Dysarthria (general) and Apraxia of speech

  1. AOS
    • can exist without clinically apparent impairments in the speech muscles for volitional production of speech
    • -disturbance in higher level planning and programming
    • -can be comorbid with broca's
  2. AOS vs Aphasia
    • AOS can exist independent of problems with reading and verbal comprehension and writing as well as spoken errors unrelated to artic and prosody.
    • -AOS has more predictable errors
    • -more initial sound errors
    • -stress and intonation are off
    • -more groping
    • -worse SMRs than AMRs
    • -the person can RECOGNIZE when they have made an error
    • - more distortions and non english phonemes
  3. motor speech planning
    • is the goal or destination
    • -movements goals of the articulators
  4. motor speech programming
    • how you are going to get to your goal or destination
    • -selects, sequences, activates and controls preprogrammed sequences of movements. Includes left posterior frontal lobe, insula and basal ganglia as well as parietal lobe
    • -specifies which muscles
  5. AOS etiologies
    • Tumours, trauma=most commonly vascular
    • less common=toxic or metabolic, infection
  6. AOS patient perspectives
    • surprised by errors
    • talk more slowly
    • know what they want to say but cant say it
  7. AOS: no difficulties with..
    • chewing, swallowing, or drooling
    • no difficulties with comprehension
    • Caveat: high comorbidity with aphasia
    • normal gag
  8. AOS Difficulties
    • oral sensory deficits
    • limb apraxia
  9. Complex speech tasks for AOS
    • -conversation and reading difficulties in intelligibility
    • -complex multisyllabic word and sentence repetition
    • -SMRs- as fast and as steady as they can
  10. Simple speech tasks for AOS
    • AMRs
    • isolated sounds or single words
    • -when do we see irregularities
  11. Perceptual Signs of AOS
    • groping or trial and error movements
    • -dysprosody
    • -difficulties initiating utterances
    • -articulatory inconsistencies
  12. AOS vs Dysarthria
    • AOS has more substitutions, more additions, more groping and less consistency(can have segments of error free speech)
    • -Normal CN exam= the movement is POSSIBLE they are just not happening
  13. CAS
    • occurs in early child hood.  Origin is often unknown but can be from CP. Could be caused by trauma, infection etc
    • Hallmarks: Speech sound production and prosody errors
  14. CAS Theoretical viewpoints: Motor theory
    a disruption in speech timing, not a language component. Disruption in feedback system
  15. CAS Theoretical viewpoints:ling theory
    not motor planning but is rooted in language and the impaired ability to develop and use phonetic/ phono heirarchy
  16. CAS Theoretical viewpoints: Motolinguistic
    a moto deficit would affect the child's ability to learn language
  17. CAS: non speech observations
    • normal receptive lang skills
    • clumsy or awkward
    • difficulty in performing volitional oral movements
    • messy eaters
  18. CAS: most common characteristics (6)
    • -difficulty sequencing sounds or syllables correctly
    • -groping
    • -silent posturing
    • -incorrect use of prosody
    • -hypernasality
    • -novel utterances more difficult to produce
  19. Diagnosis of CAS
    • feeding history
    • artic and phono
    • motor functioning
    • intelligibility
    • social behaviour
    • fine motor
    • cognitive development
  20. CAS therapy
    few functional words, songs, repitition, AACs
  21. Dysarthria
    Caused by damage to the CNS and or PNS, characterized by paralysis, weakness and or incoordination of the muscles during movement
  22. Variables to take into consideration when trying to diagnose Dysarthria
    • age of onset
    • etiology
    • natural course
    • site of lesion
    • speech components
    • perceptual characteristics
    • severity
Card Set
Dysarthria (general) and Apraxia of speech
Dysarthria and Apraxia of speech