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Questions and Answers
The facilitatory approach to motor speech disorders is based on the idea that vegetative movements of respiration are unrelated to speech.
The facilitatory approach to motor speech disorders is based on the idea that vegetative movements of respiration are unrelated to speech.
False
Non-speech oral motor treatments focus only on phonetic and phonemic aspects of speech.
Non-speech oral motor treatments focus only on phonetic and phonemic aspects of speech.
False
The facilitatory approach incorporates isotonic and isometric exercises to improve tone abnormalities.
The facilitatory approach incorporates isotonic and isometric exercises to improve tone abnormalities.
True
Nonspeech oral motor treatments are not concerned with developing motor skills for speech production.
Nonspeech oral motor treatments are not concerned with developing motor skills for speech production.
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A primary goal of the facilitatory approach is to correct speech before improving posture, tone, and strength.
A primary goal of the facilitatory approach is to correct speech before improving posture, tone, and strength.
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Stroking muscles helps in reducing muscle tension and creating a state of emotional relaxation.
Stroking muscles helps in reducing muscle tension and creating a state of emotional relaxation.
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Strength training primarily targets muscle endurance, but not muscle power.
Strength training primarily targets muscle endurance, but not muscle power.
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Tapping on muscles increases muscle relaxation by stimulating the muscle spindle.
Tapping on muscles increases muscle relaxation by stimulating the muscle spindle.
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Low-frequency vibration helps to stimulate muscle activity.
Low-frequency vibration helps to stimulate muscle activity.
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Isometric exercise involves changing the length of the muscle while holding a contraction.
Isometric exercise involves changing the length of the muscle while holding a contraction.
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Active stretching can be performed by both the client and the practitioner.
Active stretching can be performed by both the client and the practitioner.
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Cold therapy is not commonly used in the treatment of persons with neuromuscular disorders.
Cold therapy is not commonly used in the treatment of persons with neuromuscular disorders.
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Superficial heat is utilized to reduce muscle spasms and spasticity.
Superficial heat is utilized to reduce muscle spasms and spasticity.
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Quick stretching generally leads to a decrease in muscle tone.
Quick stretching generally leads to a decrease in muscle tone.
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Range of Movement (ROM) refers to movement of a muscle beyond its typical operating range.
Range of Movement (ROM) refers to movement of a muscle beyond its typical operating range.
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Study Notes
Facilitatory Approaches in the Treatment of Motor Speech Disorders
- Techniques include sensory-motor and non-speech oromotor techniques
- Approaches are divided into facilitator and compensatory
- Facilitatory approach assumes vegetative movements of respiration and feeding underlie speech, assuming speech can be facilitated by certain procedures
- Reflex based therapies are one type of vegetative therapies
- Other therapies include motokinesthetic treatment, sensorimotor stimulation of oral structures, oral motor programs with non-speech exercises, and manipulation techniques(intraoral and extraoral)
- Improving posture, tone, and strength are prioritized before speech correction
- Isotonic and isometric exercises are used to improve tone abnormalities
Nonspeech Techniques
- Nonspeech oral motor treatments (NSOMTs) differ from phonetic and/or phonemic treatments
- NSOMTs target nonspeech motor movements and oral postures
- The aim of NSOMTs is to develop motor patterns for speech sound production
- NSOMTs use exercise movements, instruments (horns, whistles), and stimulatory techniques
- The purpose is to facilitate the development of motor skills needed for speech sound production through sensorimotor and oral motor intervention.
- This allows the child to develop motor skills for speech and motor memory of speech sound productions so they can acquire placement of articulators.
Assumptions Underlying NSOMTs Use
- NSOMTs imply a muscle deficit is the root of developmental sound system disorders
- The approach suggests parallels between the neurophysiology of limbs and oral musculature, implying similar therapeutic principles apply to rehabilitation of both
- There's a proposed transfer of training from NSOMT tasks to speech tasks
Types of NSOMTs
- Active muscle exercises (strength training and stretching) are commonly used
- Isotonic exercise movements result in changes in muscle length
- Isometric exercise movements create tension without significant muscle length change
- Examples include: lip pops (isotonic) and holding a tongue depressor between lips (isometric) to improve strength
Strength Training
- Strength training programs can involve isotonic or isometric muscle exercises
- Isotonic movements change muscle length with relatively constant tension.
- Isometric movements create tension without considerable length changes
Stretching
- Stretching involves moving a muscle or muscle group beyond its typical range
- A corollary to stretching is range of motion (ROM), wherein muscle or muscle group is moved within its expected range
- Stretching exercises can either increase or decrease muscle tone
- Active stretching (where the client moves the muscle) and passive stretching (where the practitioner moves the muscle) are both used
- Quick stretching increases muscle tone, while slow stretching inhibits the stretch reflex, thus decreasing muscle tone
Sensory Stimulation
- Sensory stimulation agents are used to improve or stimulate muscle function
- These techniques utilize massage, vibration, temperature (hot/cold), and electrical stimulation
- The inputs are sensed by different types of receptors (mechanoreceptors, proprioceptors, nociceptors, thermoreceptors)
- Incoming sensory information is processed at different levels of the nervous system, eliciting a motor system response
- Sensory agents can affect muscle function in ways like relaxation, increased range of movement, and altered tone
Massage
- Massage can involve stroking or tapping muscles
- Stroking is used to reduce muscle tension and promote emotional relaxation
- The technique includes stroking, kneading, and rubbing muscles
Tapping
- Tapping stimulates muscle spindles, increasing muscle tone
- It's done by striking the muscle belly during active contraction
- Tapping may also affect adjacent muscles
Vibration
- Vibration is another sensory stimulation technique employed in muscular rehabilitation
- High-frequency vibration generally stimulates muscle activity, while low-frequency vibration generally inhibits muscle activity
- High-frequency elicits a tonic vibratory response, resulting from muscle spindle stimulation
- In combination, there's accompanying decrease in antagonist muscle tone through reciprocal inhibition
Temperature
- Superficial heat is applied to reduce muscle spasms, though it hasn't been as extensively used for speech musculature
- Superficial cold is used more frequently for neuromuscular disorders
Electrical Stimulation
- Electrical stimulation is used to stimulate muscle contractions
Procedure Types
- Active exercise includes strength training and stretching that overloads muscles beyond normal levels or stretches muscles (increasing or decreasing muscle tone)
- Passive exercise involves facilitating muscle movement through assistive support
- Sensory stimulation strategies utilize massage, vibration, temperature, and electrical stimulation based on individual needs which aim at relaxation or muscle tone modification
Speech Facilitation Techniques
- Facilitative techniques can be implemented independently or as adjunct therapies to improve articulatory skills
- Techniques involve extra-oral manipulations, cues (auditory, visual, tactile), and phonodental guides
- The techniques assist in teaching articulation through extra-oral manipulations, phonodental guides, and intra-oral cues
Terminologies
- Stimulator: The person directing the extra-oral manipulation
- Respondent: The person receiving the stimulation
- Manipulations: The methods used to achieve the desired outcomes
Speech Facilitation Principles
- Establishing stimulator-respondent rapport
- Teaching of position and movement for each sound in consideration of rhythmic movement, rate, pause, pressure, and duration
- Addition or exclusion of sensory stimuli
Purpose of Speech Facilitation
- To clarify and amplify initial moto-kinesthetic instructions
- To explain the production and placement of speech facilitation guides
Moto-Kinesthetic Method
- Stresses development of correct movement patterns for the articulators
- Requires clinician manipulating or stimulating the articulators to help establish the patterns
Other Stimulation Systems
- Techniques for producing visual, auditory or kinesthetic cues, and vibrotactile stimulation
Materials
- Items used for facilitation include plastic palates, tongue blades, phonodental guides, zonds, and other intra-oral devices/aids
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Description
This quiz explores the various facilitatory and compensatory approaches in treating motor speech disorders. It covers techniques such as sensory-motor treatments, oral motor programs, and the importance of improving posture and tone before speech correction. Test your knowledge of these critical therapeutic techniques and their underlying principles.
