The MSD Podcast by Sofia and Mishqa: Recent Episodes
Sofia Lamberti
This podcast series will explore motor speech disorders, namely dysarthria and apraxia of speech. It will define each disorder, discuss differential diagnosis, assessment and management of these motor speech disorders.
This podcast discusses differential diagnosis of motor speech disorders and talks through the usefulness of the linked tool for the assessment and differential diagnosis of dysarthria and apraxia of speech. Additionally, the importance of certain treatment principles are discussed. These principles include the importance of considering how a patient is going to generalise the skills they have learnt in therapy to other communication contexts, as well as the importance of the inclusion of family in therapy sessions so that they can help the patient practice and implement different communication strategies they are given at therapy to their home environment. The International Classification of Functioning, Disability and Health (ICF), which is a framework that is used to consider the domains of body functioning, body structure, activities and participation of a patient, is discussed with regard to treatment principles. The ICF is also applied to a case in this podcast in order to help clinicians understand the use of this framework when developing treatment goals that are patient-centred and inclusive of the multidisciplinary team (MDT).
Tool for differential diagnosis of motor speech disorders:
https://asha.figshare.com/articles/online_resource/Motor_speech_rating_tutorial_Iuzzini-Seigel_et_al_2022_/19709146?file=35021935
References:
American Speech-Language-Hearing Association. (n.d.). Family-Centered Practice. Retrieved October 18, 2022, from https://www.asha.org/practice-portal/clinical-topics/autism/family-centered-practice/
Enderby, P. (2013). Disorders of communication: dysarthria. Handbook of clinical neurology, 110, 273-281. https://doi.org/10.1016/b978-0-444-52901-5.00022-8
Iuzzini-Seigel, J., Allison, K. M., & Stoeckel, R. (2022, October 6). A Tool for Differential Diagnosis of Childhood Apraxia of Speech and Dysarthria in Children: A Tutorial. Language, Speech, and Hearing Services in Schools, 53(4), 926–946. https://doi.org/10.1044/2022_lshss-21-00164
McNeil, M. R., Ballard, K. J., Duffy, J. R., Wambaugh, J. U. L. I. E., van Lieshout, P., Maassen, B., & Terband, H. (2017). Apraxia of speech theory, assessment, differential diagnosis, and treatment: Past, present, and future. Speech motor control in normal and disordered speech: Future developments in theory and methodology, 195-221.
Link to MCQ:
https://forms.gle/wp7KDDCvGehzhrZh8
This podcast discusses Apraxia of Speech (AOS), which is a type of motor planning disorder. There are two types of CAS, namely Childhood Apraxia of Speech (CAS) and Acquired Apraxia of Speech (Acquired AOS). There are various characteristics of AOS, which can be used to diagnose this disorder. These characteristics include groping movements and self-correction attempts during speech production, evident dysprosody, the presence of articulatory errors (like sound substitutions), and articulatory variability (which means that a word is likely to be produced differently each time it is said). There are various ways to assess AOS, and subjective measures are seen as the ‘gold-standard’ for CAS assessment. This type of assessment requires a speech-language pathologist to perceptually interpret a client's speech from activities such as connected speech tasks. Alternatively, instrumental measures can be used to analyse the phonetic and suprasegmental prosodic features of speech, and this can be done through software such as ‘Praat’. Some methods that can be used for CAS include Melodic intonation therapy (MIT), the Touch Cue Method (TCM), as well as Integral Stimulation/ Dynamic Temporal and Tactile Cueing (DTTC). Some intervention methods that are used for acquired AOS include the Articulatory–Kinematic approach, as well as rate and/or rhythm control approaches. If a client has a severe case of AOS, and they are not able to functionally communicate due to their unintelligible speech, then
Augmentative and Alternative Communication (AAC) devices can be introduced as an effort to help them to be able to effectively communicate with others.
Here are two free tools on teacherspayteachers.com that you can download and use to screen for AOS:
A helpful tool made by Speech Language League:
https://www.teacherspayteachers.com/Product/Speech-Intelligibility-Rating-4906258?st=5c8c89b1c9223bf84c1f4fdc0f5b60c9
Another helpful tool made by Speech Dreams:
https://www.teacherspayteachers.com/Product/Vowel-Screening-and-Speech-Therapy-Assessment-for-Articulation-and-Apraxia-4671645?st=5c8c89b1c9223bf84c1f4fdc0f5b60c9
References:
Ballard, K. J., Wambaugh, J. L., Duffy, J. R., Layfield, C., Maas, E.,
Mauszycki, S., & McNeil, M. R. (2015). Treatment for Acquired Apraxia of Speech: A Systematic Review of Intervention Research Between 2004 and 2012. American Journal of Speech-Language Pathology, 24(2), 316–337. https://doi.org/10.1044/2015_ajslp-14-0118
McNeil, M. R., Ballard, K. J., Duffy, J. R., Wambaugh, J. U. L. I. E., van Lieshout, P., Maassen, B., & Terband, H. (2017). Apraxia of speech theory, assessment, differential diagnosis, and treatment: Past, present, and future. Speech motor control in normal and disordered speech: Future developments in theory and methodology, 195-221.
Murray, E., McCabe, P., & Ballard, K. J. (2014, August). A Systematic Review of Treatment Outcomes for Children With Childhood Apraxia of Speech. American Journal of Speech-Language Pathology, 23(3), 486–504. https://doi.org/10.1044/2014_ajslp-13-003
MCQ Link:
https://forms.gle/qaPvbtwmeQodi6EG9
This podcast discusses dysarthria, which is a type of motor speech disorder. This disorder results from a disturbance in neuromuscular control, which leads to weakness which affects the way in which one is able to speak. The different types of dysarthria, namely flaccid, spastic, hyperkinetic, hypokinetic, ataxic and mixed dysarthria, and the features thereof, are also discussed in this episode. Additionally, the assessment of dysarthria is discussed, which includes case history, OSME, speech production assessment, as well as a swallowing assessment. The most commonly used standard assessment is the Frenchay Dysarthria Assessment. The goal of therapy in dysarthria is to improve respiratory support, phonation, and resonance, as well as the strength of the articulators. This can be done through a prosodic and articulatory approach to therapy, as well as through behavioural and environmental modifications in order to maximise the patient’s ability to effectively communicate. Lastly, a patient with severe dysarthria can use Augmentative and Alternative Communication (AAC) devices in order to functionally and socially communicate.
References:
Altaher, A., Chu, S., Kam, R., & Razak, R. (2019). A Report of Assessment Tools for Individuals with Dysarthria. The Open Public Health Journal, 12(1), 384-386. https://doi.org/10.2174/1874944501912010384
Enderby, P. (2013). Disorders of communication: dysarthria. Handbook of clinical neurology, 110, 273-281. https://doi.org/10.1016/b978-0-444-52901-5.00022-8