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ASSESSMENT OF ORGANIC AND NEUROGENIC SPEECH DISORDERS

ASSESSMENT OF ORGANIC AND NEUROGENIC SPEECH DISORDERS. I. CEREBRAL PALSY**. A. Introduction-definition (non-progressive motor disorder due to pre-, peri-, or post-natal damage) Youtube—Charrise’s Story: My Life Journey with Cerebral Palsy (first few minutes).

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ASSESSMENT OF ORGANIC AND NEUROGENIC SPEECH DISORDERS

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  1. ASSESSMENT OF ORGANIC AND NEUROGENIC SPEECH DISORDERS

  2. I. CEREBRAL PALSY** • A. Introduction-definition (non-progressive motor disorder due to pre-, peri-, or post-natal damage) • Youtube—Charrise’s Story: My Life Journey with Cerebral Palsy (first few minutes)

  3. Fogle, 2019—CP often results from:

  4. Types of CP:

  5. B. Speech Problems and Their Assessment** • Oral motor—assess speech, nonspeech tasks • Feeding—sucking, chewing, swallowing • Slow DDK rates, discoordination of tongue • Resonance—nasal emission on consonants, hypernasality on vowels

  6. II. DYSARTHRIA** • A. Introduction • Neuromotor disorder affecting all systems: respiration, phonation, articulation, resonance, prosody • Due to: CP, degenerative diseases, stroke

  7. B. Characteristics to Look for in Assessment** • Breathy respiration • Difficulty with appropriate syllable stress • Artic: imprecise, distorted consonants; weak pressure consonants

  8. III. CHILDHOOD APRAXIA OF SPEECH** • Youtube—childhood apraxia of speech 3 year old (UrbanKowboy) • Youtube Severe Apraxia and Possible ASD (Julian)

  9. 2020 asha.org • CAS occurs in 1-2 children per 1,000 • Found in approximately 4% of ch referred for SSDs • Idiopathic CAS affects more boys than girls by a ratio of 2 or 3:1

  10. We know that: • Most ch with CAS have a family member with a speech or lang disorder • CAS has a genetic component

  11. A. Introduction** • Inconsistent errors • Flat prosody • Difficulty sequencing sounds and syllables • Moderately to severely unintelligible

  12. B. Associated Problems

  13. C. Assessment—Evaluate:** • 1. Pitch, loudness, prosody • 2. Overall intelligibility • 3. Resonance—e.g., hypernasal? • 4. DDKs—alternating /pʌpʌpʌpʌ/ • and sequential motion /pʌtʌkʌpʌtʌkʌ/

  14. CAS Assessment (continued)

  15. CAS Assessment (continued)** • 8. Receptive and expressive lang skills • 9. Articulation—give test, administer items repeatedly to assess consistency of production • 10. Connected speech sample

  16. One of my very favorites**: • 12. Production of polysyllabic words —have them say the words several times, check for consistency. E.g.: (words are not on test) • Expensive • Refrigerator • Buzz Lightyear’s Zurgotronic Ionblaster (ha ) • Congratulations • Cafeteria • Computer

  17. IV. CLEFT PALATE (cleft is an opening in a normally closed structure)**

  18. Youtube • LT 5 1/2 years old with cleft palate

  19. A. Introduction-major categories** : • Isolated cleft lip

  20. Cleft uvula alone**

  21. Cleft of the hard palate**

  22. **

  23. Adult cleft of soft palate and part of hard palate**

  24. Combined Cleft Palate and Lip** • This can be unilateral or bilateral • Here is a unilateral cleft

  25. Unilateral cleft of the lip and palate**

  26. Unilateral cleft palate and lip**

  27. Example of a bilateral combined cleft lip and palate:**

  28. Bilateral combined**

  29. Bilateral combined**

  30. Fortunately, surgical repair is excellent in the 21st century**

  31. Surgical repair “after”**

  32. Surgical repair “after”** • He had 5-6 surgeries, the last of which was in 6th grade • He is now a model and actor

  33. B. Assessment of Patients with Cleft Palate** • Difficulty with pressure consonants (stops, fricatives, affricates) • Nasal emission, hypernasality • Compensatory errors like glottal stopshoarseness • Middle ear dysfunction (Eustachian tube), OME

  34. Test question: • Nadia, a 7-year old with a partially repaired cleft palate, has immigrated with her family from Jordan. She is somewhat unintelligible. Which of the following probably is/are TRUE? • A. She has difficulty with pressure consonants • B. Pressure consonants in error include stops, fricatives, and affricates • C. She probably has a severe bilateral sensorineural hearing loss • D. A, B • E. B, C

  35. C. Assessment Strategies** • 1. Work with team of professionals • 2. Help plan surgical interventions • 3. Assess intelligibility in connected speech • 4. Esp. assess production of pressure consonants in words and sentences • 5. Determine presence of hypernasality on vowels and nasal emission on consonants

  36. Hold a mirror under the child’s nose…** • Have her prolong /i/ • Also assess pressure consonants, look for fog • Mirror should be clear if there is no hypernasality

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