What is cerebral palsy?
A non progressive motor disorder due to pre- peri- or post- natal damage
What are the types of CP?
- Spastic
- Athetoid
- Ataxic
- Rigid
- Mixed
What is Spastic CP?
- about 50% of kids have it.
- Slow jerking movements with increased muscle tone
What is Athetoid CP?
- about 10% of kids.
- Have slow writhing and involuntary movements.
What is Ataxic CP?
- 5 to 10% of kids.
- Have balance problems but normal reflexes and normal muscle tone
What is Rigid CP?
- 1% of kids.
- Simultaneous contraction of all the muscle groups
What is Mixed CP?
- about 30% of kids.
- They might have several types
Speech Problems and Their Assessment for CP
- Oral motor
- Feeding
- Slow DDK rates
- Resonance
- Prosody
- Respiration
- Phonation
- Articulation
What is oral motor for CP speech problem?
-we have to assess speech and nonspeech tasks
What is slow DDK rates for CP speech problem?
-discoordination of tongue
What is prosody for CP speech problem?
-monotone
What is respiration for CP speech problem?
-they’re breathy, they can have rapid breathing, and wasted air, and trailing off at the ends of sentences
What is phonation for CP speech problem?
-weak and strained voice because the vocal folds are hyperadducted
What is articulation for CP speech problems?
- They are imprecise and have weak pressure consonants
What is Dysarthria?
Neuromotor disorder affecting all systems: respiration, phonation, articulation, resonance, prosody
What is Dysarthria due to?
Due to: CP, degenerative diseases, stroke
Dysarthria Characteristics to Look for in Assessment
- Breathy respiration
- Difficulty with appropriate syllable stress
- Artic: imprecise, distorted consonants; weak pressure consonants
- Resonance: hypernasality
- Phonation: monotone, monoloudness, often soft voice
- PRAXIS tip: Festination means small, shuffling steps
What is Childhood Apraxia of Speech?
- Inconsistent errors
- Flat prosody
- Difficulty sequencing sounds and syllables
- Moderately to severely unintelligible
What did (Owens, Farinella, & Metz 2015) say about CAS?
- CAS is not the result of neuromuscular weakness
- Children with CAS have impaired motor planning and programming capabilities
- Unable to automatically learn motor plans necessary for rapid, accurate speech production
- Better at word level than connected speech
CAS associated problems:
- Family history in some children
- Possible learning disability
- Better receptive language skills, lower expressive language
- Slow treatment progress
- Oral apraxia/difficulty with volitional nonspeech tasks
- Slow DDKs
- Soft neurological signs-gross and fine motor incoordination (clumsy)
CAS Assessment:
- Pitch, loudness, prosody
- Overall intelligibility
- Resonance-ex: hypernasality?
- DDKs-alternating /pupupupupu/
And sequencial motion /putukuputuku/ - Sample production of same phoneme in multiple trials
- Ask them to produce words in both imitative and spontaneous modes
- Developmental history-feeding, sucking problems? Slow language development?
- Volitional nonspeech movements of oral muscles in isolation and in sequence
- Receptive and expressive language skills
- Articulation-give test, admin items repeatedly to assess consistency of production
- Connected speech sample
- Production of polysyllabic words—have them say the words several times, check for consistency.
Remember :
inconsistency is a hallmark of CAS
What is cleft palate?
cleft is an opening in a normally closed structure
Cleft major categories:
- Isolated cleft lip
- Cleft uvula alone
- Cleft of the hard palate
- Adult cleft of soft palate and part of hard palate
- Cleft of soft and hard palate
- Combined Cleft Palate and Lip
- Unilateral cleft of the lip and palate
- Unilateral cleft palate and lip
- Bilateral
