1. Treatment
1.1. Goals
1.1.1. To learn or relearn accurate production of speech, to improve speech intelligibility
1.2. Targets and Strategies
1.2.1. Speech and Non-speech
1.2.1.1. The targeting of improving speech, such as intelligibility, and non speech such as tongue and muscle strength.
1.2.2. Simple and Complex Tasks
1.2.2.1. How complex or simple the speech task is such as a simple task such as "m-m-m-m" and a complex task such as " I want a cookie"
1.2.3. Conditions of Practice
1.2.3.1. Practice Variability, the amount of targets being reached, Practice Schedule, the order the targets are practiced, Practice amount, how many trials, Practice Distribution, how close in time the sessions are.
1.2.4. Conditions of Feedback
1.2.4.1. Feedback frequency how often the learner receives feedback, Feedback timing, how soon after an attempt the learner recieved feedback.
1.2.5. Pretreatment Considerations
1.2.5.1. memory
1.2.5.1.1. determining if there are any memory impairments are presents in the patient
1.2.5.2. Attention
1.2.5.2.1. How long the clients attention span can last which can indicate a memory impairment
1.2.5.3. Motivations
1.2.5.3.1. Motivation is important to how they understand the relevance of their treatment.
1.2.5.4. Reference
1.2.5.4.1. Getting the client to understand which references of correctness or productions are appropriate or acceptable to the situation
2. Identification
2.1. Assessment
2.1.1. Measurement Methods
2.1.1.1. The most common measurement used is Perceptual measurements which is when the clinician listens to and watches the individual during a variety of speech and non speech tasks.
2.1.1.2. Acoustic measurements are more visual views of the individual's speech motor abnormalities.
2.1.2. Referral
2.1.2.1. Most people are referrd to speech motor assessments by a pediatrician for a child and a family practitioner for an adult.
2.1.3. Screening
2.1.3.1. Interviews with a clinician to determine the severity, nature, and cause of a potential motor abnormality.
2.1.4. Comprehensive Motor Speech Evaluation
2.1.4.1. Determines how much the motor system impairment contributes to the observed speech difficulties.
2.2. Diagnosis
2.2.1. When the professional take all the findings and compiles them to diagnose the individual therefore allowing treatment plans to be organized.
3. Characteristics
3.1. Motor Programming and Planning Disorders and Acquired Aparaxia
3.1.1. Characteristics
3.1.1.1. Apraxia of Speech: the inability to articulate a word but have the proper understanding of what it is.
3.1.1.2. The person puts a lot of effort into their speech, has an increase in pauses, distorts many speech sounds, reduction of differences in pitch, and their errors are constantly the same.
3.1.2. Causes
3.1.2.1. AOP is caused by a damaging factor to the neurological system There are several regions of the brain that are a cause for this that are under debate. Some are thought to be the left frontal cortex, the parietal cortex, and the anterior insula.
3.2. Childhood Apraxia
3.2.1. Characteristics
3.2.1.1. the inability to translate linguistic or phonetic information concerning speech production into articulate motor behaviors and the inability to learn how to do so.
3.2.2. Causes
3.2.2.1. The definite cause of Childhood Apraxia is unknown however many attribute it to a hereditary trait or a developmental cause such as Down Syndrome
3.3. Acquired Dysarthria
3.3.1. Characteristics
3.3.1.1. Spastic Dysarthria
3.3.1.1.1. characterized by low muscle tone, weakness, reduced speed and range of movement and state of hyperflexia
3.3.1.2. Flaccid Dysarthria
3.3.1.2.1. muscle weakness, atrophy, and hypotoncity that can cause reduced speed and range of movement
3.3.1.3. Hypokinetic Dysarthria
3.3.1.3.1. slowness of movement, increased muscle tone, whit effects most noticed in articulation, and articultation
3.3.1.4. Hyperkinetic Dysarthria
3.3.1.4.1. slow or fast involuntary movements, variable muscle tone. There are many time and range in how the muscles are affected. One or many muscles may be affected.
3.3.1.5. Ataxic Dysarthria
3.3.1.5.1. is a result of damage to the cerebellum that results in loss of coordination, the undershooting or overshooting when trying to reach a target and the presence of tremors.
3.3.1.6. Unilateral Upper Motor Neuron Dysarthria
3.3.1.6.1. Effects the muscle tone of one side of the articulators and usually a result of the damage of the pathway of the motor cortex
3.4. Developmental Dysarthria
3.4.1. Characteristics
3.4.1.1. Spastic Dysarthria
3.4.1.1.1. characterized by a high muscle tone, hypertonicity, and high sensitivity to reflexes, hyperreflexia
3.4.1.2. Dyskinetic Dysarthria
3.4.1.2.1. the loss of coordination of muscles, involuntary movement, such as sudden fast, flailing, jerking movement, and slow movements.
3.4.2. Causes
3.4.2.1. per, peri, or postnatal damages to the nervous system such as dificietnt oxygen flow, maternal infections, chemical exposure.
4. What is a Motor Speech Disorder
4.1. Definition
4.1.1. an impairment of speech production caused by defects of the neuro muscular system, the motor control system, or both.
4.2. Systems of Speech Production
4.2.1. Respiratory System
4.2.1.1. this is a huge aspect of speech. Weather the language uses ingressive or egressive airflow to speak it is necessary to produce fluent speech.
4.2.2. Phonatory System
4.2.2.1. regulates the production of voice and the prosodic or intonational, aspects of speech.
4.2.3. Resonatory System
4.2.3.1. regulates the resonation or vibration of the airflow as it moves from the pharynx into the oral or nasal cavities.
4.2.3.2. velopharyngeal port: the opening between the soft palate and the back of the pharynx
4.2.4. Articulatory System
4.2.4.1. regulates the control of the articulators within the oral cavity to manipulate the outgoing airflow in different ways at a very high speed.
4.3. Speech and Motor Control
4.3.1. Motor Units
4.3.1.1. movement patterns that can change is size and length of time that fit the situation
4.3.2. Motor planning, programming, and Execution
4.3.2.1. Planing:
4.3.2.1.1. refers to the processes that define and sequence articulatory goals prior to when they happen. Such as lip closure and the onset of voice production
4.3.2.2. Programming:
4.3.2.2.1. refers to the processes responsible for establishing and preparing the flow of motor information across muscles for speech production and specifying the timing and force required for the movements
4.3.2.3. Execution:
4.3.2.3.1. refers to the processes responsible for activating relevant muscles during the movements and used in speech production
4.3.3. Motor Learning
4.3.3.1. when practice of certain motor coordination is changed permanently. That is now the way the person articulates as compared to the way they did before.
5. Classification
5.1. Etiology
5.1.1. Acquired: onset is after a particular event weather it be a stroke, Traumatic Brain Injury, or Parkinson's disease.
5.1.2. Developmental: onset is due to the abnormal development of the nervous system or from damage to the nervous system at an early age. These may include, Cerebral Palsy, Down Syndrome, and other genetic disorders.
5.2. Manifestation
5.2.1. Breakdowns at the execution level: when there is a disturbance in a physical part of speech such as paralysis of the tongue.
5.2.2. Breakdowns at the planning and programing stage: muscles are intact but the coordination of all of them put together is not functioning
5.3. Severity
5.3.1. Body Structure: when there is an underlying cause for the improper function such as the central and/or peripheral nervous system being damaged.
5.3.2. Body Function: they disruption of the physiological and psychological systems such as the ability to plan or to execute speech.
5.3.3. Activity/Participation: the limitations that are present to the function or structure of speech such as fluency and naturality