Advanced Articulation Disorders Final Chapters 14-20

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Advanced Articulation Disorders Final Chapters 14-20
2012-12-13 11:12:49
Advanced Articulation Disorders Final Chapters 14 20

Advanced Articulation Disorders Final Chapters 14-20
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  1. __________ is an affective disorder of mood.
  2. _____________ or _____________ depression can exist without a nonaffective psychiatric disorder or any serious organic disorder, whereas ___________ or ________ depression is associated with preexisting organic or psychiatric illness.
    (Primary and major), (secondary or minor)
  3. What is the lifetime prevalence of the general population for major depression?
    can be as high as 9% in women and 4% in men
  4. Depression can occur throughout the ___________ years
  5. This is a presumed precipitating event (emotional loss, chronic stress) in approximately ________% of cases.
  6. Depression frequently presents with __________ symptoms.
  7. Depression that is accompanied by mania is a condition known as?
    manic depression
  8. A condition in which a depressed may present with that is characterized by reduced speech and facial expression, fixed gas and reduced eye scanning, stooped posture and slow movement is called?
    psychomotor retardation
  9. As many as ___________ of patients with ____________ disease may have severe depression or anxiety.
    One-third, neurologic
  10. Depression tends to last long when a patient has what type of lesion?
  11. Depression most often occurs in which hemisphere?
  12. Depression is more common in which type of aphasia patient? Non fluent, global, or fluent
  13. What is the most common psychotic disorder?
  14. When does schizophrenia usually begin?
    adolescence or early adulthood
  15. Delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, and affective flattening are all characteristic symptoms of what?
  16. Individuals effected with this can exhibit social isolation or withdrawal, peculiar behavior (talking to one self) reduced or inappropriate affect, digressive, vague, overelaborated or metaphoric speech, odd or bizarre thinking.
  17. ____________________ can be caused by closed heal injury, encephalitis, temporal lobe epilepsy, Huntington's disease, Wilson's disease and demyelinating disease?
  18. Involves physical symptoms without demonstrable organic causes and for which there is evidence of a link between the symptoms and psychologic factors or conflicts.
    Conversion disorder
  19. The __________ ___________ enables the patient to prevent conscious awareness of emotional conflict or stress that would be intolerable if faced directly.
    conversion reaction
  20. Symptoms of ____________ tend to be abrupt in onset and sometimes remit rapidly and many symptoms are ____________.
    conversion, transient
  21. Conversion symptoms are frequently ________ in character.
  22. _______________ _______________ is a chronic illness characterized by recurrent, multiple physical complaints and a belief that one is ill.
    Somatization disorder.
  23. People with this disorder ten to have numerous, dramatic complaints involving multiple organs.
    Somatization disorder
  24. ____________ is a state of bodily or mental tension resulting from factors that alter equilibrium.
  25. _____________ comes from many sources, such as working conditions, family and social relationships and events.
  26. Some nonorganic disturbances are under volitional control? T or F
  27. Individuals consciously and deliberately feign physical or psychological symptoms of disease by do so for uncontrolled, unconscious psychological reasons that lead them to seek out the role of the patient or sick person. The best know factitious disorder is called?
    Munchausen's syndrome
  28. _____________ involves the deliberate, voluntary feigning of physical or psychologic symptoms for consciously motivated external purposes (ex. to avoid work or combat, for financial gain, to avoid prosecution)
  29. Is malingering considered a mental disorder?
  30. What are the speech characteristics of depression and manic depression?
    reduced stress, monopitch, monoloudness
  31. What are the speech characteristics of schizophrenia?
    Rapidly alternating melody and pitch, inappropriate stress patterns, incoherent, illogical, digressive, vague or excessively detailed language.
  32. Conversion aphonia, conversion dysphonia, psychogenic spasmodic dysphonia, iatrogenic voice disorder is all what type of disorders?
    Psychogenic disorders
  33. Whisper involuntarily is called
    conversion aphonia
  34. hoarseness, breathiness
    Conversion dysphonia
  35. "Suggested" by the clinician
    latrogenic voice disorder
  36. Dysfluencies similar to those of developmental stuttering including struggle behaviors and generally not reduced by singing or choral reading is called?
    Psychogenic stuttering
  37. Patients who make no attempt to speak, or they mouth words without voice or whispering is called.
    Psychogenic Mutism
  38. With psychogenic mutism _________ is normal, establishing the capacity for vocal fold adduction.
  39. What questions need to be answered in the examination process by the clinician to decide whether a problem is psychogenic? ###Not sure about this question####
    • 1. Can the speech disorder be classified neurologically?
    • 2. Is the oral mechanism examination consistent with the speech disorder and patterns of abnormalities found in a neurologic disease?
    • 3. Is the speech deficit suggestible?
    • 4. Is the speech deficit susceptible to distractibility?
    • 5. Does speech fatigue in a lawful manner?
    • 6. Is the speech deficit reversible?
  40. Is dysarthria a speech disorder or a language disorder?
    Speech Disorder
  41. Is Aphasia a speech disorder or a language disorder?
    Language disorder
  42. Which disorder (dysarthria or aphasia) involves deficits that cross all language modalities (listening, speaking, reading, and writing)?
  43. Which disorder (dysarthria or aphasia) involves deficits in handling symbolic information?
  44. Which disorder (dysarthria or aphasia) leaves auditory comprehension and reading skills preserved?
  45. Which disorder (dysarthria or aphasia) involves deficits in word-finding skills?
  46. Which disorder (dysarthria, aphasia, or both) is characterized by articulatory errors?
    Both, especially fluent aphasia
  47. Where do lesions that produce aphasia occur?
    language areas of the left hemisphere
  48. Where do lesions that produce dysarthria occur?
    variety of sites in the central and peripheral nervous systems
  49. Which disorder (dysarthria or aphasia) is characterized by respiratory, phonatory, resonance, prosodic, stress, and voice quality problems?
  50. Is dysarthria always a characteristic of dementia?
    No. Language deficits are seen n all dementias but dysarthria is observed only in a subgroup of dementias associated with movement disorders, including parkinsonism, Huntington’s chorea and progressive supranuclear palsy.
  51. How is language of confusion often induced?
    traumatically-dysarthria often coexists with language of confusion in TBI
  52. Unclear thinking, faulty memory, and irrelevant responses are frequent characteristics of what?
    language of confusion
  53. Which of the following are motor speech disorders? (dysarthria, aphasia, apraxia)
    Dysarthria and apraxia
  54. What is a speech deficit of motor production?
  55. What is a speech deficit of motor programming?
  56. True or false: Apraxia of speech involves speech production tasks and automatic/involuntary tasks like chewing and smiling.
    FALSE, apraxia of speech does NOT include automatic involuntary tasks like chewing and smiling.
  57. Which of the following disorders involves abnormalities in movement rates, precision, coordination and strength in both speech and nonspeech movements? (Dysarthria, apraxia, aphasia)
  58. In which disorder are the motor control problems influenced by tasks and context?
  59. In which disorder are motor control problems present regardless of tasks or context?
  60. Which of the following are NOT associated with dysphagia? (dysarthria, apraxia of speech, or both)
    apraxia of speech
  61. Which of the following is frequently associated with aphasia? (dysarthria, apraxia of speech, or both)
    apraxia of speech
  62. Which of the following is characterized by misarticulations that are inconsistent? (dysarthria, apraxia of speech, or both)
    apraxia of speech
  63. In which of the following disorders is the production of automatic utterances better than the production of propositional utterances? (dysarthria, apraxia or speech, or both)
    apraxia of speech
  64. In which of the following disorders is the production of automatic and propositional utterances equally impaired? (Dysarthria, apraxia of speech, or both)
  65. In which of the following disorders do word length, meaningfulness, and frequently of occurrence influence error production? (dysarthria, apraxia of speech, or both)
    Apraxia of speech
  66. Which of the following disorders are not characterized by articulatory groping? (dysarthria, apraxia of speech, or both)
  67. Which of the following disorders are characterized by attempts at self-correction? (dysarthria, apraxia or speech, or both)
    apraxia of speech
  68. True or False: Co-occurrence of dysarthria and neurologic communication disorders is relatively common.
    True, especially post onset of acquired disorders and in developmental disorders
  69. True or false: mild dysarthria may accompany aphasia, especially in the period immediately following a stroke.
    True, but the dysarthria may not always be mild-may be more severe.
  70. Do apraxia and dysarthria ever coexist?
  71. Which type of dysarthria is characterized by imprecise consonants, monopitch, reduced stress, harsh voice, monoloudness, low pitch, slow rate, hypernasality, strained-strangled voice, and short phrases?
    spastic dysarthria
  72. Which type of dysarthria is characterized by hypernasality, imprecise consonants, breathy voice, and monopitch?
    flaccid dysarthria
  73. Which type or types of dysarthria (as in ALS) are characterized by imprecise consonants, hypernasality, harsh voice, slow rate, monopitch, short phrases, distorted vowels. low pitch, monoloudness, excess and equal stress, prolonged intervals?
    Mixed spastic and flaccid dysarthria
  74. Which type of dysarthria is characterized by imprecise consonants, excess and equal stress, irregular articulatory breakdowns, distorted vowels, and harsh voice?
    ataxic dysarthria
  75. Which type of dysarthria (as in Parkinson's disease) is characterized by monopitch, reduced stress, monoloudness, imprecise consonants, inappropriate silences, short rushes, harsh voice, and breathy voice?
    hypokinetic dysarthria
  76. Which type of dysarthria (as in dystonia) is characterized by imprecise consonants, distorted vowels, harsh voice, irregular articulatory breakdown, strained-strangled voice, monopitch, and monoloudness?
    hyperkinetic dysarthria
  77. Which type of dysarthria (as in choreoathetosis) is characterized by imprecise consonants, prolonged intervals, variable rates, monopitch, harsh voice, inappropriate silences, distorted vowels, and excess loudness?
    hyperkinetic dysarthria
  78. This research by a Mayo study found that each of seven neurologic disorders could be characterized by a unique set of clusters of deviant speech dimensions and that no two disorders had the same set of clusters. Thus, differential diagnosis could be based on clusters of related dimensions rather than on single features.
    Clusters of Speech Dimensions
  79. What are the management goals for motor speech disorders? (in order)
    • 1. Restore lost function: to reduce impairment
    • 2. Promote the use of residual function: to compensate
    • 3. Reduce the need for lost function: to adjust
  80. In general in ongoing intervention recommended it there is negligible disability and no limitation associated with a MSD?
    No it is not recommended. (not interfering with his life, no need for therapy)
  81. Is direct intervention recommended if the patient is unmotivated?
  82. What can be done if direct intervention or ongoing intervention is not recommended?
    Counseling of the patient and family may be undertaken instead, with an option to resume direct intervention if motivation changes.
  83. What should the general focus of treatment be on?
    The component of speech that should be treated is the one from which the greatest functional benefit will be derived most rapidly or that will provide the greatest support for improvement in other aspects of speech.
  84. For how long should treatment be provided?
    For as long as is necessary to accomplish its goal but for as short of a time as possible. In general not management program should begin without a plan about when it will end.
  85. Dopaminergic agents for Parkinson's disease, Mestinon for Myasthenia gravis, dietary modifications and chelating agents for Wilson's disease, Botox for spasmodic dysphonia are all what type of medical intervention?
    Pharmacologic (we don't do these)
  86. Pharyngeal flap to improve velopharyngeal function for speech, thyroplasty for vocal fold paralysis are what types of medical intervention?
    Surgical management (We don't do these)
  87. To facilitate velopharyngeal closure during speech you would use what for prosthetic management?
    palatal lift prosthesis or nasopharyngeal obdurator
  88. To inhibit mandibular hyperkinesis you would need to use what for prosthetic management?
    A bite block positioned between the upper and lower teeth.
  89. To slow speech rate and increase syllabic stress you would use what for prosthetic management?
    pacing boards, metronomes, delayed auditory feedback
  90. To augment speech or serve as alternatives to speech you would use what for prosthetic management?
    AAC devices such as pictures, letters, and word boards, including computerized devices with synthesized speech.
  91. ____________ management includes all intervention efforts that are neither medical nor prosthetic?
  92. With behavioral management, what kind of approaches serve to improve communication by altering speech; focus primarily on improving intelligibility and secondarily on improving efficiency and naturalness of communication.
    Speech-Oriented Approaches- treatment of MILD impairments tend to be speech oriented
  93. With behavioral management, what kind of approaches serve to improve communication by altering speaking strategies, the behavior of listeners, or the communication environment; focus primarily on modifying aspects of the communicative interactions.
    Communication-Oriented Approaches- treatment of SEVERE impairments tends to be communication oriented.
  94. Focus primarily on improving intelligibility and secondarily on improving efficiency and naturalness of communication.
    Speech-Oriented Approaches
  95. Treatment of MILD impairments tends to be _________ _________.
    speech oriented
  96. Focus primarily on modifying aspects of the communicative interactions.
    Communication-Oriented Approaches
  97. treatment of SEVERE impairments tends to be _____________ _____________.
    communication oriented.
  98. The manner in which care is provided may be as important from the patient's perspective as the actual outcome of efforts to improve their speech or communication? T or F
  99. Is the brain a static organ?
    No it is not a static organ
  100. _____________ ______________ occurs with muscle use?
    Neural adaptation
  101. The organization of the cortex in adult animals is fixed? T or F
    False it is NOT fixed.
  102. The nervous system is capable of recovery and reorganization after injury? T or F
  103. Motor reorganization after injury requires ________.
  104. __________ and __________ diagnoses are relevant to management.
    medical and speech
  105. Management usually should start early, but not always? T or F
  106. ___________ data are necessary for establishing goals and measuring change?
  107. Increasing ________________ support often should be the initial focus of treatment?
  108. Compensation requires that speech production become ______________.
  109. Speech Oriented treatment Principles of motor learning includes the following:
    • 1. Improving speech requires speaking
    • 2. Drill is essential
    • 3. Feedback is necessary
    • 4. Practice should vary
    • 5. Increasing strength is important
    • 6. ****Emphasizing speed tends to reduce accuracy, whereas emphasizing accuracy reduces speed.****
  110. Emphasizing _________ tends to reduce accuracy; whereas emphasizing ___________ reduces speed.
    speed, accuracy
  111. Organization of session: treatment session should be?
    frequent, especially early in the course of treatment
  112. Organization of session: In what order should tasks be in?
    Easy tasks should precede difficult ones.
  113. Organization of session: How should error rates be?
    They should be kept low because high error rates tend to promote failure and may reduce learning
  114. Organization of session: What do we do about fatigue in our patient's?
    Therapy may need to be done early in the day to be most productive
  115. Clinicians generally prefer individual therapy, especially early in the course of treatment? T or F
  116. Group therapy may be desirable for patients with ______ degree of disability?
  117. Studies tend to support the view that management of MSD's is efficacious? T or F
  118. Evidence based practice emphasized evidence of effectiveness, but is not meant to replace clinical experience? T or F
  119. What type of treatment will we use most often one-on-one or across the table?
    Speaker-Oriented treatment
  120. True or false: As a general rule, if a patient has adequate loudness and demonstrates flexible breath patterning during speech, then respiration does NOT require attention.
  121. True or false: respiratory demands for speech are NOT great.
  122. True or false: improving function in the phonatory, resonatory, and articulatory valves generally does NOT promote efficient use of the airstream,
    False-it does promote efficient use of the airstream.
  123. True or false: the presence of abnormal respiratory function does NOT necessarily mean that respiration is not adequate for speech.
  124. When the need exists, management efforts for respiration are primarily what? (two blanks)
    behavioral and prosthetic
  125. What objective do the following tasks target? blowing into a water glass, maximum vowel prolongation, keeping utterances within the optimal breath group, pushing, pulling and bearing down during speech or nonspeech tasks, controlled exhalation tasks, and postural adjustments?
    Increasing respiratory support.
  126. What is the number of syllables that a patient can comfortably produce on one breath called?
    optimal breath group
  127. Pushing, pulling, and bearing down during speech or nonspeech tasks increase tension, and are not used for treating which type of dysarthria?
  128. Postural adjustments are used a lot with which disease?
    Parkinson's Disease
  129. What type of assistance uses abdominal trussing (binders or corsets) to enhance posture, support weak abdominal muscles and improve respiratory support and air flow?
    Prosthetic assistance-medical approval and supervisions is important when binding is used because it can restrict inspiration and increase the risk of pneumonia.
  130. Which type of treatment uses biofeedback to improve respiratory control in some dysarthric speakers?
    Instrumental feedback
  131. Which type of treatment has patients inhale more deeply or use more force when exhaling, initiate speech at appropriate points in the cycle, terminate speech at appropriate points in the cycle, and eliminate maladaptive compensatory breathing strategies?
    Behavioral compensation
  132. What type of laryngeal surgery is performed to improve phonation in people with vocal fold paralysis or weakness?
  133. Which laryngeal surgery is performed to induce unilateral vocal fold paralysis, to prevent hyperadduction in spasmodic dysphonia?
    Recurrent laryngeal nerve resection.
  134. What type of injection is given to manage vocal fold paralysis?
    Teflon injection
  135. What type of injection is given to treat spasmodic dysphonia?
    Botox injection
  136. What are four types of prosthetic management that help with phonation?
    • 1) a portable amplification system to increase loudness
    • 2) artificial larynx to increase loudness
    • 3) neck braces or cervical collars to stabilize the head and neck during speech
    • 4) a vocal intensity controller to provide feedback about excessive or inadequate loudness
  137. The primary goal of THIS TYPE of management of phonation is to increase utterance length per breath group and obtain loudness levels that are sufficient for the social context.
    Behavioral management
  138. Effort closure techniques, learning to initiate phonation at the beginning of exhalation, turning the head to the left or right when speaking to increase tension, and lateral digital manipulation of the thyroid cartilage to increase tension are all What TYPE of management for phonation?
    Behavioral management
  139. Are surgical interventions recommended for the treatment of resonance?
    There is insufficient evidence to permit recommendations about surgical interventions for velopharyngeal dysfunction is dysarthria.
  140. What prosthetic is used to treat issues of resonance in dysarthria?
    palatal lift prosthesis-consists of a palatal portion that is attached to the teeth and a lift portion that extends posteriorly to lift the palate in the direction of velopharyngeal closures. Fitting it requires adequate dentition to retain the device.
  141. Do dysarthric people with severe and chronic velopharyngeal impairments benefit from behavioral intervention?
    It is felt that they do not benefit from behavioral therapy alone. Prosthetic or surgical intervention should be considered in such cases.
  142. True or false: Botox injections can be used to treat hemifacial spasms and oral mandibular dystonia.
  143. True or false: drugs that facilitate or improve movement in the extremities often do NOT have a significant impact on the bulbar speech muscles (refers to pharmacologic management of articulation)
  144. What type of prosthetic management is used to help improve jaw control in patients with hypokinetic, hyperkinetic and spastic dysarthrias?
    a bite block
  145. True or false: a behavioral focus on articulation has traditionally been viewed as a major part of dysarthria treatment for many patients.
    True. HOWEVER, this is probably less frequently the case for many patients today, especially if efforts to improve articulation by slowing rate and modifying prosody are placed outside the realm of articulation activities.
  146. True or false: articulation sometimes improves when respiratory support is optimized.
  147. What is included in the behavioral management of articulation?
    strength training, relaxation, stretching, biofeedback, and traditional articulation methods.
  148. True or false: If the goal is to improve the accuracy and precision of sound production, it can often be accomplished by focusing on functions other than those directly related to place and manner of articulation.
  149. What is the most powerful, single, behaviorally modifiable variable for improving intelligibility?
  150. What frequently facilities articulatory precision and intelligibility by allowing time for a full range of movement, increased time for coordination, and improved linguistic phrasing?
    Rate modification, most often rate reduction
  151. What are three types of prosthetic management that can be used to address rate?
    • 1) delayed auditory feedback
    • 2) pacing board
    • 3) alphabet board
  152. What are two nonprosthetic rate reduction strategies?
    • 1) hand or finger tapping
    • 2) visual feedback from a computer
  153. What is the goal of prosody and naturalness treatment?
    to maximize the naturalness of prosodic patterns
  154. Is work on prosody appropriate at all severity levels?
    Yes. There are potential benefits to intelligibility when impairment is severe and benefits to naturalness when impairment is mild.
  155. When treating flaccid dysarthria, it is best to increase strength, but if you can't do that, then you should focus on WHAT?
    compensating for weakness
  156. What is the speaker-oriented treatment for spastic dysarthria?
    Relaxation exercises
  157. What is the speaker-oriented treatment for ataxic dysarthria?
    compensating for problems with motor control and coordination
  158. What is the surgical intervention for hypokinetic dysarthria?
    Thalamotomy. To reduce symptoms of Parkinson’s Disease
  159. What is the pharmacologic treatment of hypokinetic dysarthria?
    Dopamine agonist medications such as levodopa
  160. What does the behavioral management treatment of hypokinetic dysarthria focus on?
    rate control, reduced loudness
  161. What is the speaker oriented treatment for hyperkinetic dysarthria?
    Primarily surgical and pharmacologic treatments (e.g. Botox)
  162. What does the speaker-oriented treatment for unilateral upper motor neuron dysarthria focus on?
    rate, prosody, and articulation
  163. In communication-oriented treatment, what type of strategy is "Preparing listeners with alerting signals"?
    Speaker strategy
  164. In communication-oriented treatment, what type of strategy is "Convey how much communication should occur"?
    Speaker strategy
  165. In communication-oriented treatment, what type of strategy is "Set the context and identify the topic"?
    Speaker strategy
  166. In communication-oriented treatment, what type of strategy is "Modify sentence content, structure, and length"?
    Speaker strategy
  167. In communication-oriented treatment, what type of strategy is "Gestures may help"?
    Speaker strategy
  168. In communication-oriented treatment, what type of strategy is "Monitor listener comprehension"?
    Speaker strategy
  169. In communication-oriented treatment, what type of strategy is "Alphabet board supplementation"?
    Speaker strategy
  170. In communication-oriented treatment, what type of strategy is "maintain eye contact"?
    Listener strategies
  171. In communication-oriented treatment, what type of strategy is "Listen attentively and actively, and work at comprehension"?
    listener strategies
  172. In communication-oriented treatment, what type of strategy is "modify the physical environment"?
    listener strategies
  173. In communication-oriented treatment, what type of strategy is "maximize listener hearing and visual acuity"?
    listener strategies
  174. In communication-oriented treatment, what type of strategy is "time important interactions"?
    interaction strategies
  175. In communication-oriented treatment, what type of strategy is "select a conducive speaking environment"?
    interaction strategies
  176. In communication-oriented treatment, what type of strategy is "maintain eye contact between listener and speaker"?
    interaction strategies
  177. In communication-oriented treatment, what type of strategy is "identify breakdowns and establish methods for feedback"?
    interaction strategies
  178. In communication-oriented treatment, what type of strategy is "repair breakdowns"?
    interaction strategies
  179. In communication-oriented treatment, what type of strategy is "establish what works best when"?
    interaction strategies
  180. In __________ therapy, an attempt is made to improve physiologic support for adequately planned and programmed speech.
  181. In _______ therapy, treatment focuses on reestablishing plans or programs or improving the ability to select or activate them or set the parameters for speech movements in a given context that will then be executed by an intact neuromuscular apparatus
  182. Aphasia is present in a high proportion of those with _____ because of the overlap of lesion sites that are associated with the two disorders.
  183. What 3 ways does aphasia influence aos treatment?
    • 1- it affects language functions in all modalities
    • 2- aphasia affects verbal expression
    • 3- aphasia may be so severe that verbal communication would not be functional even if motor speech ability was intact.
  184. Treatment for aos should focus on task that provide the greatest __ benefit most rapidly or that provide the best foundation for improvement over the course of tx.
  185. Managing aos is primarily a __________ enterprise.
  186. There are ______ medical interventions specifically designed to improve aos for which there is strong evidence for efficacy.
  187. Mechanical and prosthetic devices are appropriate for some people with aos but are almost always _________ and primarily intended to stimulate improved speech without the prosthesis.
  188. AOS is predominantly a disorder of ___ and _____.
    articulation and prosody
  189. Tx is rarely focused on _________, ___________, or _________ for any patient with aos besides the most severely impaired patients.
    resonance, respiration, phonation
  190. ______________ speech is easier than volitional purposive speech.
  191. ________ distinctions are easier than voicing distinction, which are easier than manner distinctions, which are easier than place distinctions.
  192. _______ and _________ places of articulation are easier than other places of articulation.
    bilabial and lingual/alveolar
  193. Consonant singletons are easier than _____.
  194. __________ frequency words are easier than _______ frequency words, and meaningful words are easier than nonsense words.
    high, low
  195. _______ syllable words are easier than multisyllabic words, and words are easier than phrases or sentences.
  196. Combined ________ and _________ stimulation lead to more accurate responses than auditory or visual stimulation alone.
    visual and auditory
  197. production of ______ words is easier than productions of unstressed words.
  198. Working on _____ stimulable targets may promote better generalization even if initial acquisition is more difficult.
  199. Tx for aos does not require efforts to increase ________ support for speech.
  200. Using speech stimuli as targets usually is more appropriate than _______ stimuli.
  201. when aos is so severe that sounds or sound segments cannot be produced, work on nonspeech _____ or movement sequences may be appropriate because tx should begin at a level at which some success can occur.
  202. Nonspeech oromotor practice should always involve movement targets or patterns that closely approximate speech _________.
  203. Every specific behavioral tx approach for aos emphasizes _______.
  204. patients should be urged to _______ their speech, search for correct targets, and self-correct errors
  205. ________ and ___________ are motivating and more meaningful and specific to the ultimate goal of tx.
    words and phrases
  206. Consistent and variable practice should be used with aos and _________ practice should be used as soon as progress can be demonstrated in response to it.
  207. 5 types of behavioral management approaches?
    • 1- the 8 step continuum for txing aos
    • 2- sound production tx
    • 3- prompts for restructuring oral muscular phonetic targets (prompt)
    • 4- melodic intonation therapy
    • 5- biofeedback
  208. _________ regimens may help to reduce dysfluencies for neurogenic stuttering.
  209. behavioral tx of ns should be deferred until after and related ________
  210. neurogenic dysfluencies may be modified by _________ strategies that are effective for modifying rate in people with dysarthria or aos.
    speech rate-reduction
  211. Little is known about tx of palilalia but patients with palilalaia and pd may improve with _____ management
  212. Management of aphasia and aos and dysarthria are quite different and the tx of one disorder cannot be expected to ________ deficits in the others.
  213. ________ for patients with aprosodia may help patients and their families
  214. Patients with psychogenic speech disorders can be managed effectively by slp and their prognosis for recovery is usually _______.
  215. For psychogenic speech disorders the clinician attitude and manner of relating to the patient is ____--
  216. Therapy for psychogenic speech disorder is best conducted following ________ of all relevant medical evaluations
  217. The _______ history is crucial to both diagnosis and management.
  218. _______ tx usually involves the identification of abnormal behaviors and the gradual behavioral shaping of more normal speech responses with continuous explanation and reinforcement for change.
  219. Symptomatic therapy involved efforts to reduce excessive musculoskeletal tension and the gradual shaping of normal _______ and ________. A high portion of patients respond well to symptomatic therapy.
    phonation and fluency