Cerebral Palsy and Treatment Techniques Quiz

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Questions and Answers

Match the following disorders with their relevant pacing board usage:

Verbal apraxia = Breaking up syllables Dysarthria = Slowing a sentence utterance down Cluttering/Fluency = Expanding mean length utterance Autism = Inclusion of medial or final consonants

Match the following treatment goals with their corresponding achievements:

Prosody = Improve emotive stress Intelligibility = Enhance comprehension Decreasing rate = Provide visual cues Delayed auditory feedback = Reduce communication speed

Match the following therapy techniques with their objectives:

Pitch control = Producing natural speech melody Loudness control = Enhancing clarity of speech Imitation of stress patterns = Building expressive language Terminal declination = Improving question inflection

Match the following tips for patients with their intended purposes:

Speak slowly and loudly = Enhance listener understanding Pause to let the other person think = Facilitate better conversation flow Say a topic word before sentences = Provide context for conversation Point or draw when speech is difficult = Aid in communication clarity Signup and view all the answers

Match the following speech improvement techniques with their descriptions:

Visual cue = Decreases rate of speech Emotive stress = Enhances emotional expression Intra-word stress = Changes meaning of words Question inflection = Modulates sentence tone Signup and view all the answers

Match the following types of cerebral palsy with their descriptions:

Monoplegia = One limb affected Diplegia = All four limbs affected, legs more than arms Hemiplegia = One side of the body affected Quadriplegia = Equal involvement of arms and legs Signup and view all the answers

Match the following common associated conditions with their prevalence:

Mental retardation = 60% Epilepsy = 33% Deafness = 10% Strabismus = 50% Signup and view all the answers

Match the following functional classifications with their activity limitations:

Class 1 = No limitation of activity Class 2 = Slight limitation Class 3 = Moderate limitation Class 4 = No useful physical activity Signup and view all the answers

Match the following early signs of cerebral palsy with their descriptions:

Abnormal crawling = Reptilian crawl Toe walking = Common in spastic diplegia Persistence of primitive reflexes = Asymmetrical tonic reflex Poor head control = Indicator of developmental delay Signup and view all the answers

Match the following early signs with their categories:

Birth history = Prematurity Delayed milestones = Failure to achieve expected developmental stages Altered tone = Changes in muscle stiffness Abnormal posturing = Non-typical positioning of limbs Signup and view all the answers

Match the following terms with their meanings:

Cerebral Palsy = Chronic disability of CNS origin Non-progressive defect = A lesion that does not worsen over time Immature brain = Brain development during fetal life or early childhood Developmental disabilities = Spectrum of challenges often coinciding with CP Signup and view all the answers

Match the following types of brain injuries with their characteristics:

Intracranial hemorrhage = Bleeding within the skull Periventricular leukomalacia = White-matter brain injury Seizures = Abnormal electrical activity in the brain Prematurity = Born before 37 weeks of gestation Signup and view all the answers

Match the following classifications of mobility impairment with their descriptions:

Paraplegia = Involvement of legs only Quadriplegia = Equal impact on arms and legs Diplegia = More affected legs than arms Double Hemiplegia = Bilateral involvement with one side more affected Signup and view all the answers

Match the following pre-practice considerations with their definitions:

Memory = Ability to recall and retain information Attention = Focusing on relevant stimuli or tasks Motivation = Desire or willingness to engage in treatment Goal setting = Establishing clear objectives for therapy Signup and view all the answers

Match the following treatments with the systems they address:

Postural adjustments = Respiratory System Vowel prolongation = Phonatory System Articulatory placement cues = Articulatory System Prosodic facilitation approaches = Prosody and Rate Control Signup and view all the answers

Match the following treatment techniques with their main focus:

Increasing duration of air intake = Inhalation Modifications Practicing nasal vs. oral airflow patterns = Velopharyngeal Control Controlling vocal folds = Voice Quality Improvement Rigid control techniques = Rate Control Approaches Signup and view all the answers

Match the following aspects of prosody with their definitions:

Loudness = Volume of speech Pitch = Perceived frequency of sound Duration = Length of speech sounds Intonation patterns = Melody, rhythm, and stress in speech Signup and view all the answers

Match the following conditions relevant to the treatment of Apraxia of Speech:

Acquired AOS = Result of brain injury in adults Childhood AOS = Developmental speech disorder Velum lift usage = Device for severe impairment Feedback from clinician = Guidance for speech production Signup and view all the answers

Match the following speech tasks used for diagnosis of AOS with their characteristics:

Repeating a particular word = Single-action task Repeating a list of words with increasing length = Multi-stage task Multiple word repetition = Assessing speech production variability Speech tasks from clinician = Guided practice in assessment Signup and view all the answers

Match the treatment approach with its description:

Phonetic Placement Techniques = Use diagrams and pictures to teach sound production Shaping/Progressive Assimilation = Non-speech gestures to promote sound production Contrastive Stress Drills = Teach stress and rhythm in spoken language Rosenbecks 8 step continuum = A structured approach to reinforce sound production Signup and view all the answers

Match the following treatment focus areas with their descriptions:

Improving voice quality = Enhancing overall vocal characteristics Controlling vocal folds = Regulating sound during speech Feedback from clinician = Providing cues to correct articulation Rate and rhythm control = Managing pacing in speech Signup and view all the answers

Match the target sound production stages with their descriptions:

Start with vowels = Begin treatment with the easiest sounds Voiceless sounds first = Progress to voiced sounds later Word-initial position = Focus initial sound production in the beginning of words Core vocabulary = Select meaningful words for initial treatment Signup and view all the answers

Match the following components of speech with the appropriate treatment focus:

Accuracy of speech movement = Articulatory System Manipulation of loudness = Prosody control Making postural adjustments = Respiratory support Increasing flexibility in speech = Enhanced expressive variation Signup and view all the answers

Match the recommendation with its purpose:

Short breaks = Prevent fatigue during treatment Repeated trials = Develop muscle memory Detailed sound descriptions = Clarify how to produce sounds Multimodality approach = Engage different learning styles Signup and view all the answers

Match the type of sound treated with its characteristic:

Vowel errors = Start with dominant issues Affricates = End treatment with more complex sounds Early-developing sounds = Target sounds commonly acquired first Visible sounds = Focus on sounds that can be easily seen Signup and view all the answers

Match the common challenge with its suggested technique:

Inability to produce /v/ = Bite lower lip and use voiced breath Loss of gains = Reinforce progress constantly Difficulty with phonetic cues = Use visual and verbal stimulation Challenges with clarity = Use contrastive stress drills Signup and view all the answers

Match the roles in the treatment process:

Clinician = Provides stimulation and cues Client = Produces the target utterance Visual cues = Assist with sound production Written stimuli = Facilitate reading and articulation Signup and view all the answers

Match the type of client engagement with its effect:

Verbal stimulation = Encourages imitation Visual cue only = Promotes independent production Several productions in a row = Reinforces learning Reading aloud = Enhances clarity and articulation Signup and view all the answers

Match the speech treatment principles with their rationale:

Initial success = Build confidence Stimulable sounds = Focus on achievable targets Increasing phonetic difficulty = Gradual skill acquisition Meaningful words = Ensure relevance in practice Signup and view all the answers

Match the following therapy approaches with their goals:

Strengthening = Increase power (force + speed) ROM/Reduce tone = Massage, stretching Intelligibility & Comprehensibility = Self-monitoring Articulation drill = Over articulate Signup and view all the answers

Match the following speech characteristics with their descriptions:

Vocal tremor = A shaking or wavering voice Hoarseness = Raspy or rough quality of voice Monotone = One pitch level without variation Reduced loudness = Decreased volume of speech Signup and view all the answers

Match the following articulation goals with their focus areas:

Increase co-articulatory coordination = Improve connected speech Improve single phoneme accuracy = Enhance articulation precision Improve coordination during speech tasks = Facilitate fluency Increase ROM = Enhance range of motion of articulators Signup and view all the answers

Match the following techniques with their respective uses:

Pacing board = To assist individuals with dysarthria Plastic nasal olive = To assess changes in resonance Tongue depressor = Simulate palatal lift effect Nonverbal communication strategies = Enhance communication without speech Signup and view all the answers

Match the following types of consonants with their definitions:

Pressure consonants = Consonants requiring increased airflow Alternate oral consonants = Consonants that can switch between oral and nasal Nasal consonants = Consonants produced with airflow through the nose Plosive consonants = Consonants produced by stopping airflow Signup and view all the answers

Match the following patient contexts with their speech intelligibility goals:

Clinic = Intelligibility within therapeutic settings With spouse = Improved communicative intimacy With strangers = Enhance general social interaction On the phone = Improve clarity in auditory communication Signup and view all the answers

Match the following resonance assessment methods with their actions:

Prolonging a vowel /a/ = Assess maximum phonation time Simulating palatal lift = Notice changes in resonance Taping plastic olive = Connect device to nostril Therapy sessions = Observe for perceptual improvement Signup and view all the answers

Match the following approaches used in AOS treatment with their descriptions:

Many repetitions = Reinforces automaticity through practice Visual cues = Enhances understanding through imagery Tactile cues = Involves touch to facilitate speech Decreasing rate = May help improve clarity of speech Signup and view all the answers

Match the following articulation therapy techniques with their approaches:

Maximum contractions (Tongue) = Focus on strength Resistance movements (Lips & Face) = Enhance muscle control Articulatory precision = Improve clarity Modify articulation difficulty = Tailor challenges for the patient Signup and view all the answers

Match the signs of Dysarthria with their descriptions:

Slurred speech = Difficult to understand Robotic speech = Sound choppy and unnatural Hoarse voice = Quality may sound breathy Fast speaking = Increased speech rate is noticeable Signup and view all the answers

Match the types of dysarthria with their goals:

Flaccid dysarthria = Increase tone and strength Spastic dysarthria = Decrease tone and increase ROM Hypokinetic dysarthria = Increase ROM and strength Ataxic dysarthria = Increase control over speech movements Signup and view all the answers

Match the speech production goals with their focus areas:

Establish correct breathing pattern = Improves breath support for speech Increase vital capacity = Enhances lung function Control inhalation and exhalation = Facilitates smoother speech delivery Strength and coordination of respiratory muscles = Supports effective speech production Signup and view all the answers

Match the treatment strategies for dysarthria with their methods:

Slowing down speech = Improves clarity Using more breath = Supports louder speech Strengthening mouth muscles = Aids in articulation Augmentative communication = Utilizes non-verbal methods Signup and view all the answers

Match the clinician's techniques with their actions:

Written stimuli presentation = Encourages target production Role-play situations = Simulates real-life interactions Eliciting target utterances = Prompts client response Questioning techniques = Guides client to provide responses Signup and view all the answers

Match the goals of therapy based on the type of neurologic damage with their focus:

Increase speech accuracy = Enhances communication effectiveness Improve independent communication = Promotes autonomy in expressing needs Increase tone and strength = Addresses flaccid dysarthria Decrease tone and increase ROM = Targets spastic dysarthria Signup and view all the answers

Match the different commands during treatment to their aided outcomes:

Client responds to questions = Promotes active participation Clinician uses visual cues = Enhances learning Tactile cues are applied = Facilitates better articulation Role-playing is employed = Simulates real-world conversations Signup and view all the answers

Study Notes

Cerebral Palsy

Chronic central nervous system disorder
Characterized by abnormal movement and posture
Appears in early life
Not a progressive neurological disease

Definition of Cerebral Palsy

Persistent but not unchanging movement
Disorder of movement, tone, and posture
Caused by non-progressive defect/lesion
Affects the immature brain (fetal life, infancy, childhood)
Often associated with:
- Mental retardation (60% of cases)
- Epilepsy (33% of cases)
- Visual, hearing (including deafness in 10% of cases), and speech defects
- Strabismus (abnormal eye alignment in 50% of cases)
- Cognitive dysfunction
- Sensory problems
- Emotional and behavioral problems

Excluding/Including CP

EXCLUDING: progressive pathology and lesion of the spinal cord
INCLUDING: non-progressive genetic or congenital malformation

Classifications of Cerebral Palsy

Monoplegia: One limb affected (most often an arm)
Hemiplegia: Upper motor neuron lesion on one side of the body
Double Hemiplegia: Bilateral UMNL
Diplegia: Upper motor neuron lesion of all four limbs, but legs more affected than arms.
Quadriplegia: Equal involvement of the arms and legs
Paraplegia: Lower parts of the body affected (toes, feet, legs, and potentially abdomen)

Functional Classification of CP

CLASS 1: No limitation of activity
CLASS 2: Slight limitation
CLASS 3: Moderate limitation
CLASS 4: No useful physical activity

Gross Motor Function Classification System (GMFCS)

GMFCS Level	Description
I	Walks without restrictions; limitations in more advanced gross motor skills
II	Walks without assistive devices; limitations in walking outdoors and in the community
III	Walks with handheld assistive mobility devices; limitations in walking outdoors and in the community
IV	Self-mobility with limitations; children are transported or use power mobility outdoors and in the community
V	Self-mobility is severely limited even with the use of assistive technology

Early Signs of Cerebral Palsy

Birth History: Prematurity, seizures, intracranial hemorrhage, periventricular leukomalacia
Delayed Milestones: Developmental delays
Abnormal Motor Performance: Handedness, abnormal crawling (reptilian crawl) toe walking (spastic diplegia)
Altered Tone: Changes in muscle tone
Persistence of Primitive Reflexes: Asymmetrical tonic reflex
Abnormal Posturing: Unusual body position

Early Markers of CP

Slow head growth
Poor head control
Eye: roving eyes, poor hand regard, persistent squint
Ear: lack of auditory response
Irritability, seizures, poor suck, poor quality of sleep
Extreme sensitivity to light
Cortical thumb beyond 8 weeks
Handedness
Lack of limb movements
Scissoring of lower limbs
Toe-walking
Abnormal tone
Stereotypic abnormal movements
Lack of alertness

Prevalence Factors

High incidence in low birth weight babies
Increased incidence in babies weighing 2.5-4kgs
Higher prevalence in boys (58%)
Higher prevalence in lower socioeconomic groups
Maternal age

Types of CP

Spastic: More than 70%, increased muscle tone, stiff muscles
Athetoid: 10-20%, uncontrollable movements
Ataxic: 5-10%, difficulties with balance and coordination
Mixed: 10%, symptoms of more than one type present

Motor Types of CP

Spastic: 70-80%, common type, stiff muscles, arises from motor cortex damage
Dyskinetic: 6%, involuntary movements, arises from basal ganglia damage
Mixed: Combination of damage

Involuntary Movement Terms

Athetosis: Slow, writhing movements, especially in hands and face
Ataxia: Unsteady walking and balance problems, typically from cerebellum damage
Chorea: Jerky movements of the head, arms, or legs
Dystonia: Twisting movements and postures of the trunk or limbs

Assessment of Cognition and Behavior

Mental retardation the most common associated condition
Conventional intelligence tests unreliable due to motor and communication deficits
Age-appropriate non-verbal intelligence tests necessary

Assessment of Vision and Hearing

Hearing impairment often associated with microcephaly and congenital heart disease
Sensorineural hearing loss prevalent where iodine deficiency is endemic

Assessment of Speech and Language

Can be due to hearing impairment, cognitive deficits or oromotor dysfunction
Communication difficulties (through language or gestures) exacerbate behavior problems

Comprehensive Assessment

Multidisciplinary team needed (neurodevelopmental pediatrician, physiotherapist, occupational therapist, clinical psychologist, speech pathologist, orthopedic surgeon, ENT, ophthalmologist, teacher, play therapist, social worker)
Ideally, all specialists are part of a single team, under one roof

Treatment of CP

Cerebral palsy is not curable, but intervention can improve capabilities and quality of life
Early intervention increases the likelihood of overcoming developmental disabilities effectively
Several disciplines, coordinated, are involved in the management
Pediatricians, surgeons, occupational therapists, speech therapists, clinical psychologists, special educators provide essential expertise

Question/Answer: Worsening of CP

Cerebral palsy is not a progressive disorder. It results from birth injury, and brain damage remains consistent. Effective therapy can reduce symptoms over time.

Question/Answer: Affecting Everyone the Same Way

CP affects individuals differently due to variable causes. Each case is unique, but may be classified into specific types based on movement disorders and the number of limbs affected.

MSD Treatment

Treatment focuses on re-learning motor aspects of speech production, involving acquisition, retention, and generalization of skills.
- Acquisition: temporary improvements during treatment.
- Retention: lasting performance enhancements
- Generalization: improvements in related but untrained behaviors, or in targeted behaviors in different contexts/settings

Treatment Targets

Nonspeech tasks (e.g., lip pursing, tongue movement) used in assessment do not necessarily translate to treatment guidelines.
Few research indicates oral motor exercises strengthen the articulators.
Complex targets are more effective than simpler ones.

Treatment Strategies (Two Approaches)

Primary Strategies: improving the impaired subsystem (specific functions in relevant speech tasks).
- Examples: improve respiratory support for speech
Compensatory Strategies: consider the individual, the environment, and communication partners

Treatment Contexts

Effective treatment demonstrates generalization in speech production in different tasks and with various conversational partners, and should be assessed regularly.

Treatment Plan

Pre-treatment considerations:
- Memory
- Attention
- Motivation
- Goal setting
- Establishing a reference point for correctness
Critical for pre-treatment planning to ensure targeted treatment success

Treatment of Respiratory System

Establish respiratory support (e.g. postural adjustments).
Modify inhalation (increase duration of air intake).
Modify exhalation (vowel prolongation).
Improve the inhalation/exhalation relationship.
Increase respiratory flexibility.

Treatment of Phonatory System

Improve voice quality (postural adjustments, relaxation therapy)
Control vocal folds to ensure natural speech.
Improve strength and control of velopharyngeal port, including nasal vs. oral airflow patterns.
Palatal lifts may be necessary for severe cases.

Treatment of Articulatory System

Focus patient's attention on accuracy, range and direction of movement during speech production.
Clinicians provide articulatory placement cues (e.g. modeling speech production).

Treatment of Prosody and Rate Control

Manipulation of factors like loudness, pitch, and duration is essential in prosody treatment.
Strategies for rate of speech reduction:
- Rigid control techniques
- Non-rigid control techniques

Rate and Rhythm Control

Use of intonation patterns to foster speech production (melody, rhythm, stress)
Improved articulation can also result; especially in individuals with AOS
Clinicians guide individuals slowly and gradually, increasing the length of utterances, encouraging patients to rely less on the clinician, and reduced intonation dependence.

Apraxia of Speech (AOS) Treatment

Formal testing: repeating specific words/phrases multiple times, or lists of increasingly longer words (e.g., love, loving, lovingly).
Treatment methods
- Repeating the same word/phrase
- Practicing specific syllables/words to transition between sounds
- Observing how a speech therapist's mouth moves
- Using visual cues (mirrors)

Apraxia: Speech Characteristics

Articulation Errors: Inconsistent, substitution errors in placement most common.
Longer Sound Sequences: Cause more errors.
Voluntary vs. Automatic speech: Voluntary speech (more complicated) is more affected than automatic.
Prosody Errors: Problems with stress, pitch, intonation.
Rate: Slow rate is common.
Stress/Pitch: Equal stress, monotone.

How is Apraxia of Speech Treated?

Spontaneous recovery is a possibility in some instances.
Speech-language pathologists use multiple approaches, and no single method is consistently the most effective - Frequent, intense, individualized sessions needed; difficult to achieve within group therapy. - Severe AOS may require prolonged, individualized therapy, ongoing while the client pursues normal schooling. - Assistive Communication Methods (e.g., formal or informal sign language, notebooks & pictures, electronic devices) may be necessary for severe cases.

Treatment (General Procedures) - AOS

Progress is slow.
Intensive, repetitive drill.
Controlled sequencing of phonemes (sounds).
Functional speech is the goal.

Special Programs - AOS

Restructuring oral muscle and phonetic targets (PROMPT) and melodic intonation therapy (MIT) are for more severe cases.
Rosenbek hierarchy for apraxia drills (8-step continuum) can be used for milder cases

AOS Treatment/General Considerations

Sequential Progression of tasks from simple to complex (CV, VC, CVC, etc., syllables, words, phrases, sentences, conversation)
General Principles: initial success, address dominant vowel errors if pronounced, importance of stimeability/early developing, visible sounds, ordering by phonetic difficulty (start with vowels), voiceless sounds before voiced. Training sounds first in word-initial position. Short breaks. Repeated trials. Choosing meaningful vocabulary.
Specific Treatment Approaches: Use a multi-modality approach; if severe, sign language and augmentative communication (AAC) may be needed.

Phonetic Placement Techniques

Provide detailed descriptions of sound production through diagrams/pictures.
Physical involvement (e.g., tongue depressors, cotton swabs, mirrors) is required.

Shaping/Progressive Assimilation

Use non-speech gestures/sounds to stimulate sound production.
Guided practice: For example, biting the lower lip, turning on the voice, and exhaling to produce /v/.

Contrastive Stress Drills

Especially effective for spoken language stress and rhythm.
Promotes better articulation.
Example: SLP asks, "Is your name Ben?". Client says, "No, my name is Ken." then the SLP questions about the name of a different person.

Treatment Principles/Considerations:

AOS therapy takes years; continuous reinforcement is crucial.

Rosenbek's 8-Step Continuum

Step 1: Clinician and client produce target utterance together.
Step 2: Clinician provides visual cues only; client produces the target word aloud
Step 3: Clinician presents the stimulus only; client produces the target
Step 4: Client produces the target without needing extra models several times in a row
Step 5: Client reads the written stimulus aloud
Step 6: Client produces the target using the written stimulus; removed stimulus
Step 7: Clinician asks a question, and client responds with target word
Step 8: Role-play eliciting a target utterance

Treatment of Dysarthria

Depending on specific dysarthria type, therapy goals may include slowing down speech, incorporating more breath for louder speech, strengthening oral/facial muscles, distinct articulation for better speech production, or using AAC (augmentative/alterative communication).
Focus of therapy: dictated by 1) affected subsystems 2) nature of neurologic damage
Some Goals:
- Flaccid: tone and strength
- Spastic: decreasing tone, increase ROM
- Hypokinetic; increasing ROM and strength
- Hyperkinetic; increasing control
- Ataxic; increasing control
General Goals: improving speech/communication efficacy; improved independent communication

Respiration

Goals:*
Establishing correct breathing pattern.
Increasing vital capacity
Facilitating control of inhalation/exhalation.
Improving strength and coordination of respiratory muscles
WHY:* Breath support for speech production; effective breath management is essential in speech production

Respiration - Strategies

Modify posture (sitting upright is usually best)
Establish diaphragmatic breathing (hands on diaphragm to feel downward/outward motion). Guiding client to clavicular breathing may be necesssary.
Practice slow deep breath
Sustained phonation, maintaining and increasing/decreasing intensity
Monitoring breaths during connected speech

Phonation

Goals:*
Establishing good coordination between respiration and phonation
Appropriate vocal onset
Controlling loudness
Achieving comfortable pitch & inflection
Achieving appropriate resonance
Therapy (LSVT):*
Originated for Parkinson's disease, now utilized for other neurological disorders
Intensive, behavioral treatment; at least 3-4 times/week
Goal: increase intelligibility & loudness

LSVT (Concepts - 1-4)

Concept 1: Increasing/improving vocal fold adduction - Maximum impact on intelligibility - Immediate reinforcement - Focused Practice: THINK LOUD/THINK SHOUT
Concept 2: High effort approach - Push patients to new effort levels for rigidity and hypokinesia - Putting the "load on the larynx" - Dealing with progressive neurological disease(s) - Clinician effort equals patient effort (scaling). Increased effort levels provide significant improvement for client
Concept 3: Intensive Approach - Daily practice opportunity - Maintains motivation - Maximizes habituation - Provides insight into daily changeability - Treatment 16 individual sessions/month
Concept 4: Calibration Approach - Establishing appropriate effort levels/results - Using feedback and knowledge of results in functional situations - Convincing clients that a "louder" voice is a normal, natural voice - Habituation and carry over

Resonance - Goals/Strategies

Improve velopharyngeal closure.
Improve oral flow.
Intra-oral pressure: Cheek blowing, straw/tissue/balloon blowing, oral vowels
Pressure consonants.
Alternative oral/nasal consonants

Resonance - Feel, Hear, See

Nasal olive attachment to one nostril
Encourage prolonged vowel /a/ production
Tongue depressor to simulate palatal-lift effect
Note changes in resonance
Perceptual judgment
Positive results typically evident within 4-5 sessions.

Articulation - Goals

Increase vocal power (force + speed)
Increase/decrease tone
Improve coordination during speech tasks
Improving single phoneme accuracy
Improve co-articulatory coordination

Articulation - Therapy Approaches

Strengthening
Tongue: Max contractions (laterally, superiorly, interiorly, anteriorly, midportion, posteriorly)
Lips & Face: Max contractions (retraction, protrusion, closure)
Resistance Movements: Neuromuscular facilitation
ROM/Reduce Tone: Massage/stretching to tongue, lips, face
Articulatory Precision: Reduced rate, over articulation, articulation drill, modify difficulty

Intelligibility & Comprehensibility

Goals:*
Intelligibility within specific contexts (clinic, with spouse, with strangers, in noise, on phone).
Self-monitoring
Clarification strategies
Approaches:*
Pacing board
Increased effort/articulation -Modify the environment (background noise, lighting)
Train listeners
Nonverbal communication
Augmentative methods

Pacing Board (Speech)

Designed for pacing speech in individuals with dysarthria; unclear, slurred articulation, and rapid rate.
Helps organize speech and improve communication.
Can be used for speech-related disorders (verbal apraxia, motor planning, dysarthria, cluttering/fluency, language disorders, autism, articulation/phonological processing).
Treatment goals:
- Breaking down syllables.
- Slowing speech.
- Including medial/final consonants.
- Expanding length of utterances

Intelligibility & Comprehensibility - Alphabet Boards (AAC)

AAC Alphabet Boards
Decreased rate of speech
Giving the listener a visual cue (letter cues).
Delayed auditory feedback

Prosody
Goals:*
Improve emotive and linguistic stress.
Produce natural speech melody
Approaches:*
Pitch control
Loudness control
Imitation of stress patterns
Production of specified stress patterns
Terminal declination
Question inflection
Intra-word stress that changes meaning

Tips for Patients

Introduce one word/phrase before starting a sentence.
For instance: say "dinner" before discussing what you wish to eat.
Check with the listener for clarity.
Speak slowly and loudly. Pause between phrases.
Avoid speaking excessively, particularly when fatigued.
Use alternative communication methods - drawing, writing, or pointing - when conventional speech is challenging.

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Description

This quiz focuses on matching various disorders and treatment techniques related to cerebral palsy. Participants will align treatment goals with achievements, as well as therapy techniques with their objectives. It enhances understanding of speech improvement techniques, mobility impairments, and early signs of cerebral palsy.