Artic Subsystem

Question 1

Currently, articulation may be the _______ target in dysarthria treatment

Answer 1

last

Question 2

Why would articulation be the last target in dysarthria treatment?

Answer 2

we can improve articulation indirectly by assessing and treating respiratory, laryngeal and VP systems first

Question 3

T or F: compensations are the articulatory level are common

Answer 3

True

Question 4

What articulatory compensations occur in ALS

Answer 4

• tongue & jaw for VPI

- jaw for tongue

Question 5

What articulatory compensations occur in PD?

Answer 5

tongue for jaw

Question 6

What is the ROM for jaw opening?

Answer 6

3-20mm

Question 7

What is the ROM for lip protrusion/separation?

Answer 7

10-12mm

Question 8

What is ROM for tongue elevation and tongue protrusion?

Answer 8

10-15mm

Question 9

What is the articulatory speed of the tongue tip

Answer 9

70-100mm/s

Question 10

What is the articulatory speed of the tongue dorsum

Answer 10

40mm/s

Question 11

What is the articulatory speed of the jaw

Answer 11

15-30mm/s

Question 12

The _______ is the fastest articulator

Answer 12

tongue tip

Question 13

Does the tongue move faster for /r/ or plosives

Answer 13

/r/ is faster than plosives, but movement for plosives is still faster than other sounds

Question 14

T or F: different underlying pathophysiologies can have identical effects on speech articulation

Answer 14

true

Question 15

Define weakness

Answer 15

reduced ability to produce force

Question 16

Define fatiguability

Answer 16

decrease in strength over time

Question 17

The maximum of the tongues force is 6-30N, but speech needs only _____% of max strength

Answer 17

5-20%

Question 18

If we want to make statements about articulator strength then we have to ___________

Answer 18

objectively measure strength

Question 19

Name an instrument to test tongue and lip strength and fatiguability

Answer 19

IOPI

Question 20

T or F: muscle spindles and golgi tendon organs have typical distribution in speech musculature

Answer 20

false

Question 21

How do we infer tone in speech musculature?

Answer 21

infer from observations at rest and reduction in ROM and speed

Question 22

T or F: strengthening exercises are not recommended in individuals with spasticity

Answer 22

True

Question 23

In terms of kinematics and acoustics, what can we expect in dysarthria?

Answer 23

• smaller displacements (reduced ROM)
• longer segments
• reduced speed of motion
• coordination problems in ataxic dysarthria/ any severe dysarthria
• reduced acoustic contrast between vowels and reduced spectral distinction between consonants

Question 24

What terms from the MAYO clinic apply to the artic subsystem?

Answer 24

• imprecise consonants
• distorted vowels
• prolonged phonemes
• repeated phonemes
• irregular articulatory breakdowns

Question 25

Intelligibility isn't the same thing as _________

Answer 25

articulatory proficiency

Question 26

which subsystem is the highest predictor of intelligibility?

Answer 26

artic

Question 27

Problems in lips/jaw lead to difficulties producing _________

Answer 27

bilabials and vowels

Question 28

Problems with the tongue tip lead to difficulties producing ____________

Answer 28

lingual consonants and vowels

Question 29

Problems with the tongue back lead to difficulties producing ____________

Answer 29

velars and back vowels

Question 30

Typical errors in dysarthria are __________

Answer 30

distortions

Question 31

In ALS the ______ is worse, in PD the _________ is worse

Answer 31

tongue | jaw and lips

Question 32

If a patient uses a bite block and speech production improves, what does this mean?

Answer 32

the jaw is impaired

Question 33

If a patient uses a bite block and speech production worries, what does this mean?

Answer 33

the tongue or lips are impaired

Question 34

What is the purpose of a bite block?

Answer 34

to assess tongue and lip mobility independently from the jaw

Question 35

Coordination and sequencing between articulators is likely the key in speech, so we need to be cautious when _________ speech components

Answer 35

isolating

Question 36

List the treatment principles for artic subsystem

Answer 36

- treatment hierarchy - multimodality and increase sensory stimulation - use intact modalities - avoid working on sounds in isolation unless very early in acquisition stage - Motor therapy (intense + carefully selected stimuli + carefully organized practice and feedback schedule)

Question 37

List the Tx techniques for the artic subsystem

Answer 37

- elicitation with 'shaping and cueing' - articulation (intelligibility) drills - prosodic methods (speaking rate) - bite block - augmented visual feedback - botox injections - non speech (strength, relaxation, stretching) - minimal pairs - discovery learning - clear speech

Question 38

What is the goal of discovery learning?

Answer 38

- pt figures out what works - to develop strategies to make self to be understood (e.g., alphabet supplementation, slowing of the rate; identifying a topic; clear speech strategy for certain sounds)

Question 39

Why would decreasing speaking rate work as artic tx?

Answer 39

more time to achieve articulatory targets on one hand for speaker – more time for listeners to process speech signal

Question 40

What are some rate control techniques?

Answer 40

- DAF - finger tapping - pacing boards - alphabet boards - rhythmic cueing (metronome)

Question 41

Describe all the effects that clear speech Tx has on speech

Answer 41

- increased contrast between speech sounds (vowels and consonants) - longer syllable durations and longer pauses - increased loudness and F0 - found to improve intelligibiltiy

Question 42

What is one downfall of clear speech

Answer 42

-it requires increased effort and is fatiguing

Question 43

What are some arguments for NS-OME?

Answer 43

- Speech is a motor act, might be similar to other motor acts (e.g., chewing) - Shared movement characteristics and demands - Get rid of linguistic component - Hierarchy of non-speech, some near speech (e. g., visuo-motor tracking) - Subsystem analysis (part-whole argument) - done as a warm up - increased awareness of articulators

Question 44

What are some arguments against NS-OME?

Answer 44

- Task specificity - control of motor behaviour is task specific not effector specific - Acoustic signal is a component of movement, build into the motor program - Differential effects of tx on speech and non-sp - Documented differences in muscle function b/n speech and chewing/ swallowing/ jaw wags behaviors/ blowing - Lack of documented relationship between strength and intelligibility (confound of severity) - artic strength needs are low compared to max strength - NS-OME encourage gross and exaggerated ranges of motion, not small, coordinated movements that are required for talking.

Question 45

When are NS-OMEs actually recommended?

Answer 45

- patients with oral motor deficits - patietns with severe impairments (obviously reduced strength and obviously unable to perform OM tasks - i.e. blowing out candles) - Don't expect changes in speech!!