OPTA 215 ( Motor Speech Disorders: Dysarthria and Apraxia of Speech)
Neurological Disorder
Causes impairment to muscles in different ways, depending on the impact of the condition
Speech Muscles
Breathing muscles and language areas of the brain are no exeption and can be affected just as others muscles are
Dysathria
results from weakness, paralysis or incoordination of muscles that control speech. It is of neurological orgin: Difficulty articulating sounds and words, difficulty coordinating the articulation, results in slurred or hypernasal speech.
-disorders affecting cerebellum cause and impact on difficulty coodinating motor musvulature and can do the same with speech
Spasticic Dysarthria
- Any disorder that causes spasticity with other musculature ex cerebral palsey, TBI, Stroke, ALS, MS
- Slower speech rate
- bilateral UMN impairment
- phonation sounds strained and slow
- Articulation is slow and effertful
- Hyperative gag reflex
- Emotional lability
Flaccid Dysarthia
- LMN impairments - weak muscle movements
- Breathy
- easiest to understand, final common pathway
- Phonation Many breaks for breathing
- Causes from Surgery, MND, Stroke, Truama, Guilian Barre Truama, Mythenia Gravis
- Articulation Sounds Weak a
Ataxic Dysathria
- Any disorder affecting cerebellum
Ie. stroke in cerebellum
- irregular rythms
- irregular errors
- decrease coordinations
Hyperkinetic Dys
- AKA Tardive Dyskinesia: Involuntary movements
Ie. Huntington’s disease, Torettes, Chorea, infections
- Have chorea type of spasticity
- Chorea - lot of tonge movements
-
Hypokinetic
- Reduced movements
- Basel ganglia Ie. Parkinson’s disease, Vascular
- soft voice
Mixed
ALS because it affects both upper and lower motor neurons
Apraxia of Speech
Difficulty producing learned speech sounds
- Motor planning issue
- Person may not appear to be affected by a neurological issue but has difficulty with speech***
- Can include difficulty initiating speech, if very severe, difficulty phonating
- Difficulty copying movements of the mouth: Ex. difficulty copying sticking out tongue but can instantly lick something off lips
- Longer words usually more difficult than shorter words
Apraxia in Childhood Treatment
- creating new pathways
- targeting particular mouth movements
- making prectice fun/real life context
- dependig on severity could take years
Treatment for MSD
Goal of treatment for any motor speech disorder is always functional communication
- Dysarthria; Treatment process is to work on retraining speech muscles
- Apraxia of Speech; Reestablish ability to initiate sentence production and to have better fluency with speech and sound production
- Any patient with a neurological condition may have full success in restoring speech or may have limited success which often depends on the nature of the neurological impairment.
- If limited success occurs, alternate communication devices may be explored.