1
Q
All behaviors used to perceive and transmit information and interact with others
A
communication
- speech, language, written
2
Q
what’s the difference between speech and language?
A
Speech: Verbal communication
- Articulation: How sounds are made
- Voice: Use of vocal folds and breathing to produce sound
- Fluency: Rhythm of speech
Language: Includes what words mean, how new words are made and put together, what words work best in which situations; much more of a cultural component
3
Q
understanding language
A
receptive language
4
Q
Sharing (Communicating) thoughts, ideas, and feelings
A
expressive language
5
Q
What are the functions fo speech organs?
A
- Function primarily for breathing & swallowing
2. Function differently when used for speech production
6
Q
Acts as a barrier to prevent aspiration of food in to the lungs; acts as a valve to lock air in to the lungs (providing stability) when completing heavy work with the upper extremities
A
larynx
- ex: door opening
7
Q
create the sound of speech; controlled by interactions at the subcortical and cortical levels
A
vocal cords
8
Q
What are the receptive language skills from birth- 3 months?
A
- Startles to sound
- Quiets when spoken to
- Recognizes voice of caregivers
9
Q
What are the receptive language skills from 4-6 months?
A
- Moves eyes in response to sound
- Responds to changes in tone of voice
- Notices toys that make sound
- Pays attention to music
10
Q
What are the receptive language skills from 7-12 months?
A
- Enjoys songs or rhyming games
- Attends to directions of sounds
- Listens when spoken to
- Recognizes common words
- Begins to respond to requests
11
Q
What are the expressive language skills from birth- 3 months?
A
- Makes pleasure sounds (cooing)
- Cries to express needs
- Smiles in response to faces
12
Q
What are the expressive language skills from 4-6 months?
A
- Babbles with speech-like sounds (p, b and m)
- Giggles
- Vocalizes excitement and displeasure
- Makes gurgling sounds when left alone or when playing
13
Q
What are the expressive language skills from 7-12 months?
A
- Advanced babbling
- Uses speech or non-crying to express needs
- Uses gestures (or sign language) to communicate
Imitates different speech sounds - Has 1-2 words
14
Q
What are the receptive language skills from 1-2 years?
A
- Points to body parts
- Follows simple commands
- Understands simple questions
- Listens to simple stories
- Points to pictures in a book when named
15
Q
What are the receptive language skills from 2-3 years?
A
- Understands opposites (go/stop)
- Follows 2-step directions
- Enjoys longer stories
16
Q
What are the receptive language skills from 3-4 years?
A
- Hears when called from another room
- Hears TV/radio at the same loudness as others
- Understands words for some colors, shapes, and family members
17
Q
What are the receptive language skills from 4-5 years?
A
- Understands “order” words (First, Last, etc)
- Understands words for time (yesterday, tomorrow)
- Follows multi-step directions
- Hears and understands what is said at home and school
18
Q
What are the expressive language skills from 1-2 years?
A
- Says more words every month
- Uses 1-2-word questions
- Strings two words
- Uses a variety of consonants to begin words
19
Q
What are the expressive language skills from 2-3 years?
A
- Has a word for almost everything
- Uses 2-3 word sentences
- Increased variety of consonant sounds used
- Speech is intelligible by familiar listeners most of the time
- Directs attention to an object by naming it
- Asks why
- May stutter
20
Q
What are the expressive language skills from 3-4 years?
A
- Talks about daily activities
- Uses about 4 sentences at a time
- Unfamiliar people generally understand speech
- Answers, “Who? What? Where?” Questions
- Says rhyming words, pronouns, plurals
- Generally talks without repeating syllables or words
21
Q
What are the expressive language skills from 4-5 years?
A
- Says all speech sounds in words; may make mistakes
- Responds to “What did you say?”
- Uses sentences with >1 action word
- Tells a short story
- Maintains conversation
- Talks in different ways depending on context/ environment
22
Q
Acquired communication disorder that manifests in people previously able to use language effectively for communication
A
aphasia
- types = fluent, non-fluent
- if there is damage, there is not a compensatory mechanism without rehabilitation
23
Q
Receptive Language Impairment, poor language comprehension; Expressive Language with typical rate and melody; Result of damage to the temporal gyrus of the left hemisphere; Characterized by difficulty with word finding; Motor function typically preserved
A
fluent aphasia
- types: wernicke’s, anomic
24
Q
Results from damage to the posterior portion of the first temporal gyrus of the left hemisphere; Impaired auditory comprehension; Word substitutions common; May produce neologisms (nonsensical words)
A
Wernicke’s
- AKA sensory or receptive aphasia
- most common type of fluent aphasia
- may evolve into anomic aphasia
25
Characterized by significant word-finding difficulty, despite fluent, grammatically correct and well-formed speech; Impaired comprehension; Adaptation may include “circumlocutions” - A person answers a question vaguely to avoid notice of their impairments
anomic aphasia
26
Characterized by - limited vocabulary, hesitant speech, awkward articulation, restricted use of grammar; Auditory comprehension is preserved; Lesion - Anterior Third frontal convolution of the left hemisphere; Often associated with right hemiparesis
nonfluent aphasia
| Types: Broca's
27
Characterized By- Awkward articulation, Restricted Vocabulary, Restricted grammatical forms, Preserved auditory comprehension, Limited to 1-2 words of expression; Lesion - Subcortical White Area of the third frontal convolution of the left hemisphere, extends to the inferior portion of the motor strip (Precentral Gyrus)
Broca's
- AKA expressive, motor, verbal
- less common in those with TBI
28
Not a “type” of aphasia, but rather a designation of severity; Impaired receptive & expressive language; Lesion - Extensive damage in the CNS; Severe limitations
Global aphasia
29
Occurs in children as a result of cerebral damage from brain injury, tumor, or stroke; Same manifestations as in the adult with aphasia; Prognosis is considered better in those children who are younger due to plasticity
acquired aphasia
30
Initially presents with difficulty naming objects, will progress (in the most severe cases) to the inability to speak; Associated with dementia
Primary progressive aphasia (PPA)
| - Outside the generally accepted scheme for classification elsewhere– not caused by CVA, trauma, tumor, or infection
31
What are the means by which aphasia is assessed?
1. Naming tasks
2. Conversational speech assessment -Fluency, Effort, Articulation, Phrase length, prosody, substitutions, or omissions
3. Repetition
4. Comprehension
5. Word finding
6. Reading
7. Writing
8. Other standardized exams
32
What is the best rehab potential of aphasia
early intervention: 2-3 months following onset
- compete recovery typically occurs within hours or days
- spontaneous recover can happen up to 1 month
- recovery rates drop at 6-12 months
33
What are the two recovery dimensions of aphasia?
1. Quantification of rehabilitation of language ability
| 2. Recovery of functional communication
34
What factors contribute to prognosis of aphasia?
1. Age - younger the better
2. Employed persons demonstrated more full recovery compared with those who were unemployed at the time of their stroke
3. Recovery from post-traumatic aphasia is better than aphasia occurring secondary to a vascular origin (CVA)
4. Global aphasia=poor prognosis
5. No differences in fluent vs. nonfluent aphasia
6. Comprehension recovers better than expression
7. Negative prognositic indicators: Depression, Anxiety
Paranoia, Premorbid personality (extroverts fared better than introverts)
35
What are the categories of rehab treatment?
1. Indirect stimulation-facilitation: Views language impairments as an “access” problem
2. Direct structure-pedagogic: Views Language impairments as a “loss”
- intensive speech therapy = effective
- pharmacologic intervention = effective
36
An impairment of speech production resulting from damage to the CNS or PNS, which causes weakness, paralysis or incoordination of the motor-speech system
dysarthria
- common in TBI or CVA
- LMN damage
- anarthria = unintelligible speech
37
What are the types of dysarthria?
1. Spastic
2. Flaccid
3. Ataxic
4. Hypokinetic
5. Hyperkinetic
6. Mixed: 2+ types co-exist
38
Results from damage to bilateral pyramidal system involve the corticobulbar tracts (UMN Lesion); Characteristics: imprecise articulation, slow and labored articulation, hypernasality, harsh or strained phonation, monotonous pitch; Respiration: weak inspiration and poor control of exhalation; High incidence in those with cerebral palsy
Spastic dysarthria
| - PTs would work on breathing
39
Results from muscle weakness or low tone; Characterized by: slow and labored articulation, hypernasality, hoarse/breathy phonation, short phrases; Respiration: Shallow inhalation, reduced control of exhalation
flaccid dysarthria
40
Caused by lesions bilaterally of the deep midline nuclei and/or pathways of the cerebellum; Common in those with MS and TBI with cerebellar damage; Characterized by: disturbed timing, movement, range, control, and coordination of the muscles that control speech
ataxic dysarthria
41
Caused by lesions in the substantia nigra; Most common amongst those with Parkinson disease and parkinsonian-type symptoms Characterized by: variable precision, slow rate, poor voice quality (harsh, hoarse), excessive pauses, reduced phonation
hypokinetic dysarthria
42
Caused by lesions within the basal ganglia and/or extrapyramidal projections; Common in those with huntington’s chorea; Characterized by: variable precision, vocal harshness, prolonged sounds and intervals between words, monotonous pitch, loud
hyperkinetic dysarthria
43
What factors the treatment of dysarthria?
1. Focus on functional speech– it won’t be “normal”
2. May emphasize compensatory speech skills, which result in decreased disability
3. Goal: Improve effectiveness of communication
4. LSVT/LOUD training for those with hypokinetic dysarthria secondary to Parkinson disease - Use of exercise to stimulate dopamine production and decrease symptomatic presentation
5. Drive neuroplastic changes through principles of exercise physiology (intensity, salience, timing of treatment)
6. Use of ACA/AAC Augmentative and alternative communication aids - Speech generating programs, iPads, etc.
44
How can a PT support speech functions?
1. Posture
2. Respiration
3. Head control
4. Sitting balance
5. Set up of augmentative communication devices
- need to be able to recognize the need for referral to SLP
45
What are the do's and don'ts of working with pt with speech impairment?
Do:
1. Short and simple sentences
2. Give patient time to process
3. Make questions “yes” or “no”
4. Give physical assistive cues
5. Make directions simple
Don't:
1. Switch topics too quickly
2. Speak too quickly
3. Background noise
4. Talk while patient is doing physical activity
5. Converse with more than one person at a time
6. Change the entire command after a pt doesn't understand the first time
Neuromotor
flashcards
Decks in class (17)
# Cards
-
Neuro Review38
-
Electrodiagnosis43
-
Intro to motor control and theories31
-
Motor Learning30
-
Neuroplasticity17
-
Motor Learning Application27
-
Speech45
-
Intro to neuro rehab12
-
Normal posture20
-
Abnormal posture39
-
Neuro Sensory23
-
Muscle Tone21
-
Balance, coordination, and function38
-
Balance Assessments17
-
Clinical Theories Motor Control (Missy)29
-
Book stuff23
-
Contrived techniques37
