Motor Speech Disorders treatment Flashcards Preview

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Flashcards in Motor Speech Disorders treatment Deck (19):

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)


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


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


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

-behavioral 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


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


tx for reducing hyper adduction of the VF (spastic)

-instruct them to talk with less effort

-relaxation approaches (Weismer, 2000)



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"


tx for VPI

-palatal lift

-nasal obturation


tx for rate control ---severe rate control needed

-alphabet board supplementation

-pacing board


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)


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

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

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


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


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


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


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

-artic (for slurred speech)


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

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


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


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


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