Motor Speech Basics
Define 3 aspects of dysarthria
Damage to CNS/PNS
Perceived weakness
Abnormal muscle tone
Incoordination
What is one etiology of flaccid dysarthria?
CVA, infection, tumor, surgical trauma
What is one etiology of spastic dysarthria?
CVA, tumors, toxins, cerebral palsy
What is one etiology of UUMN dysarthria?
CVA, TBI, infection, surgical trauma, tumors
What is one etiology of hypokinetic dysarthria?
Parkinsons disease
What is one etiology of hyperkinetic dysarthria?
Huntingtons disease
What is the etiology of ataxic dysarthria?
Cerebellar damage, Friedrich's ataxia, Trauma, Degeneration
Name three aspects of an assessment for dysarthria?
Case hx, hearing screen, oral mech, respiration, phonation, resonance, articulation, prosody, functional communication
What are 3 systems can be affected with dysarthria?
Respiration, phonation, resonation, articulation, prosody
LMN
Where is the damage for spastic dysarthria?
Bilateral UMN
Where is the damage for UUMN dysarthria?
What structure is damaged in Hypokinetic dysarthria?
Basal ganglia
What structure is damaged in hyperkinetic dysarthria?
Basal ganglia
What structure is damaged in ataxic dysarthria?
Cerebellum
What is one assessment for dysarthria?
CAIDS
List two ways dysarthria differs from apraxia
Dysarthria errors are consistent vs. AOS
Dysarthria errors are on all verbal output vs. AOS
Automatic speech easier with AOS
Flaccid dysarthria occurs when what type of nerve is damaged?
Cranial
When is spastic dysarthria damage ipsilateral?
Is UUMN hypertonic or hypotonic?
Hypertonic
What does hypokinetic mean?
Lack of movement
What does hyperkinetic mean?
Excess movement
What does ataxia mean?
Incoordination
Why might a speech sample be beneficial for assessment of dysarthria?
Determine errors in each subsystem based on sample
What does bilateral mean?
Both right and left sides
Flaccid dysarthria damage is ipsilateral or contralateral?
Ipsilateral
When is spastic dysarthria damage contralateral?
Is UUMN hyperreflexive or hyporeflexive?
Hyperreflexive
What subsystem(s) are impacted from hypokinetic dysarthria?
What subsystem(s) are impacted by hyperkinetic dysarthria?
Respiration, articulation, phonation, prosody
What subsystem(s) are affected with ataxic dysarthria?
Articulation, prosody
What is one example of a non-speech compensatory strategy?
Low tech AAC/board
Active listening
Self-advocacy
What is contralateral vs. ipsilateral?
Contra = right side responsible for left
Ipsilateral = right side responsible for right side
Name two cranial nerves important for speech.
Facial, trigeminal, glossopharyngeal, vagus, accessory, hypoglossal
The pyramidal system transmits impulses for what?
Volitional movement
True or False: UUMN dysarthria is more mild in severity than spastic dysarthria.
True
How would you explain what hypokinetic dysarthria is?
Basal ganglia is suppressing movement more than it should
How would you explain what hyperkinetic dysarthria is?
Basal ganglia is not suppressing movement allowing extra movement
How would you explain what ataxic dysarthria is?
Difficulty with coordination from the cerebellum making speech sound drunken or slurred
What is one speech-related compensatory strategy?
Overarticulation, increasing breath support for speech, voice tx, palatal lift
What is paralysis vs. paresis?
Paralysis = no movement
Paresis = weakened movement
Flaccid dysarthria is due to continued connection or disconnection of LMN to UMN?
disconnection
The extrapyramidal system transmits impulses for what?
Autonomic functions below our level of awareness
What is one characteristic of UUMN dysarthria?
Unilateral weakness or spasticity
Slowed movements
Reduced ROM/force
Can manifest in any speech subsystem
What is one characteristic of hypokinetic dysarthria?
Monotone, monopitch, Imprecise phonemes, decreased vocal volume
What is one characteristic of hyperkinetic dysarthria?
Varied rate, Irregular artic, imprecise consonants, short rushes of speech
What is one characteristic of ataxic dysarthria?
Excess stress, prolonged phonemes, imprecise consonants, incoordinated speech
What is one restorative strategy for dysarthria?
Strengthening with speech
Laryngeal massage