Classifying Speech Motor Disorders, Dysarthria, & Cerebral Palsy

Classification

100

Define dysarthria.

"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" (Duffy, 2012)

200

Define Childhood Apraxia of Speech (CAS).

“Childhood apraxia of speech (CAS) is a neurological childhood (pediatric) speech sound disorder in which the precision and consistency of movements underlying speech are impaired in the absence of neuromuscular deficits" (ASHA, 2007)

300

Name the five areas of classification for motor speech disorders.

1. Age at onset

2. Course (progressive, congenital, chronic, etc.)

3. Site of lesion

4.  Neurologic diagnosis

5. Pathophysiology (changes that are the cause of disease)

400

Name three examples of a neurologic diagnosis.

- Degenerative

- Inflammatory

- Toxic-metabolic (affects CNS and PNS; multiple possible causes)

- Neoplastic (often in PNS, autoimmune disorder)

- Traumatic

- Vascular

500

Name three potential lesion sites for a motor speech disorder.

- Brainstem

- Cerebellum

- Cerebral cortex

- Peripheral and cranial nerves

- Neuromuscular junction

- Basal ganglia

- Pyramidal and extrapyramidal pathways

Dysarthria

100

Flaccid dysarthria involves to the _____ motor neuron unit.

Name three possible etiologies.

lower

1. Tumor

2. Trauma

3. Infection

200

Spastic dysarthria involves to the _____ motor neuron unit.

Name three possible etiologies.

upper

1. Tumor

2. Trauma

3. Degenerative disease

4. Inflammatory disease

300

Name three speech characteristics of spastic dysarthria.

- Hypernasality

- Imprecise consonants

- Vowel distortions

- Reduced speaking rate

- Harsh vocal quality

400

Name three speech characteristics of spastic dysarthria.

- Nasal emission

- Short phrases/breath groups

- Audible inspiration

- Hypernasality

- Imprecise consonants

500

Spastic dysarthria generally involves damage to the ______ and ________ ________ of the CNS.

Possible sites of lesion include the corticospinal tract, which houses the ______ ______, and the corticobulbar tract, which houses the _______ ______.

direct, indirect pathways

spinal nerves, cranial nerves

Dysarthria 2: Electric Boogaloo

100

For spastic dysarthria, signs to the direct pathways include: (list 3)

Signs to the indirect pathways include: (list 3)

Direct: hypotonia, weakness, Babinski sign, hyporeflexia

Indirect: increased muscle tone, spasticity, clonus, hyperactive gag reflex

200

Name three elements of prosodic insufficiency (common in individuals with spastic dysarthria).

Monopitch

Monoloudness

Reduced stress

Short phrases

300

List three characteristics of ataxic dysarthria.

Poor coordination

Hypotonia

Slow movements

Inaccurate movements

400

List three symptoms of individuals with hypokinetic dysarthria. (Think Parkinson's!)

- Tremor

- Masked facial expression

- Reduced ROM

500

Name five categories of abnormal movement (related to hyperkinetic dysarthria).

- chorea

- myoclonus

- athetosis

- dyskinesia

- dystonia

Diseases of the LMN Unit

100

Name three diseases of the lower motor neuron unit.

Bells Palsy

Myasthenia gravis

Moebius syndrome

200

Name three environmental factors that influence movement.

- Distance

- Conditions

- Dynamics of movement

300

Name three intrinsic factors that influence movement.

- Motivation

- Attention

- Experience

- Degree of skill

400

T/F: There is an impact on feeding for Moebius syndrome, Bells Palsy, AND myasthenia gravis.

True!

500

Moebius syndrome is a disease of the cranial nerve _____ ______.

Bells Palsy is a disease of the cranial nerve ____.

Myasthenia gravis is a disease of the _____________ ________.

Moebius - motor neuron

Bells Palsy - axon

Myasthenia gravis - neuromuscular junction

Cerebral Palsy

100

Cerebral palsy is caused by damage to the _______ _______ ______.

central nervous system

200

T/F: Cerebral palsy is considered a progressive disease that is congenital.

False! It is non-progressive and can be congenital OR acquired.

300

Name three potential etiologies of cerebral palsy.

- Trauma

- Jaundice

- Anoxia

- Infections

- Brain hemorrhage

- TBI

400

What are the four terms used to describe the distribution of CP?

Monoplegia

Hemiplegia (half the body divided sagitally)

Diplegia (two arms or two legs)

Quadriplegia

500

Name two systems further used to classify CP.

Gross Motor Function Classification System (GMFCS)

International Classification of Functioning, Disability and Health (ICF)