pediatric msds
developmental dysarthria & CAS
developmental dysarthria causes
-a form of neurogenic speech impairment manifesting in children
-caused by problems in an underdeveloped human brain when reconciling with the also developing motor control centers in the brain
-associated with cerebral palsy
developmental dysarthria deficits
deficits in the neuromuscular areas across several areas such as speed, range of motion, and steadiness
cerebral palsy
disorder of movement, muscle tone, or posture that is caused by damage that occurs in the immature, developing brain, before birth
signs & symptoms of CP
impaired movement associated with abnormal reflexes, floppiness or rigidity of the limbs and trunks, abnormal posture, involuntary movements, unsteady walking or some combination of these
congenital cp
-brain damage before or during birth
-risk factors:
-being born to small or early
-being born a twin or multiple birth
-being conceived by IVF
-mother had infection during birth
-having kernicterus
-having birth complicatios
acquired CP
-brain damage that occurs more than 28 days after birth
risks:
-brain infection
-suffering a serious head injury
-most is unknown
early signs of CP in 3-6 months of age
-head falls back when picked up while lying on back
-feels stiff
-feels floppy
-seems to overextend back and neck when cradled in someone’s arms
-legs get stuff and cross or scissor when picked up
early signs of CP for older than 6 months
-doesn’t roll over
-cannot bring hands together
-has difficulty bringing hands to mouth
-reaches out with only one hand while keeping the other fisted
early signs of CP in babies older than 10 months of age
-crawls in lopsided manner, pushing off with one hand and leg while dragging the opposite hand and leg
-scoots around on buttocks or hops on knees, but does not crawl on all fours
signs & symptoms of developmental dysarthria
-one or more of the speech processes may be affected
-difficulty producing sounds that need precise tongue control and movements for consonants and vowels
-difficulty prodcuing the rapud, coordinated movements across muscle groups required for voicing distinctions and consonant clusters
assessment of developmental dysarthria
-administer case history
-thorough oral motor exam
-exam of primitive reflexes
-speech assessment
-rule out other aspects
-confirm diagnosis
speech assessment would find
-marked difficulties with strength, speech, and accuracy of movement
-weak vocal quality
-hypo- or hypernasality
-weak articulatory contacts
-rapid or slow speaking rate
-vowel disotritions
-imprecise or weakly targeted consonants
-generally weak, muschym garbled, imprecise speech
non-speech findings
difficulties with sucking, chewing, and swallowing that may cause drooling, gagging, and choking
management issues and decisions
-focus on communication rather than speech in terms of management
goals of treatment
-maximize the effectiveness, efficiency of communication
-restore lost function (if possible)
-promote the use of resuidal function (compensenate)
-reduce the need for lost function (if possible)
