Upload
dennis43
View
4.014
Download
0
Embed Size (px)
Citation preview
CSD 2230HUMAN COMMUNICATION
DISORDERS
Topic 7Speech Disorders
Motor Speech Disorders
Motor or Neurogenic Speech Disorders
Speech difficulties that are related to problems of movement as a result of some neurological disorder or injury
Heterogeneous Affect the planning, coordination,
timing, and execution of speech movements
May affect phonation, resonation, and articulation
Major Types of Neurogenic Impairment
1. Cerebral Palsy2. Dysarthria of speech3. Apraxia of speech
Cerebral Palsy
Heterogenous group of neurological disorders that result in difficulty with motor movements
Acquired shortly before, during, or after birth
Developmental disorder Continuum of physical
manifestations
DysarthriaGroup of related speech impairment that
result from disturbed muscular control caused by damage to the mature nervous system
Acquired disorder May affect respiration, phonation,
resonation, and/or articulation Speech characteristics include slow or rapid
motor function, decrease in the range or strength of motor skills, poor directionality or motor timing
Apraxia
Affects the phonological selection and sequencing of speech sounds and articulation
Acquired disorder Affects the ability to organize,
plan, and execute the movement of speech muscles
What Causes Motor Speech Disorders?
Stroke Traumatic brain injury (TBI) Anoxia Neoplasms Infections and toxins Acquired diseases
Cerebral Palsy
A group of nonprogressive neurological difficulties resulting from brain injury very early in life
Areas affected include motor movement, communication, growth and development, locomotion, learning, and sensation
Incidence is 1.5-3/1000 births Primary characteristics
A developmental neurogenic disorder that results from abnormal brain function
It’s not a disease Predictable motor patterns
Types of Cerebral Palsy
1. Spastic (hypertonia)Characterized by too much muscle tone
2. Athetoid (dyskinesia)Characterized by slow involuntary
movements
3. AtaxicCharacterized by uncoordinated
movements
Spastic Cerebral Palsy
60% of individuals with cerebral palsy
Motor movements are jerky, labored, and slow
Infantile reflex patterns
Athetoid Cerebral Palsy
30% of individuals with cerebral palsy
Slow involuntary writhing Infantile reflex patterns
Ataxic Cerebral Palsy
10% of individuals with cerebral palsy
Uncoordinated movements Disturbed balance which is
especially noticeable in their gait Damage is to the cerebellum
Motor and Motor Speech Characteristics
with Cerebral Palsy Speech isn’t always affected and
varies somewhat with the type of CP When speech is affected, all aspects
of speech production may be affected including respiration, phonation, resonation, articulation, and prosody
CD-ROM Ch.14.02 shows a speaker with spastic CP talking about sports. How much can you understand?
Motor and Motor Speech Characteristics
with Cerebral PalsyOther issues related to cerebral palsy:
Breathing problems Rigidity Velopharyngeal incompetency Uncoordinated articulator movements Intellectual processing Auditory processing Language impairments
Intervention might include augmentative and alternative communication systems
CD-ROM Ch14.03 illustrates conversation with such a device
The Dysarthrias A group of impairments that may
affect the speed, range, direction, strength, and timing of motor movements
Results from paralysis, weakness, or discoordination of speech muscles
Not a language disorder but rather a difficulty in motor speech control
Types and Associated Etiologies
Flaccid dysarthria Characterized by hypotonia (weak muscle
tone) which results in weakness or paralysis of the affected muscle
Speech characteristics include shallow breathing, breathy voice, aphonia (no voice), reduced pitch and loudness, monotone, hypernasality, and imprecise articulation
Etiologies include Bell’s Palsy, myasthenia gravis, and muscular dystrophy
Audio examples of flaccid dysarthria
Types and Associated Etiologies
Spastic dysarthria Characterized by hypertonia (stiff and rigid
muscles) commonly caused by stroke Speech movements are difficult and
speech is characterized as slow with jerky, imprecise articulation and reduction in the rapidly alternating movements of speech
Audio examples of spastic dysarthria
Types and Associated Etiologies
Ataxic dysarthria Characterized by a combination of
hypotonia (reduced tone) and ataxia resulting in problems in the accuracy, timing, and direction of movement
Speech movements are jerky and imprecise
Audio examples of ataxic dysarthria
Types and Associated Etiologies
Hypokinetic Dysarthria Characterized by hypokinesis (decreased
movement) Parkinson’s disease results in a good
example of this kind of dysarthriaProgressive disorder where the muscles become
rigid, resulting in reduced motor movements, involuntary shaking or tremors, slowness of movement, and difficulty initiating voluntary movements
Audio examples of hypokinetic dysarthria from Parkinson’s
Types and Associated Etiologies
Hyperkinetic dysarthria Characterized by hyperkinesia
(increased movements) in the form of involuntary tremors and tics
Major speech characteristic is imprecise articulation
Dystonia and chorea provide examples Audio examples of hyperkinetic
dysarthria from dystonia and chorea
Types and Associated Etiologies
Mixed dysarthria Caused by diffuse brain damage ALS provides a good example of
mixed dysarthria Audio examples of mixed
dysarthria from ALS
Apraxia
Disorder of motor placement and sequencing that’s unrelated to muscle weakness, slowness, or paralysis
When speech muscle groups are affected, it is called apraxia of speech
Speech difficulties are not the result of muscle weakness or slowness (dysarthria) or of linguistic processing (aphasia)
Almost always due to damage to Broca’s area in the cortex
Characteristics of Apraxia of Speech
Groping attempts to find the correct articulatory position
Frequent articulation errors Self-correcting behaviors Variable in their abilities Audio example apraxia of speech