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Questions and Answers
You are evaluating a patient. The results of the comprehensive motor speech exam revealed reduced breath support, irregular articulatory breakdowns, distorted prosody, slow articulatory movements in both single and repetitive motion tasks, imprecise consonant articulation, distorted vowels, and imprecise consonant and vowel productions that can vary from utterance to utterance but most markedly in multisyllabic words. During diadochokinesis, significantly reduced breath support, a rounded shoulder posture, glottal fry and improperly voicing voiceless sounds were observed. The most likely diagnosis is?
You are evaluating a patient. The results of the comprehensive motor speech exam revealed reduced breath support, irregular articulatory breakdowns, distorted prosody, slow articulatory movements in both single and repetitive motion tasks, imprecise consonant articulation, distorted vowels, and imprecise consonant and vowel productions that can vary from utterance to utterance but most markedly in multisyllabic words. During diadochokinesis, significantly reduced breath support, a rounded shoulder posture, glottal fry and improperly voicing voiceless sounds were observed. The most likely diagnosis is?
You are evaluating a child who is 6;9. Her teacher reported that she has a “difficult” time understanding E.K.’s speech, and that unfamiliar and familiar listeners often ask E.K. to repeat herself. In addition, it was reported that E.K. is aware of her speech difficulties, which causes frustration. The S/Z ratio was used to evaluate E.K’s respiratory and phonatory capacity, vocal efficiency to
rule out or confirm any signs of an existing pathology. E.K. sustained an s/z ratio of 1.14,
placing her within age-appropriate limits. Results of assessment revelead Her S/Z ratio was found to be within normal limits based on her age group, and her maximum
phonation duration was found to be sufficient for her age. Although E.K. attained an S/Z ratio
within normal limits, E.K.’s average duration of the /s/ and /z/ phoneme place her outside of
normal limits suggesting a respiratory deficit. Based on the data, E.K.’s DDK rates fall outside of normal limits. There were noticeable distortions in the /pʌ/ and /kʌ/ tasks and E.K. required numerous breaths to complete this task.E.K.’s vocal characteristics were assessed via clinical judgment, it was observed that she
presented with a hypernasal vocal quality, increased loudness, and an altered rate of speech
characterized by slow-to-fast. In addition, her pitch was observed to be normal. Overall, her
vocal characteristics were judged to fall outside of normal functional limits, negatively affecting
her speech intelligibility. What is the likely diagnosis
You are evaluating a child who is 6;9. Her teacher reported that she has a “difficult” time understanding E.K.’s speech, and that unfamiliar and familiar listeners often ask E.K. to repeat herself. In addition, it was reported that E.K. is aware of her speech difficulties, which causes frustration. The S/Z ratio was used to evaluate E.K’s respiratory and phonatory capacity, vocal efficiency to rule out or confirm any signs of an existing pathology. E.K. sustained an s/z ratio of 1.14, placing her within age-appropriate limits. Results of assessment revelead Her S/Z ratio was found to be within normal limits based on her age group, and her maximum phonation duration was found to be sufficient for her age. Although E.K. attained an S/Z ratio within normal limits, E.K.’s average duration of the /s/ and /z/ phoneme place her outside of normal limits suggesting a respiratory deficit. Based on the data, E.K.’s DDK rates fall outside of normal limits. There were noticeable distortions in the /pʌ/ and /kʌ/ tasks and E.K. required numerous breaths to complete this task.E.K.’s vocal characteristics were assessed via clinical judgment, it was observed that she presented with a hypernasal vocal quality, increased loudness, and an altered rate of speech characterized by slow-to-fast. In addition, her pitch was observed to be normal. Overall, her vocal characteristics were judged to fall outside of normal functional limits, negatively affecting her speech intelligibility. What is the likely diagnosis
An adult patient comes to you in a wheelchair for an evaluation. She has no use of her left leg or arm. Oral motor exam reveals left-sided facial asymmetry, slow and imprecise SMR and AMR, as well as breathy weak voice. In speech tasks, she presents with slow rate of speech, consistently slurred production of bilateral, alveolar, fricative, and affricate consonants. These errors are consistent across single syllable production, single word reading, automatic speech tasks, and in running speech. Intelligibility is approximately 70% in single word level, and 60% in conversation, the diagnosis is:
An adult patient comes to you in a wheelchair for an evaluation. She has no use of her left leg or arm. Oral motor exam reveals left-sided facial asymmetry, slow and imprecise SMR and AMR, as well as breathy weak voice. In speech tasks, she presents with slow rate of speech, consistently slurred production of bilateral, alveolar, fricative, and affricate consonants. These errors are consistent across single syllable production, single word reading, automatic speech tasks, and in running speech. Intelligibility is approximately 70% in single word level, and 60% in conversation, the diagnosis is:
An adult patient comes to you for an evaluation. Oral motor exam was limited, as the patient was unable to follow directions like “stick out your tongue” or “smile”. Spontaneous symmetrical smile noted when patient first walked in but was unable to reproduce on command. Automatic speech tasks were 100% intelligible, however, when completing confrontation naming tasks and sentence repetition, sound distortions were noted throughout with slow, effortful speech and intermittent groping movement of the lips. Patient was visibly frustrated by his errors. The likely diagnosis is:
An adult patient comes to you for an evaluation. Oral motor exam was limited, as the patient was unable to follow directions like “stick out your tongue” or “smile”. Spontaneous symmetrical smile noted when patient first walked in but was unable to reproduce on command. Automatic speech tasks were 100% intelligible, however, when completing confrontation naming tasks and sentence repetition, sound distortions were noted throughout with slow, effortful speech and intermittent groping movement of the lips. Patient was visibly frustrated by his errors. The likely diagnosis is:
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Your patient demonstrates rapid speech rate, fleeting dysfluencies, and reduced loudness. She reports feeling as if she speaks loudly, but everyone asks her to speak up. What type of dysarthria do you diagnose?
Your patient demonstrates rapid speech rate, fleeting dysfluencies, and reduced loudness. She reports feeling as if she speaks loudly, but everyone asks her to speak up. What type of dysarthria do you diagnose?
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Your patient demonstrates overall good intelligibility with occasional disruptions and imprecision caused by involuntary movements. Loudness is typically within normal limits but is intermittently too loud or too soft. What type of dysarthria do you diagnose?
Your patient demonstrates overall good intelligibility with occasional disruptions and imprecision caused by involuntary movements. Loudness is typically within normal limits but is intermittently too loud or too soft. What type of dysarthria do you diagnose?
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You are conducting a comprehensive motor speech exam on an individual who just had a CVA. The most noticeable perceptual characteristic include a change in articulation and a slow rate of speech. The patient complains of slurred speech, drooping lower face, thick tongue, drooling, and mild swallowing difficulty. The likely diagnosis is:
You are conducting a comprehensive motor speech exam on an individual who just had a CVA. The most noticeable perceptual characteristic include a change in articulation and a slow rate of speech. The patient complains of slurred speech, drooping lower face, thick tongue, drooling, and mild swallowing difficulty. The likely diagnosis is:
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Study Notes
Patient Diagnosis 1
- Reduced breath support, irregular articulatory breakdowns, distorted prosody, slow articulatory movements, imprecise consonant articulation, and distorted vowels suggest a diagnosis of Dysarthria.
Patient Diagnosis 2
- E.K., a 6-year-old, has a high S/Z ratio, but her average duration of /s/ and /z/ phonemes fall outside of normal limits, indicating a respiratory deficit.
- Her vocal characteristics include hypernasal quality, increased loudness, and altered rate of speech, leading to poor speech intelligibility.
- The likely diagnosis is Childhood Apraxia of Speech (CAS).
Patient Diagnosis 3
- The patient, an adult, presents with left-sided facial asymmetry, slow and imprecise SMR and AMR, and breathy weak voice.
- Slow rate of speech, consistently slurred production of consonants, and approximately 70% intelligibility suggest a diagnosis of Dysarthria.
Patient Diagnosis 4
- The patient demonstrates impaired oral motor skills, inability to follow directions, and automatic speech tasks with 100% intelligibility.
- However, sound distortions, slow, effortful speech, and intermittent lip movements during confrontation naming tasks and sentence repetition suggest a diagnosis of Apraxia of Speech.
Patient Diagnosis 5
- Rapid speech rate, fleeting dysfluencies, and reduced loudness, despite the patient's perception of speaking loudly, suggest a diagnosis of Hypokinetic Dysarthria.
Patient Diagnosis 6
- Good intelligibility with occasional disruptions, imprecision, and involuntary movements, along with intermittently loud or soft loudness, suggest a diagnosis of Hyperkinetic Dysarthria.
Patient Diagnosis 7
- Complaints of slurred speech, drooping lower face, thick tongue, drooling, and mild swallowing difficulty after a CVA suggest a diagnosis of Dysarthria.
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Description
Test your knowledge on diagnosing motor speech disorders based on a comprehensive motor speech exam. Evaluate symptoms such as reduced breath support, irregular articulatory breakdowns, distorted prosody, and more to determine the most likely diagnosis.
