Motor Speech Disorders Treatment Techniques

Facilitatory Approaches in the Treatment of Motor Speech Disorders

• Facilitatory approaches assume vegetative movements (respiration, feeding) underlie speech.
• These approaches use procedures that aim to facilitate speech development.
• Vegetative Therapies include reflex-based therapies.
• Other techniques involve sensorimotor stimulation of oral structures and manipulation (intraoral and extraoral).
• Improving posture, tone, and strength is crucial before correcting speech.
• Isotonic and isometric exercises help improve tone abnormalities.

Nonspeech Techniques (NSOMTs)

• NSOMTs differ from phonetic/phonemic treatments.
• NSOMTs target nonspeech motor movements and oral postures for speech sound production.
• These techniques employ various exercises, instruments (horns, whistles), and stimulatory techniques.
• The goal of NSOMTs is to facilitate the development of motor skills for speech sound production, motor memory of speech production, and placement of articulators.

Assumptions Underlying NSOMTs

• NSOMTs imply a muscular deficit is the primary cause of developmental sound system disorders.
• Oral musculature and limb musculature share similar neurophysiology.
• Principles established for limb rehabilitation apply to oral rehabilitation.
• Training from NSOMT tasks transfers to speech tasks.

Types of NSOMTs

• Active muscle exercises (strength training, stretching)
• Passive muscle exercises (PROM and passive stretch)
• Sensory stimulation (massage, vibration, temperature, electrical stimulation)

Strength Training

• Strength training programs use isotonic or isometric exercises.
• Isotonic exercises cause muscle length change with relatively constant muscle tension.
• Isometric exercises create muscular tension without changing muscle length.

Stretching

• Stretching involves moving a muscle or muscle group outside its typical operating range.
• Range of movement (ROM) is a corollary of stretching.
• Stretching exercises can increase or decrease muscle tone.
• Active stretching involves the client, passive stretching involves a practitioner.

Sensory Stimulation

• Sensory stimulation employs differing agents to improve or stimulate muscle function (massage, vibration, temperature, electrical stimulation).
• Inputs are processed by various nerve receptors.
• Sensory stimulation produces relaxation, altered range of movement, and changed muscle tone.

Massage

• Massage can involve stroking or tapping muscles.
• It aims to reduce muscle tension and foster a state of relaxation.
• It may enhance functional performance, improve local blood flow, reduce pain, and promote muscle suppleness.

Tapping

• Tapping muscles aim to stimulate muscle spindles, increasing muscle tone.
• It's done with fingertips during active contraction.
• Tapping may be less effective on oral structures due to neurophysiological differences compared to limbs.

Vibration

• Vibration is a sensory stimulation used in muscular rehabilitation.
• High-frequency vibration stimulates muscle activity, while low-frequency vibration inhibits activity.
• Vibration can influence muscle tone and activity via reciprocal inhibition.

Temperature

• Superficial heat can reduce muscle spasms and spasticity.
• Cold can decrease nerve conduction speeds and reduce spasticity.

Electrical Stimulation

• Electrical stimulation can address muscular problems, but has less extensive research in speech pathology.
• Applications include intramuscular stimulation, applied to skin or muscles via electrodes.
• Low-level electrical voltage targets stimulating muscle contractions.

Speech Facilitation Techniques

• These techniques enhance or supplement articulatory skills training.
• Techniques involve extraoral manipulation (using cues, guides, and phonation guides).
• They are used to assist in teaching articulatory functions.
• Creating an awareness of articulatory movements and placements is a major goal.

Terminologies

• Stimulator: Person applying extraoral manipulations (finger and hand cues, phonodental guides).
• Respondent: Person responding to the stimulation.
• Manipulations: Skillful or dextrous extraoral treatment.

Speech Facilitation Principles

• Rapport between stimulator and respondent is crucial.
• The practitioner specifically teaches the position and movement of each phoneme (sound).
• Controlled manipulation techniques (rhythm, rate, pause, pressure, duration).
• Sensory stimuli are either included or excluded as needed.

Purpose of Speech Facilitation

• Amplifying and clarifying original instructions for motor-kinesthetic stimulation.
• Describing production and placement of speech facilitation phonodental guides.

Moto-Kinesthetic Method

• This method stresses the development of correct movement patterns to manipulate the articulators.
• It aims for individual articulator coordination for sound production.

Additional Stimulus Systems

• Techniques can include visual, auditory, and kinesthetic cues.
• Vibrotactile stimulation may be part of treatments.

Devices

• Tongue blades, phonodental guides, and dental devices (e.g., plastic palates, zonds, intraoral training aids, etc.) can be used for speech stimulation.

Programs

• Some programs utilize three phases to address speech errors: observation, stimulation, and discussion.

This quiz covers key concepts and techniques related to the treatment of motor speech disorders, particularly focusing on the facilitatory approach and nonspeech oral motor treatments. Participants will explore the roles of various methods including muscle stimulation and sensory techniques in rehabilitation. Test your understanding of these important practices in speech therapy and neuromuscular treatment.