Flashcards in Chapter 13 Deck (46)
What is apraxia of speech (AOS)?
-neurologic speech disorder
-impaired ability to plan or program sensorimotor commands needed for directing movements that result in phonetically and prosodically normal speech
T/F AOS is synonymous with Broca's or non fluent aphasia
false; people with broca;s or nonfluent aphasia OFTEN have an accompanying AOS
T/F All sound level errors made by persons with aphasia are manifestations of AOS
T/F Ideomotor apraxia is the loss of ability to carry out motor plan for movements
true; AOS, limb apraxia, and nonverbal oral apraxia are subtypes of this form of apraxia
Where is the brain damage located for someone with AOS?
left frontal lobe, especially if damage is near Broca's area
Where is the motor speech programmer located in the brain?
left cerebral hemisphere, especially parietal-frontal
Describe what nonverbal (nonspeech) oral apraxia (NVOA) is
the inability to imitate or follow commands to perform volitional movements of speech structures (cough, blow, click tongue)
NVOA cannot be attributed to... (3 things)
T/F someone with NVOA is able to do voluntary, but not involuntary movements
false; can do involuntary, not voluntary
What is the most common etiology for AOS?
left hemisphere stroke
T/F a patient with AOS will usually complain of chewing or swallowing difficulties
What should someone with AOS also be screened for?
T/F If no dysarthria is present, then chewing/swallowing functions may be entirely normal
Name 3 perceptually salient characteristics of AOS
consonant and vowel distortions
slow overall rate
Describe the hierarchy of difficulty for phonemes from easiest to most difficult
easiest- vowels, semivowels /r/ and /l/, glides, nasals
more difficult- plosives, fricatives, affricates
most difficult- clusters of consonants
T/F there will be fewer errors in producing singe words, and more errors in production of phrases and sentences
What assessment could be used to measure intelligibility?
Word Intelligibility test, ABA
What are some major goals of treatment?
-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
Name the two broad avenues of treatment
Intrasystemic reorganization and intersystemic reorganization
ask patient to watch, listen and do it with you
Multiple input phoneme therapy
-for severely apraxic patient
-begin with patient's stereotype
-repetitions of stereotypey become varients of stereotypy and move up a hierarchy
Sound production treatment
-aka minimal contrast treatment
-uses repetition, integral stimulation, modeling, phonetic placement cues, feedback to facilitate consonant production
-determine stimuli based on error patterns
Voluntary control of involuntary utterances (Helm-Estabrook)
-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
Melodic intonation therapy
-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
How can you help with apraxia of phonation (muteness)
-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
What is anarthria?
speechlessness due to severe loss of neuromuscular control over speech
T/F Individuals with anarthria do not speak because they don't want to speak
false; because they cannot speak
T/F flaccid dysarthria almost always leads to anarthria
false; flaccid dysarthria alone seldom leads to anarthria
What type of dysarthrias are the most likely reasons for anarthria?
spastic and hypokinetic