49
Q

acquired motor speech disorders are a result from what?

A

damage to a previously intact nervous system

most often caused by stoke, degenerative diseases such as Parkinson’s, brain tumors, and traumatic head injury

50
Q

developmental motor speech disorders are a result from what?

A

abnormal development of the nervous system or from damage to the nervous system in early development

51
Q

Abnormal development vs Damage to the developing nervous system

A

various congenital diseases, including cerebral palsy and genetic syndromes such as Down syndrome

traumatic brain injury, brain tumors, and stroke

52
Q

two divisions of motor speech impairments

A

motor planning and programming

impairments of motor execution

53
Q

true or false: breakdowns at all levels of the motor speech system are possible

A

true

54
Q

example of breakdowns at the level of execution

A

Paralysis of the tongue will seriously impede speech production regardless of whether speech is planned and programmed normally or not

55
Q

example of breakdowns at the level of planning and programming

A

The patient may not experience paralysis of the tongue but may have difficulty moving the tongue in the right way

56
Q

three aspects of a disorder that determines how it affects a patient’s life

A

disease, activity, and participation in life

57
Q

Definition of disease with a motor speech disorder

A

the neurological deficit impacting speech production and its systems

58
Q

Definition of activity level with a motor speech disorder

A

the actual behavioral or performance deficits that result from the disease - speech intelligibility and fluency or naturalness

59
Q

Definition of participation in life with a motor speech disorder

A

how the speech impairment impacts an individual’s performance at home, at school, at work, and in the community

60
Q

true or false: the effects of neurological disease on an individual differ from person to person even if the cause and severity of the disease are similar

A

true

61
Q

what two disorders are motor speech disorders divided into?

A

motor planning and programming

motor execution

62
Q

what are motor planning and programming disorders caused by?

A

an inability to group and sequence the relevant muscles with respect to one another in order to plan or program movement.

63
Q

what are motor execution disorders caused by?

A

deficits or inefficiencies in basic physiological or movement characteristics of the musculature, such as muscle tone, movement speed, and movement range

64
Q

Definition of apraxia of Speech

A

an impairment of motor programming and planning that involves an inability to transform a linguistic representation into the appropriate coordinated movements of the articulators

65
Q

true or false: AOS is the result of a language disturbance or an impairment of the neuromuscular system

A

false: result of an impairment of the ability to plan and program the relevant articulator movements

66
Q

where is the location of the AOS impairment?

A

the articulatory system

67
Q

seven characteristics of AOS

A

effortful, slow speech with increased pauses between syllables and sounds

prolonged durations of speech sounds

distortions of speech sounds

reduced prosody

errors that are consistent in type and location within an utterance although the actual error may vary across utterances or productions.

Difficulties with initiating speech

Grouping of the articulators when producing speech

68
Q

true or false: AOS occurs as a result of neurological damage to the area, surrounding Broca’s area

A

true

69
Q

what is the most common cause of AOS?

A

stroke

70
Q

Definition of Childhood Apraxia of Speech (CAS)

A

a phonetic-motoric disorder of speech production

71
Q

what are children with apraxia of speech unable to do?

A

translate linguistic or phonetic information concerning speech production to accurate motor behaviors

are unable to learn the motor behaviors to execute planned speech

72
Q

true or false: The symptoms of CAS are the same as those of AOS

A

true

73
Q

true or false: For many cases of CAS there is no evidence of specific neurological damage to the brain

A

true

74
Q

three symptoms of CAS

A

delays in their development of speech production

have a limited sound inventory when producing syllables and words

severe unintelligibility and progress slowly in speech therapy

75
Q

true or false: dysarthria is not an impairment of planning and programming of speech movements

A

false: it is a disruption in the execution of speech movements

76
Q

what does dysarthria result from?

A

underlying neuromuscular disturbances to muscle tone, reflexes, and kinematic aspects of movement, such as speed, range, accuracy, and steadiness

77
Q

characteristics of dysarthria

A

speech that sounds:

slow
slurred
overly harsh or quiet
uneven

78
Q

true or false: dysarthric speech is generally more consistent in types of errors and amount of intelligibility compared to apraxic speech

A

TRUE

79
Q

Definition of spasticity

A

increased deep tendon reflexes, hypertonic muscles, and underdevelopment of limbs

80
Q

Definition of dyskinesia

A

slow, writhing involuntary movements due to disturbances in muscle tone

81
Q

Definition of ataxia

A

weakness, tremors, and lack of coordination

82
Q

what are the two types of developmental Dysarthria?

A

spastic and dyskinetic

83
Q

characteristics of Spastic Dysarthria

A

hypertonicity and hyperreflexia

84
Q

true or false: there are considerable variability among children with respect to severity and the systems affected with Spastic Dysarthria

A

true

85
Q

do many children have spasticity of upper or lower limbs or both?

A

both

86
Q

what other disorder’s symptoms does Spastic Dysarthria match?

A

acquired spastic dysarthria + may have inadequate breath support for producing speech + may produce speech in short phrases

87
Q

characteristics of Dyskinetic Dysarthria

A

impaired coordination of muscles and involuntary movements, including chorea and athetosis

88
Q

Definition of chorea

A

sudden fast, flailing, jerking movements

89
Q

Definition of athetosis

A

slow, writhing movements

90
Q

true or false: in most cases of dyskinetic dysarthria all four limbs are affected

A

true

91
Q

symptoms of children with dyskinetic dysarthria

A

a hard time producing speech

speech may be strained, harsh, and low

abnormally large jaw movements when producing speech, resulting in imprecise and unintelligible speech

92
Q

Causes and Risk Factors of dyskinetic dysarthria

A

damage to the nervous system prenatally, perinatally, and postnatally

93
Q

perceptual measures of assessment for motor speech disorders

A

the most commonly used

involves perceptual judgments of intelligibility, accuracy, and speed of speech production

characterize the impact of the disorder on various aspects of speech

94
Q

acoustic measures of assessment for motor speech disorders

A

involves a visual representation of the speech sound wave and allowing for a more detailed examination of speech abnormalities that may not be perceptible to the eye and ear

95
Q

physiological measures of assessment for motor speech disorders

A

involve measurement of physiological aspects of the· speech motor system such as muscle strength, endurance, and airflow

96
Q

true or false: assessment for motor speech disorders should include motor control tasks that involve speech and nonspeech movements

A

true

97
Q

true or false: the examination of motor speech tasks that do not involve language should not exhibit some degradations of motor control when a motor speech disorder is present

A

false - they should exhibit

98
Q

The evaluation of should include assessments of each of the speech systems ______.

A

SEPARATELY

99
Q

Respiration system assessment

A

assess both perceptual measures (e.g., how long patient can sustain a breath) and physiological measures (e.g., determining patient’s vital capacity).

100
Q

phonation system assessment

A

use perceptual, acoustic, and physiological measures

101
Q

resonation system assessment

A

Watch for hypernasality, hyponasality, and nasal emission

102
Q

articulation system assessment

A

Watch for reduced muscle strength of the tongue, reduced speech rate, and speech sound substitutions and distortions

103
Q

Dysarthric errors are likely to be _____, while apraxic errors are likely to be ______

A

consistent; inconsistent

dc, ai

104
Q

prosody assessment

A

Watch for inappropriate prosodic variations (loudness, pitch, duration, rhythm).

105
Q

Definition of differential diagnosis

A

a diagnosis that differentiates a person’s disorder from other similar disorders

106
Q

why is differential diagnosis in motor speech disorders so important?

A

because the type of treatment depends on the nature of the disorder, and what may be effective for one disorder may not be effective for another

107
Q

true or false: treatment for the motor speech impairment itself is typically provided by the SLP through inpatient or outpatient therapy

A

true

108
Q

what is the first goal of therapy with motor speech treatment?

A

to learn or relearn accurate production of speech for improved speech intelligibility

109
Q

what is the second goal of therapy with motor speech treatment?

A

to maximize generalization - underlying capability for movement should be facilitated by treatment so that untrained tasks also improve

110
Q

what are the two primary therapeutic strategies of motor speech disorders?

A

to (1) improve the impaired system(s), and (2) teach compensatory strategies

111
Q

five retreatment considerations for motor speech therapy

A

Memory

Attention

Motivation

goal setting

correctness reference

112
Q

three goals in treatment of the respiratory system

A

improving respiratory support

modifying inspiration and exhalation and their interrelationship

improve the buildup of subglottic air pressure

113
Q

two goals in treatment of the phonatory system

A

improve voice quality

improve control over the vocal folds

114
Q

goal of reatment of the resonatory system

A

strengthen and increase control over the velopharyngeal port

115
Q

treatment of the articulatory system

A

look up

116
Q

two goals in treatment of prosody and rate control

A

exercises geared toward increasing the range of the affected factors, such as contrastive drills (differ vs defer)

117
Q

true or false: prosody is non-essential for producing natural sounding speech

A

false - it is essential

118
Q

prosody involved reductions of the range in one or more of what three factors?

A

loudness, pitch, and/or duration