Chapter 13 Flashcards

(46 cards)

1
Q

What is apraxia of speech (AOS)?

A
  • neurologic speech disorder
  • impaired ability to plan or program sensorimotor commands needed for directing movements that result in phonetically and prosodically normal speech
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2
Q

T/F AOS is synonymous with Broca’s or non fluent aphasia

A

false; people with broca;s or nonfluent aphasia OFTEN have an accompanying AOS

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3
Q

T/F All sound level errors made by persons with aphasia are manifestations of AOS

A

false

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4
Q

T/F Ideomotor apraxia is the loss of ability to carry out motor plan for movements

A

true; AOS, limb apraxia, and nonverbal oral apraxia are subtypes of this form of apraxia

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5
Q

Where is the brain damage located for someone with AOS?

A

left frontal lobe, especially if damage is near Broca’s area

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6
Q

Where is the motor speech programmer located in the brain?

A

left cerebral hemisphere, especially parietal-frontal

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7
Q

Describe what nonverbal (nonspeech) oral apraxia (NVOA) is

A

the inability to imitate or follow commands to perform volitional movements of speech structures (cough, blow, click tongue)

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8
Q

NVOA cannot be attributed to… (3 things)

A

poor a/c
sensory deficits
neuromuscular deficits

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9
Q

T/F someone with NVOA is able to do voluntary, but not involuntary movements

A

false; can do involuntary, not voluntary

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10
Q

What is the most common etiology for AOS?

A

left hemisphere stroke

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11
Q

T/F a patient with AOS will usually complain of chewing or swallowing difficulties

A

false

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12
Q

What should someone with AOS also be screened for?

A

aphasia

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13
Q

T/F If no dysarthria is present, then chewing/swallowing functions may be entirely normal

A

true

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14
Q

Name 3 perceptually salient characteristics of AOS

A

consonant and vowel distortions
slow overall rate
prosodic abnormalities

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15
Q

Describe the hierarchy of difficulty for phonemes from easiest to most difficult

A

easiest- vowels, semivowels /r/ and /l/, glides, nasals
more difficult- plosives, fricatives, affricates
most difficult- clusters of consonants

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16
Q

T/F there will be fewer errors in producing singe words, and more errors in production of phrases and sentences

A

true

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17
Q

What assessment could be used to measure intelligibility?

A

Word Intelligibility test, ABA

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18
Q

What are some major goals of treatment?

A
  • 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
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19
Q

Name the two broad avenues of treatment

A

Intrasystemic reorganization and intersystemic reorganization

20
Q

integral stimulation

A

ask patient to watch, listen and do it with you

21
Q

Multiple input phoneme therapy

A
  • for severely apraxic patient
  • begin with patient’s stereotype
  • repetitions of stereotypey become varients of stereotypy and move up a hierarchy
22
Q

Sound production treatment

A
  • aka minimal contrast treatment
  • uses repetition, integral stimulation, modeling, phonetic placement cues, feedback to facilitate consonant production
  • determine stimuli based on error patterns
23
Q

Voluntary control of involuntary utterances (Helm-Estabrook)

A
  • 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
24
Q

Melodic intonation therapy

A
  • 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
25
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
26
What is anarthria?
speechlessness due to severe loss of neuromuscular control over speech
27
T/F Individuals with anarthria do not speak because they don't want to speak
false; because they cannot speak
28
T/F flaccid dysarthria almost always leads to anarthria
false; flaccid dysarthria alone seldom leads to anarthria
29
What type of dysarthrias are the most likely reasons for anarthria?
spastic and hypokinetic
30
Unilateral or bilateral involvement for anarthria?
bilateral
31
Locked-in syndrome (brain-stem stroke)
- mute and quadriplegic; preserved consciousness and vertical eye movements - severe dysphagia
32
Biopercular syndrome
- rare disorder | - bilateral damage to lower part of heminspheres
33
Cerebellar mutism
- primarily in children - almost always after surgery/transient - surgery in the posterior fossa
34
T/F Apraxia of speech and mutism seldom lasts longer than a few days when caused by a stroke
true; they also tend to have NVOA
35
T/F Aphasia and mutism persisting even in persons with global aphasia is uncommon
true
36
Describe what a coma is
- "state of unarousable unresponsiveness" - absence of sleep/wake cycles on EEG - voluntary behavior is absent (eyes remain closed) - reflects a failure of the RAS, cortex, and absence of functions above brainstem level - usually secondary to TBI and vascular events
37
Describe what being in a vegetative state means
- "wakeful awareness" - no purposeful behavior - do not interact meaningfully with environment - muteness is consistent with a severely reduced level of arousal and cognition - follows an initial period of coma after TBI
38
T/F recovery from vegetative state is considered unlikely when it persists longer than 3 weeks after trauma
false; 3 months after trauma
39
define minimally conscious state
- much more common than a vegetative state - persons show a degree of awareness/responsiveness - usually bedbound, incontinent, and require tube feeding
40
8 step continuum
- uses integral stimulation | - hierarchy that begins with most support and fades cues as time goes on
41
Inter-systemic reorganization
- use of non speech activities to facilitate speech | - pairing speech training with gestural cues, rate/rhythm cues, and vibro-tactile stimulation
42
PROMPT
A multi sensory approach in which visual, auditory, tactile, and movement cues are given
43
Kaufman Speech to Language Protocol
- bottom up style of teaching and learning by beginning with easier, shorter approximations of a word and gradually advancing to more difficult approximations of the word as the child's motor coordination improves - CAS
44
Lee Silverman Voice Treatment
- targets respiration and phonation - teaches patients with PD to improve functional intelligible oral communication by increasing vocal loudness, accomplished through phonatory effort tasks and respiratory support
45
Horn therapy
- oral/motor placement therapy - 12 horns that progress in a hierarchy from least to most complex - assists in improving speech clarity by targeting muscle-based systems while increasing sentence length
46
Therapeutic singing
-addresses decreased respiratory and coordination of breath and decreased rate of speech, intelligibility, breath control, and vocal output