Motor Speech Disorders treatment Flashcards Preview

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Flashcards in Motor Speech Disorders treatment Deck (19):
1

management of respiration treatment options (broad categories)

1. establishing respiratory support
2. stabilizing respiratory pattern
3. increasing respiratory flexibility
4. maximizing speech naturalness (teach natural stress patterning)

2

tx for increasing respiratory flexibility

training respiratory flexibility in 3 levels:

1. conceptual -- taught the general rules that g govern respiratory performances (read paragraphs that have been marketed)

2. conversational scripts - where resp markers

3. speaker reads aloud or speak conversationally w/o the aid of the respiratory pattern markers

3

2 tx for increasing respiratory flexibility

maximizing speech naturalness

---teach stress patterning ....because the breath group may be the unit of prosody, adequate respiratory control and appropriate phrasing are necessary for natural speech

4

tx for increasing loudness for persons with hypo adduction of the VF due to flaccid dysarthria

-behavioral training
....training the speaker to generate greater levels of sub glottal air pressure to innate phonation at appropriate lung volume levels

-increasing medial compression in speakers:
...."effortful closure techniques" or rotating their head to the left or the rt

5

tx for increasing vocal loudness & voice quality in speakers with VF hyoadduction and hypo kinetic dysarthria

-LVST (Ramig, 2001)
...increase loudness and decrease brethiness and improve vocal quality by increasing stability of VF vibration

-prosthetic mannagement
....amplification device

6

tx for reducing hyper adduction of the VF (spastic)

-instruct them to talk with less effort

-relaxation approaches (Weismer, 2000)

-botox

7

tx for improving laryngeal coordination

-respiratory/laryngeal timing
....something like the visipitch can be use and the respiratory-phonatory timing patterns can be captured and presented to the speakers as biofeedback

-articulatory distractions
...tach exaggerated other aspects of voice-voice distinctions in structured tasks "cab" vs. "cap"

8

tx for VPI

-palatal lift

-nasal obturation

9

tx for rate control ---severe rate control needed

-alphabet board supplementation

-pacing board

10

tx for rate control that preserve prosody

-rhymic cueing
....the clinician signals the desired speaking rate by pointing to the words of a written passage in a rhymic fashion

-"backdoor approaches"
....train increased loudness or increase pitch variation
....train appropriate phrasing and breath patterning (chunking utterances)

-delayed aud feedback (hypo kinetic)

11

tx articulation for normalizing function (designed to normalize the muscular function in dysarthria)

-reducing tone
...biofeedback training (will learn to regulate the physiological variable)
...botox
....anti-spasticity meds

-optimizing speaking rate
...delayed aud fedback (esp hypokinetic)
...computerized pacing

12

tx for arctic -- compensating for the impairment

-contrastive production drills
...tasks in which 2 sounds are produced in juxtaposition to each other and the speaker is asked to make these sounds as different as possible

-intelligibility drills
...production of a small set of words that are the same except for a single phoneme where the focus is not on correctness, but on the listener attempts to identify the utterance being produced

-rate reduction approaches

***important to talk about breakdown resolution strategies

13

tx for prosody (general)

--"make the target word stronger"
--"emphasize the target word"
---"use extra force on the target word"

-impacted by use of rate strategies and articulation strategies

14

tx for prosody issues in ataxic dysarthria

-use durational adjustments as primary means of signaling stress (learn prolonged stressed syllables)

-encourage extension of breath group and thus to make the entire sentence an intonational unity

15

pts with flaccid dysarthria may benefit from....(general types of tx)

-respiratory
-VPI
-artic (for slurred speech)

16

pts with spastic dysarthria may benefit from....(General tx)

-relaxation (Weismer, 2000)
-breathy/easy onsets
-management of psudobulbar affect via meds

17

pts with hypo kinetic dysarthria may benefit from .... (general tx)

-LVST (Ramig, 2001)
-voice amplifiers
-dealyed aud feedback
-L-dopa meds
-deep brain stimulation to control tremors

18

pts with hyerkinetic dysarthria may benefit from (general tx)

-botox injections (spasmodic dysphonia)
-bite blocks to inhibit excess jaw movements
-RATE reduction strat in improve arctic (Yorkston)
-Respiration/relaxaton strategies
-AAC if severe

19

pt with ataxic dysarthria may benefit from (general tx)

---behavioral focus to improve/compensate for motor control and coordination
-pacing boards
-target loudness & pitch control