ad # 1

  1. What process is when the thoughts are converted to verbal symbols?
    Cognitive-Linguistic Processes
  2. What is the selction and sequencing of sensorimotor programs that activate the speech muscles?
    Motor Speech Planning and Programming
  3. What are the innervations of the respiratory, phonatory, resonatory, and articulatory muscles.
    Neuromusclar Execution
  4. What is the combined processes of speech motor planning, programming, and neuromuscular execution?
    Motor Speech Processes
  5. Changes in speech may announce the ________ of a neurologic disease.
  6. The effects of neurologic disease are usually a _________ correlation with lesion and speech effect.
  7. ________ changes often are the first manifestation of disease.
  8. Speech diagnosis does not always follow__________  _______.
    medical diagnosis
  9. Speech management is not always ________ from medical management.
  10. Neurologic disorers are _____________.
  11. ______ neurologic disorders are curable.
  12. ________ disorders are a major cause of disability.
  13. Neurologic speech disorders will _________ in prevalence because of increased survival rates for a number of neurologic diseases and increasing longevity.
  14. Understanding the underlying _________ can help in planning treatment.
  15. A collective name for a group of neurologic speech disorders resulting from abnormalities in the strength, speed, range, steadiness, tone, or accuracy of movements required for control of the respiratory, phonatory, resonatory, articulatory, and prosodic aspects of speech production.
  16. For dysarthria the responsible pathophysiologic disturbances are due to ___________ or _______ nervous system abnormalities and most often reflect weakness, spasticity, incoordination, involuntary movements, or excessive, reduced, or variable muscle tone.
    central or peripheral
  17. Dysarthria is a disorder of _________ or _________ _______.
    movement or movement control
  18. Dysarthria is _________ in origin and can be categorized into different types according tot the localization of the causal disorder.
  19. A neurologic speech disorder reflecting an impaired capacity to plan or program sensorimotor commands necessary for directing movements that result in phonetically and prosodically normal speech.
    Apraxia of Speech
  20. Apraxia of speech can occur in the absence of _________  ______________ associated with the dysarthrias and in the absence of disturbance in any component of language.
    physiologic disturbances
  21. Apraxia of speechs localization and management is ____________ than for that for most dysarthria and aphasia.
  22. A speech disorder resulting from neurologic impairments affecting the motor planning, programming, neuromuscular control,  or execution of speech. They include the dysarthrias and apraxia of speech.
    Motor Speech Disorders (MSDs)
  23. What is the compulsive repetition of utterances?
  24. What is the unsolicited repetition of another's utterances?
  25. Neurologic speech disturbances that are not MSDs are hard to distinguish apart from MSDs because they often co-occur. What are the 6 Neurologic speech disturbances?
    • 1. Acquired neurologic stuttering
    • 2. palilalia
    • 3. echololia
    • 4. certain forms of mutism
    • 5. pseudoforeign dialect
    • 6. aprosodia associated with right hemisphere dysfunction
  26. ___________ disturbances have been implicated in certain MSDs.
  27. Motor speech processes and disorders should be thought of as _______________ and not just motor in character.
  28. What nonneurologic disturbance inludes laryngectomy, cleft lip and palate, fractures, and abnormal variants in cavity size and shape?
    Musculoskeletal defects
  29. In a _____________  ________ speech can be altered by injury, disease, congenital absence, loss to aging or poor care, or surgical removal of muscle, cartilage, or bone. 
    musculoskeletal defect
  30. What are some nonneurologic or nonpsychogenic voice disorders?
    They include dysphonias associated with hormaonal disturbances, head or neck neoplasms, and vocal abuse.
  31. Speech undergoing changes as a result of abnormal psychologic states and they are not primarily neuromotor in nature.
    Psychogenic and related nonorganic disorders.
  32. ________ are prominent among acquired communication disorders.
  33. Approximately ____ of noncomatose people who have had strokes sufferf rom some kind of speech or language impairment.
  34. _________ occurs in 25% of patients with lacunar (small) strokes and in one-third of those with traumatic head injury.
  35. Dysarthria is present in 60%  of people with ___________ with increased prevalence as the disease progresses.
    Parkinson's Disease
  36. Dysarthria sometimes is a presenting sign of ________________ and often emerges during the diseases course.
    Amyotrophic lateral sclerosis (ALS)
  37. What method for studying motor speech disorders are based on the auditory-perceptual attributes of speech?
    Perceptual methods
  38. What is the gold standard for clinical differential diagnosis, judgements of severity, many decisions about management , and the assessment for functional change?
    Perceptual methods
  39. What instrumental method can visually display and numerically quantify numerous aspects of the acoustic speech signal?
    Acoustic methods
  40. What instrumental method focuses on the movements of speech structures and air, muscle contractions, and neural activity? Can provide feedback during management.
    Physiologic methods
  41. What instrumental method uses numerous instruments to visually image parts of the upper aerodigestive tract during speech?
    Visual imaging methods
  42. The parts of the nervous system that control voluntary movements are known collectively as the __________  ___________.
    Motor system
  43. Where are the nerve cells located that play an important role in contolling the voluntary movements of the body?
    The Precentral Gyrus
  44. The most important function of the ________ is to coordinate voluntary movements so that muscles contract with the correct amount of force and at the appropriate times.
  45. __________ damage can cause significant deficits in thr performance of both gross and fine motor actions such as walking, writing, and speech.
  46. In the brainstem the ________ _______________  project out form the CNS and they convey motor impluses from the CNS to the muscles of the larynx, face, tongue,pharynx, and velum.
    cranial nerves
  47. In the motor system an imbalance between excitatory and inhibitory neurotransmitters may be a cause of _______.
  48. ______________ is thought to analyze tone patterns and sound properties and it may help in the localization of sound.
    Primary auditory cortex
  49. ______________is thought to perform a preliminary analysis of depth and perhaps integration of visual informatio from both eyes.
    primary visual cortex
  50. __________ is where the cortex receives the first neural input about bodily sensation.
    primary sensory cortex
  51. Most planning for movement does not originate in the _________ _____________ ___________.
    primary motor cortex
  52. The initial planning of a movement is formulated primarily in the ___________ ___________.
    association cortex
  53. The ______ __________ ___________ is involved in the recognition of complex visual stimuli, integrating auditory stimuli with other centers of the brain, and the formation of memories.
    temporal association area
  54. The _______ association area plays an important role in initiating and planning volitional movements.
  55. The _________ association area integrates bodily sensations and visual information.
  56. The ______ association area is involved with visually guided movements.
  57. __________ __________ is important in the planning of slow, continuous movements.
    Basal ganglia
  58. The neural tract from the substantia nigra to the striatum contains a large number of neurons that produce the neurotransmitter _________.
  59. The motor speech disorder associated with PD is called ________ ____________.
    hypokinetic dysarthria
  60. __________ is a disturbance in the speed, range, and direction of moements. The muscle groups near the shoulders and pelvis in particular may be affected.
  61. The gait of a person with ________ is wide-based, lurching, and stumbling. (drunken)
  62. ________ ________ is caused by lesions to the cerebellum. This tremor only occurs during the performance of voluntary movement.
    Intention tremor
  63. Disorders caused by lesions to the cerebellum:
    • 1. Ataxia
    • 2. Intention tremor
    • 3. nystagmus
    • 4. Increased or decreased muscle tone
    • 5. disturbances of the equilibrium
  64. The motor speech disorder usually associated with cerebellar lesions is ______ ______.
    Ataxic dysarthria
  65. Practically every sensory impulse from the body passes through the ______ on its way to the cortex.
  66. The ________ __________ ________ receives the neural impulses that have been processed, smoothed, and coordinated by the basal ganglia , the cerebellum, and the thalamus.
    primary motor cortex
  67. The primary role in the _______ _________ is to take voluntary movement patterns that are formulated elsewhere and to transmit them to the cranial nerves via a tract of motor neurons called the pyramidal system.
    primary cortex
  68. Damage to the _________ ___________ usually results in muscle weakness and rapid fatigue. It is also reported that increased mental concentraion is needed to perform motor tasks that previously were accomplished with ease.
    pyramidal system
  69. In the motor speech mechanism, _______ damage to the pyramidal system results in a loss of fine motor movements in the articulators, a condition known as __________ upper motor neuron dysarthria.
    Unilateral, unilateral
  70. Damage that affects the pyramidal tract almost always will affect other _______ ________ as well, with results that complicate the clinical picture.
    neural tracts
  71. The ___________ system influences the reflexes, muscle tone, and some voluntary movements of the speech mechanism.
  72. Upper motor neuron damage results in __________.
  73. Spastic dysarthria is the result of ________ upper motor neuron damage.
  74. Lower motor neuron damage results in muscle ________ or ______.
    paralysis or paresis
  75. ________ __________ is the result of damage to the lower motor neurons in those cranial nerves that innervate the muscles of speech production.
    Flaccid dysarthria
  76. __________ characterizes the features of speech and the structures and functions related to speech.
  77. The process of narrowing diagnostic possibilities and arriving at a specific diagnosis is known as?
    differential diagnosis
  78. What are characteristics of every one of the dysarthrias?
    Imprecise consonants and harsh vocal quality
  79. Motor speech disorders requires clinicians to match what they hear in a patient's speech with what they know about the functioning of the human ________ _________.
    motor system
  80. What are the two basic methods of evaluating motor speech disorders?
    instrumental and perceptual analysis
  81. What method uses sophisticated devices to objectively measure the components of speech production?
  82. What method uses the ears of the examiner to detect motor speech disorders?
    Perceptual analysis
  83. What is the ultimate judge of whether or not there is a problem with an individuals speech?
  84. What are the five components that speech is dependent on the coordinated interaction between?
    • Respiration
    • Phonation
    • Resonance
    • Articulation
    • Prosody
  85. When one or any combination of the five is affected by a neuromotor disturbance, the result will be a motor speech disorder, either _______ or _________.
    Dysarthria or apraxia of speech
  86. What is a speech production deficit that results from neuromotor damage to the peripheral or central nervous system?
  87. ________ is not a language disorder!
  88. __________ is strictly a speech production disorder caused by neuromotor damage.
  89. What is a motor speech disorder defined as a deficit in the ability to sequence the motor commands needed to correctly position the articulators during the voluntary production of phonemes?
    Apraxia of speech
  90. Apraxia of speech is the result of _______ nervous system damage. It is NOT the result of muscle weakness or slowness.
  91. What disorder is the ability to sequence the motor commands needed to move the articulators smoothly from one posistion to another during the production of voluntary speech?
    Apraxia of speech
  92. ___________ is nearly always associated with damage to the left hemisphere of the brain?
    Apraxia of speech
  93. ______ can be caused by damage to many parts of the nervous systmen.
  94. ________ _________ means less air for speech production, which limits the affected individuals ability to speak in anything but short phrases.
    Nerve damage
  95. Respiratory deficits that reduce the amount of air available for speech can also cause reduced ________ and _____ voice quality.
    loudness and breathy
  96. What is the production of voiced phonemes through vocal fold vibrations in the larynx?
  97. Normal phonation is dependent on the _____ of the vocal folds and enough subglottic air pressure to set the vocal folds into vibration.
  98. Spastic dysarthria causes the adduction to be too __ which causes the phonation to have a strained-strangled quality.
  99. In flaccid dysarthria the damage may cause the adduction to be ________ or _____.
    weak or incomplete
  100. Neuromotor damage to the laryngeal muscles may reduce the ability to change _______ or ___________ during phonation.
    pitch or loudness
  101. What is the proper placement of oral or nasal tonality into phoemes during speech. It is accomplished by the raising and lowering of the velum.
  102. _________ resonance is produced when the velum is raised and closes off the nasal canity from the coal airstream.
  103. ________ resonance is produced when the velum is lowered and the oral cavity is blocked by the lips or tongue, which thereby directs the entire airstream out through the nose.
  104. WHen the velar muscles are damaged it results in a _______ quality because nasal resonance is being applied to phonemes that ordinarily have only oral resonance.
  105. ________ is the shaping of the vocal airstream into phonemes.
  106. ___________ is the melody of speech. It conveys meaning within an utterance through the use of stress and intonation.
  107. Motor speech disorders are __________ disorders.
  108. What are the six salient features of neuromuscular function?
    • muscle strength
    • speed of movement
    • range of motion
    • accuracy of movement
    • motor steadiness
    • muscle tone
  109. ______ speed of movement is a common characteristic of most dysarthrias.
  110. In Hypokinetic dysarthria there may be ______ speed of movement.
  111. How is Speed of movement assessed?
    alternate motion rates (AMR) and sequential motion rates(SMR)
  112. What task moves the articulators through a single series of rapide back and forth movements  such as puh, puh, puh?
    Alternate motion rate (AMR)
  113. What task moves the articulators repeatedly through a quick sequence of movements such as puh, tuh, kuh on one breath of air.
    Sequential motion rates (SMR)
  114. __________ is how far the articulators can travel during the course of a movement.
    Range of movement
  115. _________ can especially be affected by reduced range of movement in the articulators.
  116. _________ is one in which strength, speed, range, direction, and timing are precisely coordinated.
    acccurate movement
  117. What is the ability to hold a body part still?
    motor steadiness
  118. What is the most common disorder in which involuntary movements prevent motor steadiness?
  119. NOrmal _________ _________ is the small, constant amount of muscle contraction that is always present, even when a muscle is fully relaxed.
    muscle tone
  120. Decreased muscle tone is associated with muscle ______ or ________.
    weakness or paralysis
  121. Increased muscle tone is associated with ___- or ________.
    spasticity or rigidity
  122. The ____________ nerve is examined during the tasks that require jaw movement.
    trigeminal cranial nerve
  123. What cranial nerve is trested when examining the tongue at rest and during movement?
    hypoglossal cranial nerve
  124. What cranial nerve is innervated in the velum and pharynx at rest and during movement?
    Vagus cranial nerve
  125. Phonatory and respiratory components of the speech mechanism are assessed at the same time because normal phonation is so dependent on an adequate supply of _________ _______ ________.
    subglottic air pressure
  126. Weakened or paralyzed velar muscles result in ________ velopharyngeal closure, which is heard perceptually as __________.
    • incomplete
    • hypernasality
  127. _________ is most frequently a symptom of flaccid, spastic, and hypokinetic dysarthria.
  128. __________ is rarely present in the speech of individuals with dysarthria or apraxia of speech.
  129. ___________ is an assessment of a patient's ability to move the articulators rapidly yet smoothly in a repetitive motion.
    Alternate motion rate (AMR)
  130. Individual's with flaccid and spastic dysarthria typically have ___ and ___ AMR's.
    slow and irregular
  131. Individual's with ataxic and hyperkinetic dysarthria often have ________ and _________ AMR's.
    slow and regular
  132. Some people with hypokinetic dysarthria have AMRs that are more _______ than normal.
  133. ________ is a task that assesses a patient's ability to move the articulators in  rapid smooth sequence of motions.
    Sequential motion rate (SMR)
  134. Stress testing of the motor speech mechanism is screening for _______________, a disorder that causes a rapid fatigue of the muscles during a sustained motor activity.
    Myasthenia gravis
  135. __________ is a disruption if the ability to voluntarily sequence complex movements accurately.
  136. What are the two types of apraxia that affect speech musculature?
    nonverbal oral apraxia and apraxia of speech
  137. What is a disruption in the sequencing of oral movements that are nonverbal, sometimes described as vegetative movements.
    Nonverbal oral apraxia
  138. Usually these two types of apraxia are ___________.
  139. Individual's with apraxia of speech especially have trouble when trying to say _________ words.
  140. Usually __________ and ___________ speech are free of apraxic speech.
    automatic and emotional
  141. __________ dysarthrias are a perceptually distinctive group of MSDs produced by injury or malformation of one or more of the cranial or spinal nerves.
  142. ________ dysarthrias may be manifes in any or all of the respiratory, phonatory, resonatory, and articulatory components of speech.
  143. The primary deviant speech characteristics of flaccid dysarthrias can be traced to muscle _________ and _______ muscle tone.
    weakness and reduced
  144. ________ dysarthrias sometimes reflect involvement of only a single muscle group of speech subsystem.
  145. What are they primary characteristics of flaccid dysarthria?
    • weakness
    • hypotonia
    • diminished reflexes
  146. What is the complete inability to contract muscles?
  147. What is the reduced muscle contraction and weakness?
  148. What is reduced muscle tone, flabbiness?
  149. What are reflexes diminished in strength?
    Reduced reflexes
  150. What is it called when muscle wastes away, loses bulk?
  151. What are visible arythmic twitches in resting muscles?
  152. What are invisible contractions of muscle fibers?
  153. What is rapid weakening and recovery with rest?
    Progressive weakeness with use
  154. What is the most common motor neuron disease. It affects the bulbar, limb,  and respiratory muscles.
    Amyotrophic lateral sclerosis
  155. What is a motor neuron disease that primarily affects LMN's?
    Progressive bulbar palsy
  156. What is associated with progressive limb wasting and weakness, can be inherited or occur sporadically, can be congenital or acquired.
    Spinal muscle atrophies (Progressive muscle atrophy)
  157. What is an uncommon x-linked recessive form of bulbospinal muscle atrophy that can be mistaken for ALS. Affects only men usually after age 30.
    Kennedys disease
  158. What is a group of genetic degenerative diseases associated with degneration of muscle fibers. Effects are generally diffuse, chronic, and progressive.
    Muscular dystrophies
  159. What is a disease of striated muscle that can be associated with a numner of infectious processes causing dysarthria or dysphagia?
  160. What is an autoimune disease that is characterized by rapid weakening of voluntary muscles with use and improvement with rest.
  161. What is characterized by weakness but with an improved response to repetitive nerve stimualtion. It occurs mostly in men with oat cell carcinoma of the lung.
    Lambert-eaton myasthenic syndrome
  162. The most common cause of _______ is contaminated food.
  163. Any brainstem stroke that affects nuclei of speech cranial nerves can lead to ________ dysarthria.
  164. What is caused by occlusion in the intracranial vertebral artery or the posterior inferior cerebellar artery. It leads to sensory loss, dysarthria and dysphagia.
    Wallenberg's lateral medullary syndrome
  165. What is caused by vascular lesions of the jugular vein and carotid artery, skull fractures, and tumors. It produces flaccid dysarthria.
    Collet-Sicard syndrome
  166. What is caused by injury to the hypoglossal nerve and produces lingual weakness?
    Medial medullary syndrom
  167. What is a disorder of unknown cause,but frequently is preceeded by viral infection, demyelination occurs in both peripheral and cranial nerves.
    Guillain-Barre syndrome
  168. What is similar to Guillane-Barre but less acute and more prolonged in course. May suffer frequent reccurent attacks.
    Chronic demyelinating polyneuritis
  169. What is a rare viral disease, recover muscles that arent paralyzed in 6 months
  170. What is a nonviral chonic infection that can occur in all organs and tissues?
  171. Affected individuals may develop neurologic complications as a result of opportunistic infections.
    Acquired immune deficiency syndrome (AIDS)
  172. What is the most common fungal infection is AIDS and can lead to cranial nerve palsies?
    Crytococcal meningitis
  173. What is the most common CNS tumor in AIDS and can lead to cranial nerve involvement and flaccid dysarthria?
    CNS lymphona
  174. What can lead to cranial nerve involvement and flaccid dysarthria?
  175. ________ _________ most often but not always limited to the laryngeal branches of the vagus nerve, is a frequent cause.
    Surgical trauma
  176. What are characteristics of phonatory incompetence for flaccid?
    • breathy voice
    • audible inspiration
    • short phrases
  177. What are characteristics of resonatory incompetence for flaccid?
    • hypernasality
    • nasal emission
    • imprecise consonants
    • short phrases
  178. What are characteristics of phonatory-prosodic insufficiency for flaccid?
    • harsh voice
    • monopitch
    • monoloudness
  179. What is a perceptually distinctive MSD produced by bilateral damage to the direct and indirect activation pathways of the CNS?
    Spastic dysarthria
  180. What are the characteristics of spastic dysarthria?
    • weakness and spasticity
    • slows movement and reduced its range and force
  181. ________ is a hallmark of upper motor neuron disease.
  182. The clinical features of spastic dysarthria reflect the effects of __________ muscle tone and ________ on speech.
    • excessive
    • weakness
  183. Damage to pyramidal tracts cause:
    • loss of fine skilled movements
    • hypotonia
    • weakness
    • babinski sign
    • hyporeflexia
  184. Damage to extrapyramidal tract causes:
    • increased muscle tone
    • spasticity
    • clonus
    • hperactive stretch reflexes
    • hyperactive gag reflex
  185. What are the most salient features in patients with spastic dysarthria?
    • spasticity
    • weakness
    • reduced range of movement
    • slowness of movement
  186. Spastic dysarthria are usually associated tow what two components of the motor system?
    direct and indirect activation pathways
  187. ___________ disorders are more frequently associated with spastic dysarthria than with most other dysarthria type.
  188. Lesions in both left and right hemispheres are required to produce the bilateral damage usually associated with _____________
    spastic dysarthria.
  189. Lacunar stokes and vascular dementia are usually associated with __________
  190. What is an inflammatory demyelinating disease that affects the white matter of the brain or spinal cord.
  191. ___________ strokes accounted for most of the vascular causes
  192. Complaints of fatigue occur more frequently in ____________ than _______ dysarthria
    spastic than flaccid
  193. People with _________dysarthria have difficulty controlling laughter and crying.
  194. Dysphagia is common in ________ dysarthria
  195. _________ dysarthria is associated with impaired movement patterns rather than weakness of individual muscles.
  196. The chief disturbances in __________ dysarthria are slowness and reduced range of individual and repetitive movements, reduced force of movement and excessive or biased muscle tone or spasticity.
  197. prosodic excess for spastic-
    excess and equal stress, slow rate
  198. articulatory-resonatory incompetence for spastic-
    imprecise consonants, distorted vowels, and hypernasality
  199. prosodic insufficiency for spastic-
    monopitch, monoloudness, reduced stress, and short phrases
  200. phonatory stenosis for spastic-
    low pitch, harshness, strained-strangles voice, pitch breakes, short phrases, and slow rate
  201. What features of spastic dysarthria help distinguish it from other types of MSDs?
    • strained- harsh voice quality
    • slow speech rate
    • slow and regular speech AMRs
  202. What is a perceptually distintive motor speech disorder associated with damage to the cerebellum? Its characteristics are most evident in articulation and prosody! 
    ataxic dysarthria
  203. _________ dysarthria most clearly reflects a breakdown in timing and coordination
  204. __________ is caused by damage to the cerebellum.
  205. __________ is a rhythmic tremor of the body or head that can occur with cerebellar disease.
  206. ________ is the most common of the abnormal eyes movements that can occur in cerebellar disease.
  207. _______ is a common sign of cerebellar disease.
  208. What are the most frequent causes for ataxic dysarthria?
    degenerative, demyelinating, and vascular diseases
  209. What is the most frequent cause of ataxic dysarthria?
    degenerative diseases
  210. _____ speech AMRs are a distinguishing characteristic of ataxic dysarthria.
  211. Articulatory inaccuracy for ataxic-
    imprecise consonants, irregular articulatory breakdowns and vowel distortions
  212. prosodic excess for ataxic-
    excess and equal stress, prolonged phonemes, prolonged intervals, and slow rate. "scanning speech"
  213. phonatory prosodic insufficiency for ataxic-
    harshness, monopitch, and monoloudness
  214. Although uncommon. intermittent _____ is more frequently encountered in ataxic dysarthria thatn any other dysarthria.
  215. What features of ataxic dysarthria help distinguish it from other motor speech disorders?
    • irregular articulatory breakdowns
    • irregular speech AMR's
    • excess and equal stress
    • excess loudness varaitions
    • distorted vowels
  216. What is characterized by decreased range of movement and is associated with basal ganglia pathology and often is tied to lack of the neurotransmitter dopamine?
    hypokinetic dysarthria
  217. ___________ ____________ are the most frequent causes of hypokinetic dysarthria.
    degenerative disease
  218. __________ _________ is the most frequent single cause of hypokinetic dysarthria.
    Parkinson's disease
  219. Although ___________  usually does not emerge for several years after the onset of other signs of PD it occurs in approximately 90% of patients, nearly always preceding the onset of dysphagia, whichoccurs in about 40% of cases.
  220. ___________ is a more generic term that refers to the clinical signs of the disease regardless of etiology.
  221. What term is used to reger to degenerative neurologic diseases that include but go beyond signs and symptoms of parkinsonism.
    Parkinsonism-plus syndromes/Atypical parkinsonian disorders
  222. What is an inadequate processing of dietary copper, can result in abnormal copper depositions in the liver and brain.
    Wilson's disease
  223. What is the most common infectious cause of parkinsonism?
  224. Most PD patients develop __________ which typically is preceded by dysarthria.
  225. What is the most significant underlying neuromuscular deficit in hypokinesia as it affects speech?
    reduced range of movement
  226. prosodic insufficiency for Parkinsonian patients-
    monopithc, monoloudness, reduced stress, short phrases, variable rate, short rushes of speech, and imprecise consonants.
  227. What is the most prominent and debilitating speech feature in people with hypokinetic dysarthria?
  228. Although not always present, ________ speech rate in hypokinetic dysarthria is unique among the dysarthrias
  229. What is compulsive repetition of utterances with increasing rate and decreasing loudness?
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