CSD 2230 HUMAN COMMUNICATION DISORDERSMotor or Neurogenic Speech DisordersMajor Types of Neurogenic ImpairmentCerebral PalsyDysarthriaApraxiaWhat Causes Motor Speech Disorders?Slide 8Types of Cerebral PalsySpastic Cerebral PalsyAthetoid Cerebral PalsyAtaxic Cerebral PalsyMotor and Motor Speech Characteristics with Cerebral PalsySlide 14The DysarthriasTypes and Associated EtiologiesSlide 17Slide 18Slide 19Slide 20Slide 21Slide 22Characteristics of Apraxia of SpeechPowerPoint PresentationCSD 2230HUMAN COMMUNICATION DISORDERSTopic 7Speech DisordersMotor Speech DisordersMotor or Neurogenic Speech DisordersSpeech difficulties that are related to problems of movement as a result of some neurological disorder or injuryHeterogeneousAffect the planning, coordination, timing, and execution of speech movementsMay affect phonation, resonation, and articulationMajor Types of Neurogenic Impairment1. Cerebral Palsy2. Dysarthria of speech3. Apraxia of speechCerebral PalsyHeterogenous group of neurological disorders that result in difficulty with motor movementsAcquired shortly before, during, or after birthDevelopmental disorderContinuum of physical manifestationsDysarthriaGroup of related speech impairment that result from disturbed muscular control caused by damage to the mature nervous systemAcquired disorderMay affect respiration, phonation, resonation, and/or articulationSpeech characteristics include slow or rapid motor function, decrease in the range or strength of motor skills, poor directionality or motor timingApraxiaAffects the phonological selection and sequencing of speech sounds and articulationAcquired disorderAffects the ability to organize, plan, and execute the movement of speech musclesWhat Causes Motor Speech Disorders?StrokeTraumatic brain injury (TBI)AnoxiaNeoplasmsInfections and toxinsAcquired diseasesCerebral PalsyA group of nonprogressive neurological difficulties resulting from brain injury very early in lifeAreas affected include motor movement, communication, growth and development, locomotion, learning, and sensationIncidence is 1.5-3/1000 birthsPrimary characteristicsA developmental neurogenic disorder that results from abnormal brain functionIt’s not a diseasePredictable motor patternsTypes of Cerebral Palsy1. Spastic (hypertonia)Characterized by too much muscle tone2. Athetoid (dyskinesia)Characterized by slow involuntary movements3. AtaxicCharacterized by uncoordinated movementsSpastic Cerebral Palsy60% of individuals with cerebral palsyMotor movements are jerky, labored, and slowInfantile reflex patternsAthetoid Cerebral Palsy30% of individuals with cerebral palsySlow involuntary writhingInfantile reflex patternsAtaxic Cerebral Palsy10% of individuals with cerebral palsyUncoordinated movementsDisturbed balance which is especially noticeable in their gaitDamage is to the cerebellumMotor and Motor Speech Characteristics with Cerebral PalsySpeech isn’t always affected and varies somewhat with the type of CPWhen speech is affected, all aspects of speech production may be affected including respiration, phonation, resonation, articulation, and prosodyCD-ROM Ch.14.02 shows a speaker with spastic CP talking about sports. How much can you understand?Motor and Motor Speech Characteristics with Cerebral PalsyOther issues related to cerebral palsy:Breathing problemsRigidityVelopharyngeal incompetencyUncoordinated articulator movementsIntellectual processingAuditory processingLanguage impairmentsIntervention might include augmentative and alternative communication systemsCD-ROM Ch14.03 illustrates conversation with such a deviceThe DysarthriasA group of impairments that may affect the speed, range, direction, strength, and timing of motor movementsResults from paralysis, weakness, or discoordination of speech musclesNot a language disorder but rather a difficulty in motor speech controlTypes and Associated EtiologiesFlaccid dysarthriaCharacterized by hypotonia (weak muscle tone) which results in weakness or paralysis of the affected muscleSpeech characteristics include shallow breathing, breathy voice, aphonia (no voice), reduced pitch and loudness, monotone, hypernasality, and imprecise articulationEtiologies include Bell’s Palsy, myasthenia gravis, and muscular dystrophyAudio examples of flaccid dysarthriaTypes and Associated EtiologiesSpastic dysarthriaCharacterized by hypertonia (stiff and rigid muscles) commonly caused by strokeSpeech movements are difficult and speech is characterized as slow with jerky, imprecise articulation and reduction in the rapidly alternating movements of speechAudio examples of spastic dysarthriaTypes and Associated EtiologiesAtaxic dysarthriaCharacterized by a combination of hypotonia (reduced tone) and ataxia resulting in problems in the accuracy, timing, and direction of movementSpeech movements are jerky and impreciseAudio examples of ataxic dysarthriaTypes and Associated EtiologiesHypokinetic DysarthriaCharacterized by hypokinesis (decreased movement)Parkinson’s disease results in a good example of this kind of dysarthriaProgressive disorder where the muscles become rigid, resulting in reduced motor movements, involuntary shaking or tremors, slowness of movement, and difficulty initiating voluntary movementsAudio examples of hypokinetic dysarthria from Parkinson’sTypes and Associated EtiologiesHyperkinetic dysarthriaCharacterized by hyperkinesia (increased movements) in the form of involuntary tremors and ticsMajor speech characteristic is imprecise articulationDystonia and chorea provide examplesAudio examples of hyperkinetic dysarthria from dystonia and choreaTypes and Associated EtiologiesMixed dysarthriaCaused by diffuse brain damageALS provides a good example of mixed dysarthriaAudio examples of mixed dysarthria from ALSApraxiaDisorder of motor placement and sequencing that’s unrelated to muscle weakness, slowness, or paralysisWhen speech muscle groups are affected, it is called apraxia of speechSpeech difficulties are not the result of muscle weakness or slowness (dysarthria) or of linguistic processing (aphasia)Almost always due to damage to Broca’s area in the cortexCharacteristics of Apraxia of SpeechGroping attempts to find the correct articulatory positionFrequent articulation