Motor speech disorders: Recent Episodes
Fatima Arbi & Monthati Hlatshwayo
With this series of podcasts, motor speech disorders will be discussed. Areas that will be covered will include differential diagnosis, assessment and intervention.
This week’s podcast focused on the assessment and intervention of apraxia of speech. The first step of an apraxia of speech assessment is a screening. During the screening process the individuals’ comorbid language, cognitive communication and swallowing deficits are observed and a hearing screening is done to rule out the presence of a hearing deficit contributing to apraxia and its possible effects on the results. After that the individual is referred to a comprehensive assessment of apraxia of speech. The assessment consists of a case history, OSME, assessment of voice and resonance as well as an assessment of motor speech planning skills.
There are a number of approaches to intervention of apraxia of speech, these include articulatory kinematic, rate and/or rhythm, alternative/augmentative communication (AAC),reorganization. There are a number of treatment techniques that can be used when applying these approaches. These include sound production treatment, speech motor learning treatment, integral stimulation, tactile cueing, prosodic facilitation and many others.
We hope you enjoyed listening to the last instalment of our podcast. Thank you!
In this week’s episode, the assessment and management of dysarthria were discussed. The goal of a dysarthria assessment is mentioned as determining which speech subsystems are affected (i.e., articulation, phonation, respiration, resonance, and prosody) and the severity of impairments, identifying other systems and processes that may be affected (e.g., swallowing, language, cognition) and assessing the impact of dysarthria on speech intelligibility, communicative efficiency and effectiveness, and participation. What a dysarthria assessment consists of, things to consider when assessing dysarthria and how to assess the severity of dysarthria are all covered under assessment. The non-speech examination is discussed as a cranial nerve exam to assess facial, oral, velopharyngeal, and laryngeal function and symmetry, an observation of facial and neck muscle tone—at rest and during nonspeech activities, a DDK to judge speed and steadiness of jaw, lip, and tongue movement and, to a lesser extent, articulatory precision. Thereafter assessment of prosody, speech intelligibility, efficiency and comprehensibility are further discussed. Prosody is defined as a variation in the individual's pitch, loudness, and duration in order to convey emotion, emphasis, and linguistic information. Speech intelligibility is mentioned as how much of the individual's speech is understandable by the listener. Comprehensibility is defined as how well is the listener able to understand the spoken message, when provided with other information or cues such as the topic, the semantic context or gestures lastly efficiency is referred to the rate at which understandable and intelligible speech is communicated. Under management, tips are provided for assessing resonance, prosody, articulation and phonation. The podcast ends with the challenges of providing intervention in South Africa and how to overcome these challenges.
In this episode, we introduce motor speech disorders and speak about characteristics used to assist in a differential diagnosis of apraxia and dysarthria.
Motor speech disorders are defined as impairments in the systems and mechanisms that control the movements necessary for the production of speech. Motor speech disorders affect different aspects of an individual's quality of life some areas affected include social interactions, self-esteem and employability. The motor disorders discussed are Dysarthria and Apraxia of Speech (AOS). Dysarthria is defined as a neuromuscular disorder of motor execution resulting from abnormalities in the strength, range of motion, tone, or precision of movements required for appropriate control of the speech subsystems. Dysarthria can be caused by a number of different pathologies such as brain tumours, trauma to the nervous system, and congenital disorders. The different causes of dysarthria are discussed: flaccid, spastic, ataxic, and dyskinetic.
Apraxia of speech is considered a disorder of speech motor planning and programming in the absence of neuromuscular deficits. Apraxia is caused by a number of different pathologies that cause damage to the brain. These include brain tumours and neurodegenerative diseases. We discuss the two different types of apraxia: acquired apraxia of speech and childhood apraxia.
In order to differentially diagnose dysarthria from apraxia, we look at the features that characterise each disorder. In the podcast, future research possibilities, tips for speaking to an individual with dysarthria and the setting in which we would see such patients are discussed.
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