Chapter 12 Flashcards
(118 cards)
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
2
Q
what defects of a motor speech disorder result in significant difficulties producing fluent, intelligible speech?
A
planning, programming, and executing speech systems
3
Q
Definition of Systems of Speech Production
A
Systems of muscles which coordinate with other muscles within and across subsystems
4
Q
four Systems of Speech Production
A
Articulatory System
Respiratory System
Resonatory System
Phonatory System
5
Q
Definition of respiratory system
A
system that regulates the inhalation/exhalation cycle for passive breathing and for producing speech
6
Q
what is the key structure of the respiratory system?
A
lungs
7
Q
what muscles and Articulators are involved with the respiratory system?
A
respiratory and postural muscles
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
9
Q
Definition of Phonatory System
A
system that regulates the production of voice and the prosodic or intonational aspects of speech
10
Q
what is the key structure of the Phonatory System?
A
larynx
11
Q
what muscles and/or Articulators are involved with the Phonatory system?
A
vocal folds
12
Q
Definition of glottis
A
the opening between the vocal folds
13
Q
Definition of subglottal air pressure
A
air pressure that sets the vocal folds into cycles of vibration
14
Q
true or false: voiceless consonants are produced without vocal fold vibration
A
true
15
Q
phonatory system coordinates with the respiratory system to provide what?
A
the airflow needed for phonation
16
Q
true or false: the phonatory system is essential for producing both voiced and voiceless sounds
A
true
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
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
19
Q
what are the key structures of the Resonatory System?
A
velopharyngeal port and pharynx
20
Q
what muscles and Articulators are involved with the Resonatory System?
A
velum and pharynx
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
22
Q
Definition of velopharyngeal port
A
opening between the velum (soft palate) and the back of the pharyngeal wall
23
Q
what is the velopharyngeal port responsible for?
A
sound quality/vocal resonance - whether the nasal cavity is used as a vibrating chamber
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
25
When the velum is _____, the velopharyngeal port is open and air flows out through where?
lowered; both the oral and nasal cavities
26
when does nasality occur?
when the velum is lowered and the velopharyngeal port is open and air flows out through both the oral and nasal cavities
27
why is regulation of the velopharyngeal port important?
for producing the difference between oral and nasal sounds
28
Definition of Articulatory System
system that regulates the control of the articulators within the oral cavity to manipulate the outgoing airflow
29
what is the key structure of the Articulatory System?
oral cavity
30
what muscles and Articulators are involved with the Articulatory System?
jaw, lips, tongue
31
what is probably the most important articulator and why?
the tongue because of its flexibility and capacity for high-speed motion
32
four sections of the tongue
apex (tongue tip)
blade (front of tongue)
center (middle part)
dorsum (back of tongue)
33
true or false: consonants involve a constriction in the vocal tract
true
34
true or false: vowels involve a constriction in the vocal tract
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
35
Definition of Diphthongs
a variety of vowels that involve a gliding movement in the production of the sound (ex. oy)
36
why does the actions of the articulatory system must work seamlessly with the other systems (respiratory, phonatory, and resonance)?
to produce well-articulated and fluent speech that unfolds overtime
37
true or false: given the complexity, only adults may experience failures in motor speech coordination
false - children and adults
38
two causes of breakdowns in the larger motor speech production system
the four individual systems are poorly coordinated
deficits in the coordination of the muscles and muscle groups within a specific system
39
Definition of Speech Motor Control
coordination of muscle activity across a wide range of muscle groups within the four systems of speech production
40
what does the coordination between the four systems of speech production involve to produce accurate and fluent articulation?
programming particular configurations of muscle activity into single motor units
41
Definition of Motor Planning
the processes that define and sequence articulatory goals prior to their occurrence (ex. lip closure, onset of voicing)
42
Definition of Motor Programming
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
43
Definition of Motor Execution
the processes responsible for activating relevant muscles during the movements used in speech production
44
true or false: motor planning and programming are aspects of motor control that occur before or during initiation of movement
false - only before
45
true or false: motor execution occurs at or after initiation of movement
true
46
Definition of Motor learning
the way in which practice or experience leads to relatively permanent changes in the capability for movement
47
true or false: Prevalence and Incidence rates for specific motor speech disorders are rare
true
48
how are motor speech disorders classified?
etiology, manifestation, severity
49
acquired motor speech disorders are a result from what?
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
developmental motor speech disorders are a result from what?
abnormal development of the nervous system or from damage to the nervous system in early development
51
Abnormal development vs Damage to the developing nervous system
various congenital diseases, including cerebral palsy and genetic syndromes such as Down syndrome
traumatic brain injury, brain tumors, and stroke
52
two divisions of motor speech impairments
motor planning and programming
impairments of motor execution
53
true or false: breakdowns at all levels of the motor speech system are possible
true
54
example of breakdowns at the level of execution
Paralysis of the tongue will seriously impede speech production regardless of whether speech is planned and programmed normally or not
55
example of breakdowns at the level of planning and programming
The patient may not experience paralysis of the tongue but may have difficulty moving the tongue in the right way
56
three aspects of a disorder that determines how it affects a patient's life
disease, activity, and participation in life
57
Definition of disease with a motor speech disorder
the neurological deficit impacting speech production and its systems
58
Definition of activity level with a motor speech disorder
the actual behavioral or performance deficits that result from the disease - speech intelligibility and fluency or naturalness
59
Definition of participation in life with a motor speech disorder
how the speech impairment impacts an individual's performance at home, at school, at work, and in the community
60
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
true
61
what two disorders are motor speech disorders divided into?
motor planning and programming
motor execution
62
what are motor planning and programming disorders caused by?
an inability to group and sequence the relevant muscles with respect to one another in order to plan or program movement.
63
what are motor execution disorders caused by?
deficits or inefficiencies in basic physiological or movement characteristics of the musculature, such as muscle tone, movement speed, and movement range
64
Definition of apraxia of Speech
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
true or false: AOS is the result of a language disturbance or an impairment of the neuromuscular system
false: result of an impairment of the ability to plan and program the relevant articulator movements
66
where is the location of the AOS impairment?
the articulatory system
67
seven characteristics of AOS
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
true or false: AOS occurs as a result of neurological damage to the area, surrounding Broca's area
true
69
what is the most common cause of AOS?
stroke
70
Definition of Childhood Apraxia of Speech (CAS)
a phonetic-motoric disorder of speech production
71
what are children with apraxia of speech unable to do?
# translate linguistic or phonetic information concerning speech production to accurate motor behaviors
are unable to learn the motor behaviors to execute planned speech
72
true or false: The symptoms of CAS are the same as those of AOS
true
73
true or false: For many cases of CAS there is no evidence of specific neurological damage to the brain
true
74
three symptoms of CAS
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
true or false: dysarthria is not an impairment of planning and programming of speech movements
false: it is a disruption in the execution of speech movements
76
what does dysarthria result from?
underlying neuromuscular disturbances to muscle tone, reflexes, and kinematic aspects of movement, such as speed, range, accuracy, and steadiness
77
characteristics of dysarthria
speech that sounds:
slow
slurred
overly harsh or quiet
uneven
78
true or false: dysarthric speech is generally more consistent in types of errors and amount of intelligibility compared to apraxic speech
TRUE
79
Definition of spasticity
increased deep tendon reflexes, hypertonic muscles, and underdevelopment of limbs
80
Definition of dyskinesia
slow, writhing involuntary movements due to disturbances in muscle tone
81
Definition of ataxia
weakness, tremors, and lack of coordination
82
what are the two types of developmental Dysarthria?
spastic and dyskinetic
83
characteristics of Spastic Dysarthria
hypertonicity and hyperreflexia
84
true or false: there are considerable variability among children with respect to severity and the systems affected with Spastic Dysarthria
true
85
do many children have spasticity of upper or lower limbs or both?
both
86
what other disorder's symptoms does Spastic Dysarthria match?
acquired spastic dysarthria + may have inadequate breath support for producing speech + may produce speech in short phrases
87
characteristics of Dyskinetic Dysarthria
impaired coordination of muscles and involuntary movements, including chorea and athetosis
88
Definition of chorea
sudden fast, flailing, jerking movements
89
Definition of athetosis
slow, writhing movements
90
true or false: in most cases of dyskinetic dysarthria all four limbs are affected
true
91
symptoms of children with dyskinetic dysarthria
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
Causes and Risk Factors of dyskinetic dysarthria
damage to the nervous system prenatally, perinatally, and postnatally
93
perceptual measures of assessment for motor speech disorders
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
acoustic measures of assessment for motor speech disorders
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
physiological measures of assessment for motor speech disorders
involve measurement of physiological aspects of the· speech motor system such as muscle strength, endurance, and airflow
96
true or false: assessment for motor speech disorders should include motor control tasks that involve speech and nonspeech movements
true
97
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
false - they should exhibit
98
The evaluation of should include assessments of each of the speech systems ______.
SEPARATELY
99
Respiration system assessment
assess both perceptual measures (e.g., how long patient can sustain a breath) and physiological measures (e.g., determining patient's vital capacity).
100
phonation system assessment
use perceptual, acoustic, and physiological measures
101
resonation system assessment
Watch for hypernasality, hyponasality, and nasal emission
102
articulation system assessment
Watch for reduced muscle strength of the tongue, reduced speech rate, and speech sound substitutions and distortions
103
Dysarthric errors are likely to be _____, while apraxic errors are likely to be ______
consistent; inconsistent
| dc, ai
104
prosody assessment
Watch for inappropriate prosodic variations (loudness, pitch, duration, rhythm).
105
Definition of differential diagnosis
a diagnosis that differentiates a person's disorder from other similar disorders
106
why is differential diagnosis in motor speech disorders so important?
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
true or false: treatment for the motor speech impairment itself is typically provided by the SLP through inpatient or outpatient therapy
true
108
what is the first goal of therapy with motor speech treatment?
to learn or relearn accurate production of speech for improved speech intelligibility
109
what is the second goal of therapy with motor speech treatment?
to maximize generalization - underlying capability for movement should be facilitated by treatment so that untrained tasks also improve
110
what are the two primary therapeutic strategies of motor speech disorders?
to (1) improve the impaired system(s), and (2) teach compensatory strategies
111
five retreatment considerations for motor speech therapy
Memory
Attention
Motivation
goal setting
correctness reference
112
three goals in treatment of the respiratory system
improving respiratory support
modifying inspiration and exhalation and their interrelationship
improve the buildup of subglottic air pressure
113
two goals in treatment of the phonatory system
improve voice quality
improve control over the vocal folds
114
goal of reatment of the resonatory system
strengthen and increase control over the velopharyngeal port
115
treatment of the articulatory system
look up
116
two goals in treatment of prosody and rate control
exercises geared toward increasing the range of the affected factors, such as contrastive drills (differ vs defer)
117
true or false: prosody is non-essential for producing natural sounding speech
false - it is essential
118
prosody involved reductions of the range in one or more of what three factors?
loudness, pitch, and/or duration
