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Questions and Answers
What is a key aspect to observe when assessing a client with stroke or MS during an interview?
What is a key aspect to observe when assessing a client with stroke or MS during an interview?
What is an important consideration when assessing the Deaf community's perception of their condition?
What is an important consideration when assessing the Deaf community's perception of their condition?
When assessing cranial nerve and oral motor functions, what would be a primary part of the examination?
When assessing cranial nerve and oral motor functions, what would be a primary part of the examination?
What is the primary basis for identifying and classifying deviant speech characteristics in dysarthria?
What is the primary basis for identifying and classifying deviant speech characteristics in dysarthria?
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Why is it important to conduct a cognitive test at the beginning of an assessment for dysarthria?
Why is it important to conduct a cognitive test at the beginning of an assessment for dysarthria?
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What is one of the key components in a Patient Interview during the examination of Motor Speech Disorders?
What is one of the key components in a Patient Interview during the examination of Motor Speech Disorders?
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Which component should be included in a Patient Interview to understand what patients want to achieve with therapy?
Which component should be included in a Patient Interview to understand what patients want to achieve with therapy?
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What does the Diadochokinetic task tell us?
What does the Diadochokinetic task tell us?
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Why is amplitude measurement crucial during the Mean Phonation Time task?
Why is amplitude measurement crucial during the Mean Phonation Time task?
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Which type of patients are likely to perform better on Automatic Speech Tasks according to the text?
Which type of patients are likely to perform better on Automatic Speech Tasks according to the text?
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What becomes more challenging in the Intelligibility Test as the words increase in complexity?
What becomes more challenging in the Intelligibility Test as the words increase in complexity?
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What happens in LMN disorders like myasthenia gravis during counting and speech tasks?
What happens in LMN disorders like myasthenia gravis during counting and speech tasks?
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What is a common physical sign associated with kyphosis mentioned in the text?
What is a common physical sign associated with kyphosis mentioned in the text?
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Why is a conversation considered a natural communication environment for clinical judgements?
Why is a conversation considered a natural communication environment for clinical judgements?
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What is an essential component required for MSD Evaluation according to the text?
What is an essential component required for MSD Evaluation according to the text?
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What aspect of breathing should be evaluated as an early treatment goal?
What aspect of breathing should be evaluated as an early treatment goal?
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During sustained phonation assessment, what is compared to age/gender norms?
During sustained phonation assessment, what is compared to age/gender norms?
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What does a short duration in sustaining phonation indicate about the respiratory system?
What does a short duration in sustaining phonation indicate about the respiratory system?
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What is used to evaluate forced vital lung capacity?
What is used to evaluate forced vital lung capacity?
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Which speech sample task assesses coordination and fatigue?
Which speech sample task assesses coordination and fatigue?
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In the DDK task, what does a break in breath indicate?
In the DDK task, what does a break in breath indicate?
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Which scale can be used to rate speech intelligibility?
Which scale can be used to rate speech intelligibility?
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Which battery can be used for assessing dysarthria in children?
Which battery can be used for assessing dysarthria in children?
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Which informal assessment tool can be utilized for dysarthria evaluation?
Which informal assessment tool can be utilized for dysarthria evaluation?
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What is assessed during DDK Perceptual Analysis of Speech?
What is assessed during DDK Perceptual Analysis of Speech?
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Which nerve is evaluated through nonspeech tasks like smiling, frowning, and puffing air in your cheeks?
Which nerve is evaluated through nonspeech tasks like smiling, frowning, and puffing air in your cheeks?
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What does the Dworkin-Culatta Oral Mechanism Exam assess?
What does the Dworkin-Culatta Oral Mechanism Exam assess?
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Which task evaluates the integrity of tongue movements with repetitions of the same syllable?
Which task evaluates the integrity of tongue movements with repetitions of the same syllable?
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What should be examined to evaluate dysphagia related to IX, X, and XI nerves?
What should be examined to evaluate dysphagia related to IX, X, and XI nerves?
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What is used to assess the pace and rate of production in the Trigeminal (V) Nerve evaluation?
What is used to assess the pace and rate of production in the Trigeminal (V) Nerve evaluation?
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During Speech Specific Tasks, what is evaluated by observing for articulation errors and pacing abnormalities?
During Speech Specific Tasks, what is evaluated by observing for articulation errors and pacing abnormalities?
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What does DDK provide information about in terms of cerebellar function?
What does DDK provide information about in terms of cerebellar function?
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What muscle movement is especially observed during evaluation of Glossopharyngeal (IX) Nerve?
What muscle movement is especially observed during evaluation of Glossopharyngeal (IX) Nerve?
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Each type of dysarthria has the same etiology and speech disorders.
Each type of dysarthria has the same etiology and speech disorders.
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It is easy to differentiate between dysarthrias during a diagnostic evaluation due to their distinct characteristics.
It is easy to differentiate between dysarthrias during a diagnostic evaluation due to their distinct characteristics.
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Motor speech samples play a crucial role in identifying and classifying deviant speech characteristics in dysarthria.
Motor speech samples play a crucial role in identifying and classifying deviant speech characteristics in dysarthria.
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Starting with a cognitive test is not important when assessing dysarthria.
Starting with a cognitive test is not important when assessing dysarthria.
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In the Patient Interview for Examination of MSDs, assessing the patient's awareness of symptoms is not necessary.
In the Patient Interview for Examination of MSDs, assessing the patient's awareness of symptoms is not necessary.
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Administering a speech handicap index scale is not part of the essential tasks for completing an assessment of dysarthria.
Administering a speech handicap index scale is not part of the essential tasks for completing an assessment of dysarthria.
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Observing breathing, eye contact, volume, and fatigue is not important during a clinical interview with a patient.
Observing breathing, eye contact, volume, and fatigue is not important during a clinical interview with a patient.
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Many people in the Deaf community consider themselves handicapped.
Many people in the Deaf community consider themselves handicapped.
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Patients may answer differently to 'Do you have difficulty swallowing?' and 'Does food ever go down the wrong pipe?'
Patients may answer differently to 'Do you have difficulty swallowing?' and 'Does food ever go down the wrong pipe?'
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The Dworkin-Culatta Oral Mechanism Exam mainly assesses speech articulation.
The Dworkin-Culatta Oral Mechanism Exam mainly assesses speech articulation.
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Evaluation of Glossopharyngeal (IX) Nerve involves observing eye movements.
Evaluation of Glossopharyngeal (IX) Nerve involves observing eye movements.
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During sustained phonation assessment, comparing results to age/gender norms is not necessary.
During sustained phonation assessment, comparing results to age/gender norms is not necessary.
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The Diadochokinetic task tells us how the tongue is communicating with the cerebellum.
The Diadochokinetic task tells us how the tongue is communicating with the cerebellum.
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Forced Vital Lung Capacity can be collected via telehealth.
Forced Vital Lung Capacity can be collected via telehealth.
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Patients with apraxia tend to perform better on tasks that require thought rather than automatic speech tasks.
Patients with apraxia tend to perform better on tasks that require thought rather than automatic speech tasks.
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Intelligibility testing involves counting from 1 to 100.
Intelligibility testing involves counting from 1 to 100.
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During speech tasks, patients with dysarthria perform consistently across all types of tasks.
During speech tasks, patients with dysarthria perform consistently across all types of tasks.
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Involuntary muscle movements are especially observed during Glossopharyngeal (IX) Nerve evaluation.
Involuntary muscle movements are especially observed during Glossopharyngeal (IX) Nerve evaluation.
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Kyphosis puts pressure on the diaphragm and makes breathing easier.
Kyphosis puts pressure on the diaphragm and makes breathing easier.
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Speech tasks like reading passages are vital for differential diagnosis of Apraxia.
Speech tasks like reading passages are vital for differential diagnosis of Apraxia.
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Automatic speech tasks are often preserved better with volitional speech.
Automatic speech tasks are often preserved better with volitional speech.
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Short conversations are not considered a natural communication environment for clinical judgements.
Short conversations are not considered a natural communication environment for clinical judgements.
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The mean breathing rate for a normal individual is 14-16 cycles per minute.
The mean breathing rate for a normal individual is 14-16 cycles per minute.
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Stridor refers to a voice that is noisy at rest.
Stridor refers to a voice that is noisy at rest.
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Harsh, hoarse, and breathy are qualities analyzed during the Mean Phonation Time task.
Harsh, hoarse, and breathy are qualities analyzed during the Mean Phonation Time task.
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A client's ability to sustain phonation for a short duration indicates a healthy respiratory system.
A client's ability to sustain phonation for a short duration indicates a healthy respiratory system.
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The Buhl spirometer is used to evaluate forced vital lung capacity.
The Buhl spirometer is used to evaluate forced vital lung capacity.
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Perceptually based clinical assessments are considered the least important component of clinical diagnosis.
Perceptually based clinical assessments are considered the least important component of clinical diagnosis.
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The Frenchay Dysarthria Assessment - 2nd edition (FDA_2) is an informal assessment tool for dysarthria evaluation.
The Frenchay Dysarthria Assessment - 2nd edition (FDA_2) is an informal assessment tool for dysarthria evaluation.
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Acoustic and physiologic measures have limited potential value for clinical diagnoses as instrumentation becomes less expensive.
Acoustic and physiologic measures have limited potential value for clinical diagnoses as instrumentation becomes less expensive.
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Using informal assessment tools can aid in systematically identifying characteristics specific to each type of dysarthria.
Using informal assessment tools can aid in systematically identifying characteristics specific to each type of dysarthria.
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Stress test involving counting from 1 to 100 is part of the Speech Specific Tasks for dysarthria evaluation.
Stress test involving counting from 1 to 100 is part of the Speech Specific Tasks for dysarthria evaluation.
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The DDK Perceptual Analysis of Speech involves gathering speech samples for analysis, including vowel prolongation and alternating motion rates.
The DDK Perceptual Analysis of Speech involves gathering speech samples for analysis, including vowel prolongation and alternating motion rates.
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During the Dworkin-Culatta Oral Mechanism Exam, the assessment includes structures such as the teeth, hard/soft palate, and musculature associated with the nose and eyes.
During the Dworkin-Culatta Oral Mechanism Exam, the assessment includes structures such as the teeth, hard/soft palate, and musculature associated with the nose and eyes.
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In the Speech Specific Tasks, the Trigeminal (V) Nerve evaluation involves looking for weakness, asymmetry, and incoordination of muscles controlling jaw movement.
In the Speech Specific Tasks, the Trigeminal (V) Nerve evaluation involves looking for weakness, asymmetry, and incoordination of muscles controlling jaw movement.
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The Glossopharyngeal (IX) Nerve, Vagus (X), and Spinal Accessory (XI) are related to the integrity of the mandibular musculature.
The Glossopharyngeal (IX) Nerve, Vagus (X), and Spinal Accessory (XI) are related to the integrity of the mandibular musculature.
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The Sequential Motion Rates (SMR) require patients to produce repetitions of a sequence of syllables like /pataka/.
The Sequential Motion Rates (SMR) require patients to produce repetitions of a sequence of syllables like /pataka/.
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During the DDK Perceptual Analysis of Speech, the Alternating Motion Rates (AMR) and Sequential Motion Rates (SMR) are both used to assess speech function.
During the DDK Perceptual Analysis of Speech, the Alternating Motion Rates (AMR) and Sequential Motion Rates (SMR) are both used to assess speech function.
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Respiration Tasks during speech evaluation focus on observing clavicular breathing as it is the most effective method for speech production.
Respiration Tasks during speech evaluation focus on observing clavicular breathing as it is the most effective method for speech production.
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The Hypoglossal (XII) Nerve evaluation includes observing tongue atrophy, fasciculation, and involuntary movements in non-speech tasks.
The Hypoglossal (XII) Nerve evaluation includes observing tongue atrophy, fasciculation, and involuntary movements in non-speech tasks.
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The Speech Specific Tasks do not involve any assessment related to facials muscles or movements controlled by the facial (VII) Nerve.
The Speech Specific Tasks do not involve any assessment related to facials muscles or movements controlled by the facial (VII) Nerve.
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In the Speech Specific Tasks, tasks like repeating days of the week, months, CVC syllables with identical initial and final consonants evaluate only speech resonance features.
In the Speech Specific Tasks, tasks like repeating days of the week, months, CVC syllables with identical initial and final consonants evaluate only speech resonance features.
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Mean phonation time is one of the essential components of MSD testing
Mean phonation time is one of the essential components of MSD testing
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During an MSD assessment, individuals with apraxia are unaware of the errors and do not attempt to self-correct.
During an MSD assessment, individuals with apraxia are unaware of the errors and do not attempt to self-correct.
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The administration of AMR/SMR would be a more important assessment task than mean phonation time for individuals with suspected apraxia of speech.
The administration of AMR/SMR would be a more important assessment task than mean phonation time for individuals with suspected apraxia of speech.
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Which assessment is vital for diagnosing Apraxia?
Which assessment is vital for diagnosing Apraxia?
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Which of the following assessments is essential a speech stress test?
Which of the following assessments is essential a speech stress test?
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Which type of assessment is important to administer for patients with myasthenia gravis or other lower motor neuron disorders?
Which type of assessment is important to administer for patients with myasthenia gravis or other lower motor neuron disorders?
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Which of the following is the most natural communication environment to observe and begin to make clinical judgements?
Which of the following is the most natural communication environment to observe and begin to make clinical judgements?
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_______ is an assessment of structures at rest and in motion
_______ is an assessment of structures at rest and in motion
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Which of the following is not an essential assessment task?
Which of the following is not an essential assessment task?
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A person with dysarthria will perform the same across all automatic speech tasks.
A person with dysarthria will perform the same across all automatic speech tasks.
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Study Notes
Assessment of Motor Speech Disorders (MSDs)
- The assessment of MSDs involves a comprehensive evaluation of speech, language, and nonspeech function.
Case History/Chart Review
- Gather information about the patient's case history, including onset and course of the problem.
- Identify associated deficits, such as hearing or vision problems.
- Assess the patient's awareness of symptoms and perception of deficits.
- Evaluate the degree of disability or handicap caused by the problem.
Cranial Nerve Exam + Oral Motor Exam
- Perform a comprehensive cranial nerve exam to assess the function of the cranial nerves.
- Evaluate the oral motor exam to assess the function of the oral mechanism.
DDK Perceptual Analysis of Speech
- Gather speech samples for analysis, including audio and/or video recordings.
- Analyze speech samples for vowel prolongation, alternating motion rates (AMR), and sequential motion rates (SMR).
- Evaluate speech characteristics, such as rate, change in volume, breath replenishment, and voicing.
Speech Specific Tasks
- Evaluate trigeminal (V) nerve function using tasks such as /p p p/ and /m m m/.
- Assess facial (VII) nerve function using tasks such as smile, frown, and puff air in the cheeks.
- Evaluate glossopharyngeal (IX), vagus (X), and spinal accessory (XI) nerve function using tasks such as /papapa/ and /kakaka/.
Respiratory Tasks
- Assess respiratory adequacy for speech using tasks such as telling a story or counting.
- Evaluate diaphragmatic breathing and posture.
Dr. B's Essential 8: MSD Evaluation Required Components
- Case history/chart review
- Cranial nerve exam paired with oral motor exam (nonspeech tasks)
- Diadochokinetic task
- Mean phonation time (3 sustained "ah")
- Forced vital lung capacity (Buhl spirometer)
- Automatic speech tasks (days of week, months of year, counting)
- Speech tasks (reading passage, word lists of increasing complexity, intelligibility test)
- Conversation (short conversation/monologue)
Intelligibility Assessment
- Use standardized tests such as the Tikofsky 50 Word Test of Intelligibility or the Sentence Intelligibility Test (SIT) to assess speech intelligibility.
Acoustic and Physiologic Measures
- Use acoustic and physiologic measures, such as spectrograms and aerodynamic measures, to assess speech production.
- Analyze speech samples using software programs to assess acoustic features of speech.
Assessment of Neuromotor Disorders
- Perform a comprehensive assessment of neuromotor disorders, including an oral mechanism exam, cranial nerve exam, and speech tasks.
- Analyze speech samples using perceptual and acoustic analysis.
Protocol for Examination of MSDs
- Patient interview: case history, associated deficits, awareness of symptoms, and degree of disability.
- Assessment of nonspeech function: cranial nerve exam, oral motor exam, and respiratory tasks.
- Speech tasks: reading passage, word lists, intelligibility test, and conversation.
- Intelligibility assessment: standardized tests such as the Tikofsky 50 Word Test of Intelligibility or the Sentence Intelligibility Test (SIT).
- Acoustic and physiologic measures: spectrograms and aerodynamic measures.
Dysarthria Examination Battery (DEB)
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A standardized assessment tool used to evaluate dysarthria in patients with neurological disorders.
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Includes a range of tasks to assess speech, language, and nonspeech function.### Dr. B's Essential 8: MSD Evaluation
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Case history and chart review are essential components of the evaluation
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Cranial nerve exam paired with oral motor exam (non-speech tasks) is crucial in the evaluation
Cranial Nerve Exam
- Diadochokinetic task helps in assessing how the tongue communicates with the cerebellum
- Mean phonation time is a measure of the intensity (dB) and duration (sec) of a sustained "ah"
- Measurements should be taken using an app, with consistent distance from the device to the client, and compared to norms
Automatic Speech Tasks
- Automatic speech tasks, such as days of the week, months of the year, and counting, are often preserved in patients with apraxia
- These tasks are done hundreds of times throughout life, making them a part of motor memory
- Patients with apraxia tend to perform better on automatic speech tasks than on volitional communication tasks
Speech Tasks
- Reading passage and word lists of increasing complexity are essential for apraxia diagnosis
- Intelligibility test, such as counting from 1 to 100, assesses a patient's ability to sustain speech over time
- This task often fatigues patients and can reveal issues with breath support, fatigue, and hoarseness
Conversation
- Short conversation and monologue tasks provide a natural communication environment for observation and clinical judgment
- Evaluate breathing rate, regularity, and quality, as well as voice quality at rest
Perceptual Analysis of Speech
- Gather speech samples for analysis, including vowel prolongation, alternating motion rates, and sequential motion rates
- Analyze speech characteristics, such as rate, volume, breath replenishment, and voicing
Trigeminal (V) Nerve
- Evaluate weakness, asymmetry, and incoordination of muscles controlling jaw movement
- Use tasks that open and close the jaw, such as /p p p/ and /m m m/ sequences
Facial (VII) Nerve
- Evaluate muscles controlling lip and facial movements with nonspeech tasks
- Use tasks such as smiling, frowning, and puffing air into the cheeks
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Description
Learn about the six types of dysarthria, their etiologies, and speech disorders. Understand the challenges in diagnosing dysarthrias and how to differentiate between them. Explore the importance of analyzing motor speech samples in identifying and classifying deviant speech characteristics.
