T Or F. medical and prosthetic devices are not used to treat apraxia.
True. pacing devices may be helpful for reducing the rate of speech
only thing would be aac devices to aid in comm,
behavioral management for AOS.
all behavioral management approaches emphasize careful selection of stimuli, orderly progression of treatment items and intensive and systematic drill
what are the 9 principles of motor learning in apraxia?
- drill, drill drill
- patients need to develop self-monitoring and self-correction skills early
- those who begin at the sound syllable or word level benefit from listen and watch me approach
- use automatic speech to begin with
- feedback is helpful (mirror)
- use speech tasks if possible (non-speech tasks have proven ineffective)
- intensive practice/therapy (w multiple reps of stimuli)
- begins with consistent practice and then moves to more variable (stress one syllable then 10 reps of stress on the other syllable)
- reduce rate to improve inaccuracy
What are Rosenbek’s 8-step continuum? aka integral stim.
- integral stimulation-ptnt listens and watches slp as she makes sound/word then ptnt imitates while slp simultaneously produces target
- same as step 1 but ptnts response is delayed and the clinician mimes the target without sound during ptnts response
- integral stim followed by imitation without cues
- integral stim with several successive productions without and intervening stim. and without cues
- written stimuli are presented without aud or vis. cues followed by patnt production while looking at the written stimuli
- written stim. with delayed production following removal of written stim. (10 sec)
- response elicited by question “what do you drink your coffee in?
- response to target in role playing situation
What is sound production treatment (SPT):
wambaugh: uses minimal contrasts bye-pie to aid in refining movement and patterns that differentiate sounds: works in hierarchy similar to 8 step plan (rosenbeck)
Prompts for restructuring oral muscular phonetic targets (prompts) ?
developed for children with AOS but now used with adults
- tactile-kinesthetic input–highly structured finger placement on ptnts face and neck to tell articulatory placement
- usually used with severe AOS with very limited verbal output.
MIT melodic intonation therapy who is a good candidate?
developed for nonfluent aphasia
-must have a good verbal comprehension and limited spontaneous output good self-monitoring (broccas with aos)
what do you do in mit?
begins with hand tapping rhythms then going to simultaneous humming with clinician addition of words and phrases and gradual fading of model
- -doesn’t use familiar tunes but emphasizes exaggerated pitch tempo and rhythm.
- -eventually modified to spoken song then speech
- success due to pulling in right brain
is biofeedback useful by itself?
no it is good in addition to other therapies
what do you use for biofeedback? (2)
EMG: feedback may help for muscle relaxation
elevtromagnetic articulography: provides visual feedback about tongue position.
what is the severe apraxia (speechless) techniques?
use automatic speech tasks
-use carrier phrases “I drink coffee in a _____”
-singing familiar songs (happy bday)
-for problems initiating phonation try yawning, sighing coughing and shaping phonation from there
pair symbolic gestures such as wave goodbye or the ok symbol for ok
what are some techniques if the client is at the sound, syllable and word level?
may help to work with nonsense words
work on isolated sounds then shape into words, hum then prolong this to ma then add a final consonant so you move to cvc
-key word technique use words correctly produced to gain control over speech by answering questions with the word, read the word etcc… then use the initial sound of this word to lead into another
-cueing strategies are helpful especially phonetic placement cues
Multiple input phoneme therapy (MIPT)?
used with severely aphasic and apraxic ptnts whose rep abilities are impaired and who have frequent stereotypical words/phrases
- identify most frequently occurring stereotypes use as target of treatement
- -1. clinician produces target many times emphasizing initial phoneme, ptnt taps simultaneously
2. patient then joins in with the repetitions
3. clinician fades voices but mouth utterance and taps as patnt says target
4. repeat these steps for other stereotypical utterances the idea is to say these stereotypical utterances voluntarily
5. then work on new words with the same initial phoneme as the stereotypical utterance.
6. targets then broadened to include all phonemes
What is voluntary control of involuntary utterances?
VCIU: similar to MIPT but relies on written as well as verbal input
-nancy helms estabrooks
What are some techniques at the multisyllabic level?
focus on rhythm stress and intonation while concurrently working on articulation
-use phonetic contrasts bye-pie
-work on rate modification via pacing board, letter board, finger tapping or metronome
contrastive stress tasks
What are contrastive stress tasks?
pick a stimulable sound, keep utterance manageable, works best with mild/mod apraxics
