Motor Speech Disorders at Portland State University | Flashcards & Summaries

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The motor speech programmer
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A network of structures that all contribute to the function of creating appropriate motor plans for speech. Although more structures are involved, certain left hemisphere structures such as Broca’s area and the supplementary motor cortex play a large role in this network. The primary motor cortex, basal ganglia, and cerebellum are also involved.
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Apraxia of speech is characterized by . . .
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articulation errors, limited prosody, slowed rate, and the visible groping about of the tongue, lips, and mandible. More often than not, resonance, coordination of respiration for speech, and phonation are left relatively intact.
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Common articulatory difficulties experienced by those with apraxia of speech include the following:
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■ Anticipatory substitutions

■ Consonant and vowel distortions (consonant distortions are more prevalent)

■ Perseverative substitutions

■ Phoneme additions

■ Phoneme prolongations

■ Phoneme substitutions

■ Voicing errors (Duffy, 2005)
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Primary progressive apraxia of speech
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a neurodegenerative condition in which patients display a slow onset of apraxia of speech that gains in severity over time as a result of continued atrophy of the lateral premotor cortex and the supplementary motor area.
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Buccofacial-oral apraxia
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(also known as nonverbal apraxia or oral apraxia): An inability to program and carry out any volitional movements of the tongue, cheeks, lips, pharynx, or larynx on command. Although individuals with this disorder might be unable to move their articulators in a volitional fashion on command, they usually can accomplish the same actions automatically in a natural context. 
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Ideomotor apraxia
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The lack of ability to program motor movements for pantomiming gestures and for the use of tools despite possessing the knowledge of how the tools are used and their function. For instance, an individual with this disorder can explain the purpose of a hairbrush and how to brush one’s hair, but if she is given a hairbrush, she is unable to accomplish the task on command. However, this same individual may wake up each morning and automatically brush her hair in the natural context of standing in front of the bathroom mirror 
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Ideational apraxia
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An inability to conceptualize a task, formulate motor plans required for the task, or hold in memory the idea of the task long enough to accomplish it successfully. Individuals with this disorder can perform individual components of a task but lack the ability to perform a series of actions sequentially to accomplish an entire act. An individual with this disorder, if handed a hairbrush, may be able to raise the brush to his head but then be unable to accomplish the remaining actions necessary to brush his hair successfully. The primary difference between this disorder and ideomotor apraxia is that individuals with this disorder cannot perform the task volitionally or automatically, whereas those with ideomotor apraxia perform well automatically and spontaneously, but not on command.
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Islands of intact articulation
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Portions of utterances entirely free from errors. A distinctive feature of apraxia that helps differentiate it from disarthria. 
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Components of the Motor Speech Evaluation
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■ A case history taken from medical records and from patient and caregiver interviews

■ An oral motor evaluation with maximum performance tasks

■ Speech tasks that assess error patterns in speech

■ Identification of confirmatory signs to support hypothesized motor speech diagnoses

■ Instrumental measures

■ Possibly, administration of a formal test of apraxia of speech, dysarthria, and/or intelligibility
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Oral Motor Evaluation
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An assessment where the speech-language pathologist asks the patient to move the tongue, lips, and mandible in certain ways so that the basic function of these structures and general appearance of the oral cavity can be evaluated. Speech-language pathologists employ a variety of nonspeech tasks to assess the integrity of the motor functions of the mobile articulators. Nonspeech tasks are used to isolate and test the functioning of any oral structure outside of the context of speech production for strength, mobility, range of motion, and symmetry.
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Maximum performance tasks
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These tasks are used to test a patient’s maximum limit of ability and to compare the patient’s greatest effort on a task with a known average performance rate of unimpaired individuals. If a patient’s maximum effort and performance fall short of those of unimpaired individuals, it can indicate a deficit.
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Apraxia of speech
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An inability to put together motor plans for speech.
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Q:
The motor speech programmer
A:
A network of structures that all contribute to the function of creating appropriate motor plans for speech. Although more structures are involved, certain left hemisphere structures such as Broca’s area and the supplementary motor cortex play a large role in this network. The primary motor cortex, basal ganglia, and cerebellum are also involved.
Q:
Apraxia of speech is characterized by . . .
A:
articulation errors, limited prosody, slowed rate, and the visible groping about of the tongue, lips, and mandible. More often than not, resonance, coordination of respiration for speech, and phonation are left relatively intact.
Q:
Common articulatory difficulties experienced by those with apraxia of speech include the following:
A:
■ Anticipatory substitutions

■ Consonant and vowel distortions (consonant distortions are more prevalent)

■ Perseverative substitutions

■ Phoneme additions

■ Phoneme prolongations

■ Phoneme substitutions

■ Voicing errors (Duffy, 2005)
Q:
Primary progressive apraxia of speech
A:
a neurodegenerative condition in which patients display a slow onset of apraxia of speech that gains in severity over time as a result of continued atrophy of the lateral premotor cortex and the supplementary motor area.
Q:
Buccofacial-oral apraxia
A:
(also known as nonverbal apraxia or oral apraxia): An inability to program and carry out any volitional movements of the tongue, cheeks, lips, pharynx, or larynx on command. Although individuals with this disorder might be unable to move their articulators in a volitional fashion on command, they usually can accomplish the same actions automatically in a natural context. 
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Q:
Ideomotor apraxia
A:
The lack of ability to program motor movements for pantomiming gestures and for the use of tools despite possessing the knowledge of how the tools are used and their function. For instance, an individual with this disorder can explain the purpose of a hairbrush and how to brush one’s hair, but if she is given a hairbrush, she is unable to accomplish the task on command. However, this same individual may wake up each morning and automatically brush her hair in the natural context of standing in front of the bathroom mirror 
Q:
Ideational apraxia
A:
An inability to conceptualize a task, formulate motor plans required for the task, or hold in memory the idea of the task long enough to accomplish it successfully. Individuals with this disorder can perform individual components of a task but lack the ability to perform a series of actions sequentially to accomplish an entire act. An individual with this disorder, if handed a hairbrush, may be able to raise the brush to his head but then be unable to accomplish the remaining actions necessary to brush his hair successfully. The primary difference between this disorder and ideomotor apraxia is that individuals with this disorder cannot perform the task volitionally or automatically, whereas those with ideomotor apraxia perform well automatically and spontaneously, but not on command.
Q:
Islands of intact articulation
A:
Portions of utterances entirely free from errors. A distinctive feature of apraxia that helps differentiate it from disarthria. 
Q:
Components of the Motor Speech Evaluation
A:
■ A case history taken from medical records and from patient and caregiver interviews

■ An oral motor evaluation with maximum performance tasks

■ Speech tasks that assess error patterns in speech

■ Identification of confirmatory signs to support hypothesized motor speech diagnoses

■ Instrumental measures

■ Possibly, administration of a formal test of apraxia of speech, dysarthria, and/or intelligibility
Q:
Oral Motor Evaluation
A:
An assessment where the speech-language pathologist asks the patient to move the tongue, lips, and mandible in certain ways so that the basic function of these structures and general appearance of the oral cavity can be evaluated. Speech-language pathologists employ a variety of nonspeech tasks to assess the integrity of the motor functions of the mobile articulators. Nonspeech tasks are used to isolate and test the functioning of any oral structure outside of the context of speech production for strength, mobility, range of motion, and symmetry.
Q:
Maximum performance tasks
A:
These tasks are used to test a patient’s maximum limit of ability and to compare the patient’s greatest effort on a task with a known average performance rate of unimpaired individuals. If a patient’s maximum effort and performance fall short of those of unimpaired individuals, it can indicate a deficit.
Q:
Apraxia of speech
A:
An inability to put together motor plans for speech.
Motor Speech Disorders

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