CSD 2230 HUMAN COMMUNICATION DISORDERS

1. CSD 2230HUMAN COMMUNICATION DISORDERS Topic 7 Speech Disorders Motor Speech Disorders

2. 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

3. Major Types of Neurogenic Impairment • Cerebral Palsy • Dysarthria of speech • Apraxia of speech

4. 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

5. Dysarthria Group 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

6. 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

7. What Causes Motor Speech Disorders? • Stroke • Traumatic brain injury (TBI) • Anoxia • Neoplasms • Infections and toxins • Acquired diseases

8. 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

9. Types of Cerebral Palsy • Spastic (hypertonia) Characterized by too much muscle tone • Athetoid (dyskinesia) Characterized by slow involuntary movements • Ataxic Characterized by uncoordinated movements

10. Spastic Cerebral Palsy • 60% of individuals with cerebral palsy • Motor movements are jerky, labored, and slow • Infantile reflex patterns

11. Athetoid Cerebral Palsy • 30% of individuals with cerebral palsy • Slow involuntary writhing • Infantile reflex patterns

12. 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

13. 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?

14. Motor and Motor Speech Characteristics with Cerebral Palsy Other 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

15. 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

16. 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

17. 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

18. 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

19. Types and Associated Etiologies Hypokinetic Dysarthria • Characterized by hypokinesis (decreased movement) • Parkinson’s disease results in a good example of this kind of dysarthria Progressive 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

20. 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

21. 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

22. 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

23. 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