Advanced Artic Ch 11

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Advanced Artic Ch 11
2012-11-05 16:37:54
Advanced Articulation

Advanced Articulation Test 2: Ch 11
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  1. An articulatory disorder resulting from impairment as a result of brain damage, of the capacity to program the positioning of speech musculatue and the sequencing of muscle movements for the volitional production of phonemes.
    Apraxia of Speech
  2. True or False: There is significant weakness, slowness, and incoordination in reflex and automatic acts with Apraxia of Speech. 
    False: NO significant weakness, slowness, or incoordination in reflex and automatic acts!
  3. Individuals with ______ ___ _______ often struggle to find the correct articulatory positions needed to produce phonemes accurately.
    Apraxia of Speech
  4. _____  alternations may be associated with the articulatory problem of Apraxia of Speech, perhaps in compensation for it.
  5. True or False: The errors in Apraxia of Speech are not caused by muscle weakness, abnormal muscle tone, reduced range of movement, or decreased muscle steadiness.
  6. The errors in Apraxia of Speech are caused by a deficit in the ability to accurately _______ the movements needed to produce speech sounds.
  7. The term Apraxia comes from the Greek word praxis which means...
    Performance of Action
  8. Apraxia literally means without ___.
  9. It is probably more accurate to describe Apraxia of Speech as:
    A. Apraxia
    B. Dyspraxia
    B. Dyspraxia: which means disordered action because individuals with apraxia of speech are not WITHOUT movement. Their problem is with the sequencing of movement.
  10. There are several types of apraxia, of which apraxia of speech is only one of the subcategories.  The two main types of apraxia are ______ Apraxia  and _____ Apraxia.
    Ideational, Ideomotor
  11. The inability to make use of an object or gesture because the individual has lost the knowledge (or idea) of the object's or gesture's function is which type of apraxia?
  12. ______ Apraxia is a disturbance in the conception of an object or gesture.
  13. A  disturbance in the performace of the movements needed to use an object, make a gesture, or complete a sequence of indicidual movements is which type of Apraxia?
  14. Individuals with ____ apraxia have not lost their knowledge of an object or gesture's function, rather, they have a deficit in carrying out the motor plan needed to use an object or make a gesture.
  15. Name the three subcategories of Ideomotor Apraxia.
    • Limb Apraxia
    • Nonverbal Oral Apraxia
    • Apraxia of Speech
  16. The inability to sequence the movements of the arms, legs, hands, or feet during a VOLUNTARY act is known as ___ Apraxia.
  17. Limb Apraxia is most often the result of ____ hemisphere damage.
  18. buccofacial apraxia, facial apraxia, orofacial apraxia, or lingual apraxia are all names for which type of apraxia.
    Nonverbal oral apraxia
  19. A deficit in the ability to sequence nonverbal VOLUNTARY movements of the tongue, lips, jaw, and other oral structures is called...
    Nonverbal oral apraxia
  20. Individuals with nonverbal oral apraxia may have difficulty performing which of the following tasks:
    A) protruding tongue
    B) biting the lip
    C) Puffing out the cheeks
    D) A & B only
    E) All of the above
    E) All of the above
  21. Nonverbal oral apraxia is often seen in individuals with ___ hemispere damage, and it can often co occur with ___.
    Left, Aphasia
  22. True or False: Nonverbal oral Apraxia affects the spontaneous and reflexive orofacial movements.
    False. Individuals with nonverbal oral apraxia can still produce spontaneous movements of te oral mechanism.
  23. Nonverbal Oral Apraxia can co-occur with the third subcategory of Ideomotor Apraxia, which is...
    Apraxia of Speech
  24. A deficit in the ability to sequence the motor command needed to correctly position the articulators during the voluntary production of phonemes.
    Apraxia of Speech
  25. True or False: Individuals with Apraxia of Speech can also have limb apraxia or nonverbal oral apraxia.
    True: Individuals may have just nonverbal oral apraxia and not apraxia of speech or have both or all Ideomotor Apraxias.
  26. Apraxia of speech is usually caused by damage to which area of the brain?
    Left Frontal Lobe: Especially when the damage occurs near Broca's area.
  27. In the majority of cases, Apraxia of speech co-occurs with ___ ____.
    • Broca's Aphasia
    • *AOS can also co-occur with unilateral upper motor neuron disorder.
  28. ___ is the most complex motor movement of the body.
  29. A neural network in the brain that sequences the motor movements needed to produce speech accurately.
    The Motor Speech Programmer: It sequences information into a neural code that represents the muscular contractions needed to produce the phonemes, words, and phrases in the intended utterance.
  30. The motor speech programmer is actually a rather ___, nebulous cerebral structure.
  31. Although the motor speech programmer has not be precisely localized in the brain, research indicates it resides near the Perisylvian area of the ____ hemisphere.
  32. Disorders that damage the motor speech programmer have the potential to cause ______
    Apraxia of Speech
  33. True or false:   damage to the perisylvian area of the left hemisphere is the only site of lesion in cases of apraxia of speech.
    False:  Injuries to the insula and the basal ganglia also have been associate with AOS.
  34. _____ is the most FREQUENT cause of Apraxia of Speech.
  35. Which lobes of the brain are often affected by stoke causing apraxia of speech?
    • Frontal and Parietal
    • *Temporal can be affected as well
  36. _____ is the SECOND most FREQUENT cause of Apraxia of Speech.
    • Degenerative Diseases: Alzheimer's, primary progressive aphasia, Creutzfeldt-Jacob disease.
    • * in the early stages the effects of these diseases can be focal and result in apraxia of speech
  37. _____ is the THIRD most FREQUENT cause of Apraxia of Speech.
    • TRAUMA:
    • Surgical trauma in the left frontal lobe is the most COMMON type of trauma that results in AOS.
  38. Most researchers agree that Apraxia of Speech is a disorder primarily of:
    A) Prosody
    B) Resonance
    C) Articulation
    D) A& C only
    E) All of the above
    D) A&C only
    (this multiple choice question has been scrambled)
  39. Individuals with Apraxia of Speech demonstrate trial and error attempts at finding the correct articulatory positions for target phonemes.  This is known as...
    Articulatory Groping
  40. Individuals with Apraxia of Speech are _____ in their speech errors.
    (Consistent or Inconsistent)
  41. ________ errors are the most COMMON problem in Apraxia of Speech.
    (resonance, prosody, articulation)
  42. The most common Articulation errors in individuals with Apraxia of speech is:
    A) Repetitions
    B) Omissions
    C) Substitutions
    D) Distortions
    C) Substitutions
    (this multiple choice question has been scrambled)
  43. Which is easier to produce for individuals with Apraxia of Speech, single consonants or consonant clusters?
    • single consonants:
    • Vowels are easier than single consonants
  44. Phonemes in which position of a word are more likely to be in error in AOS, initial, medial or final?
  45. Articulation errors in Apraxia of Speech:
    • Phonemes that appear infrequently in speech
    • Articulation is more accurate on real words
    • Articulation errors are more common on multisyllabic words
    • Voluntary production is more difficult than Automatic speech
  46. Many articulation deficits in Apraxia of Speech make normal ____ extremely difficult.
  47. Prosodic Errors in Individuals with Apraxia of Speech:
    • The rate of connected speech is slower than normal
    • Equal stress is often placed on all syllables
    • Silent pauses may occur at the initiation of a word
    • The normal variations of pitch and loudness in utterances may be reduced
  48. When an individual with Apraxia of Speech is asked to voluntary take a breath and the result is a halting, effortful movement, this is due to what effected part of speech?
    • Respiration
    • Reflexive respiration is not affected by apraxia
  49. ____ is seldom a significant problem in apraxia of speech.
    (respiration, prosody, resonance)
    Resonance: Hyper and Hyponasality are not seen often
  50. Individuals with mild or moderate apraxia of speech seldom demonstrate isolated deficits of _______.
  51. Severe apraxia of speech may cause significant deficits in phonation. This can cause unsuccessful attempts at:
    A) Voluntary phonation
    B) Spontaneous phonation
    C) Both A&B
    D) Only A
    C) Both A&B
    (this multiple choice question has been scrambled)
  52. What four conditions do you need to rule out when diagnosing Apraxia of Speech?
    • 1. Muscle Weakness: In AOS, only the voluntary movements of the affected body part will have the problem.
    • 2. Sensory Loss: In AOS, only for volitional acts
    • 3. Comprehension Deficit:  make sure they understand the task
    • 4. Incoordination: In AOS, only in volontary movements
  53. _____ _____ errors are the incorrect placement of one or more phoneme into a word.
    • Literal Paraphasic
    • *transposition of phonmes/syllables
    • *addition of extra syllables
    • *substitusions of phonemes/syllables
    • Auditory comprehension, reading and writing will be unaffected
    • Anterior brain damage and right hemiparesis
    • Usually have a co-occurring Broca aphasia
    • Usually have disturbed prosody
    • Often have difficulty initiating speech
    • Substitutions are usually close to target sound
  55. APHASIA/Literal Paraphasias
    • Affects all four language modalities
    • Posterior brain damage/ no hemiparesis
    • Usually have Wernicke or Conduction Aphasia
    • Usually have normal prosody
    • Typically don’t have much trouble initiating
    • Substitutions are wildly off target
  56. Apraxia of Speech Vs. Broca's Aphasia
    • Both have nonfluent, effortful,halting, and disturbed prosody
    • Extremely difficult to tel the difference between the two disorders
  57. Many individuals with mild or moderate apraxia of speech can complete the___ task accurately because it involve only one movement sequence with only one place of articulatory contact.
  58. Individuals with apraxia of speech are unable to complete the ___ task accurately because it requies the sequencing of multiple articulatory positions in three different sites within the mouth.
  59. ______ speech and _____ are important taske for determining the effects of the apraxia on prosody.
    conversational, reading
  60. Nearly all treatments for ____ __ _____ are behaviorally based procedures that help affected individuals improve their ability to sequence speech sounds correctly.
    Apraxia of Speech
  61. True or False:  Unlike some of the treatment for dysarthria, prosthetic and medical interventions for apraxia of speech are rare.
    • True
    • The treatment sessions for apraxia of speech ten to be time-intensive, repetitive, and highly structured.
  62. Name four Specific Treatments for Apraxia of Speech
    • 1. Eight Step Continuum Treatment
    • 2. Darley, Aronson, and Brown's Procedure
    • 3. Melodic Intonation Therapy (MIT)
    • 4. PROMPT
  63. This treatment program was developed by Rosenbek et al. and is an eight step sequence of activities that moves the patient from repeating target phonemes with the clinician to independent production of utterances in role playing situations.
    • Eight Step Continuum Treatment
    • * clinician says "watch me" and "Listen to me"
    • * moves from maximal to minimal cueing
  64. In the treatment process by Darley et al. this stage is for low level beginners and helps with voluntary phonation, tongue protrusion, and simple oral movements.
    Initiating Speech Activities
  65. In the treatment process by Darley et al. this stage employs common expressions, counting, or singing well known songs.
    Using Automatic Responses
  66. In the treatment process by Darley et al. this stage helps the patient return to working on volitional speech production, starting with easy phonemes such as /m/ and increasing in difficulty such as producing two word phrases ending with /m/.
    Phonemic Drill
  67. _____ is based on the observation that many individuals with aphasia or apraxia of speech can sing the words of a song much better than they can say the same words in conversation.
    Melodic Intonation Therapy
  68. It is said that Melodic Intonation Therapy allows the ____ hemisphere to facilitate the function of the damaged ____ hemisphere. 
    Right, Left
  69. At this level of Melodic Intonation Therapy the clinician hums and taps syllables, then words, then allows the patient to hum and tap the word, then sing the word in response to a question.
    Elementary Level
  70. At this level of the Melodic Intonation Therapy the same steps in the Elementary level are performed but a period of several seconds is inserted between each task.
    Intermediate Level
  71. At this level of the Melodic Intonation Therapy speech song is used to closely match normal speech intonation.  Speech Song is similar to choral reading.
    Advanced Level
  72. This treatment program for Apraxia of Speech uses a combination of proprioceptive, pressure, and kinesthetic cues that show patients how to sequence their oral movements for speech.
  73. This treatment program requires the clinician to act as an external motor speech programmer by by guiding the patients articulators through the correct motor sequence.