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The physical act of speech occurs as a result of contributing processes and operations. Name the 4 processes and explain each.
- Neurocognitive: Intent to communicate
- Neuromotor: Planning, programming, control, execution
- Neuromuscular: Contractions & movement of speech structures
- Musculoskeletal: Further execution
What are 3 issues with the normal aging population?
What are the physiological, acoustic, and perceptual changes associated with normal aging?
- Complexity (co-occurring disorders), Frequency, Variability
- Physiological: muscle changes, sensory changes
- Acoustic: Pitch changes
- Perceptual: pitch, decreased loudness, slower rate, poorer vocal quality
- Be aware of range of normal.
What is the population that dysarthria is most present?
Dysarhtria is one of the first symptoms in about 25% of people with _____
- PD (90%); 25% in small CVA and 33% w/ TBI
Define motor speech disorders.
Speech disorders resulting from neurologic impairment affecting planning, programming, control, and execution of speech, including dysarthrias and apraxia of speech
What is speech motor planning?
- Transformation of abstract symbols to something the motor system can use
- Spatial & temporal markers
What is speech motor programming?
Tells muscles how to function relative to ___, ___, ___, and ___ to accomplish goals determined at the level of motor planning
- Sequencing of motor programs for muscle movement
- speed, tone, range, direction
Group of neurologic speech disorders that reflect abnormalities in the strength, speed, range, steadiness, tone, or accuracy of movements required for breathing, phonation, resonation, articulation, or prosodic aspects of speech production
In dysarthria, neuropathologic deficits are due to: (5)
- Weakness, spasticity, or incoordination
- Involuntary movements
- Excessive or reduced or variable muscle tone
Characteristics of Dysarthria
1. Is ___ in origin
2. Is a disorder of ___
3. Can be categorized into different types.
It is not just an ___ disorder
Define apraxia of speech
- Neurologically based speech disorder; deficit in planning/programming, does not directly exult from neurophysiologic disturbances associated with dysarthrias--NOT due to weakness, spasticity, etc.
- Not a language problem
Other neurologic disorders:
These can affect speech production but are not classically considered motor speech disorders
- Cognitive-linguistic (affective, mutism)
- Sensory deficits
- Musculoskeletal problems (i.e. cleft palate)
- Non-neurologic and nonpsychogenic voice disorders
- Psychogenic/non-organic disorders
Methodology for Examining Speech production
- Perceptual (gold standard)
- Instrumental (not widely used for diff dx)
Types of Instrumental speech production exams
- Visual imaging (widely used but reliability still a concern)
What is the Directions into Velocities of Articulators (DIVA) model?
What is important for this model?
- Uses 2 main types of information: auditory, somatosensory, motor
- Identifies specific areas of brain relevant for speech production
- Model based on neurophysiology and neuroanatomical data
- Role of Feedback & feedforward
According to the DIVA model, what is the importance of sensori- & motor integration?
It says articulatory movements are ___-___, for example babbling. Guides feedback because the articulator movements produce auditory and somatosensory feedback (creates a link b/w systems).
- Feedback control; feedback
- Learning in the babbling stage is not phoneme or syllable specific; will be used for all speech sounds that will be learned later; concept=relationships
Explain the DIVA model (the procedure)
- Present with speech sounds to learn
- Learns auditory target
- tries to produce sound (feedback initially more important than feedforward)--with repetition of sound, somatosensory target region defined
- Eventually feedback not necessary (after practice, feedforward info)
Speech Motor Control model
Task dynamics (Saltzman & Munhall)
General Speech production models
(Levelt) Comprehensive Message formulation through ____ encoding.
(Dell) Comprehensive. Most well specified at level of ____ ____
- Gestural coordination, Interarticulatory incoordination
- Phonologic encoding
What is van der Merwe's framework?
- 1. Linguistic symbol planning (encoding)
- 2. Motor planning
- 3. Motor programming
- 4. Execution
According to Van der Merwe, motor planning is:
- Motor goals for speech sounds ID'ed
- Sequential organization of movements for each sound
- Planning of consecutive movements relative to phonetic context and rates (coarticulation)
- Adaptation of spatial and temporal specifications of movement
- Motor equivalence (hearing correct production, end goal is acoustic goal)
- adaptation occurs before sound is initiated
- Articulator specific (lip rounding, jaw depression, glottal closure)
van der Merwe's motor planning:
Acquired during _____
When we talk, core motor plans for ___ ___ ___ recalled
Plan has to be __, and possibly ___ depending on context
Relevant neural structures? (4)
- development of speech
- abstract phonological symbols
- implemented, adapted
- Pre-motor cortex, supplementary motor area, prefrontal & parietal association areas (including Broca's)
According to van der Merwe, what is motor programming?
sequencing of motor programs for muscles of the articulators (including vocal folds) and specification of muscle-specific programs in terms of spatiotemporal and force dimensions such as muscle tone, direction, and range of movements
According to van der Merwe, what is execution ?
Specifications are relayed to lower motor centers that control joins and muscles through final common path (AKA LMN)
According to van der Merwe, MSDs are the inability to... (name a few, related to planning)
As a result of those motor planning difficulties.... (2)
- Learn/recall invariant core motor plans for specific phonemes
- sequentially organize movements for each phoneme and series for a sequence of phonemes
- control interarticulatory synchronization
- implement tac-kin feedback for adaptation
- Relay structure specific motor plan subroutines to the motor programming system
- Slow, struggling speech w/ distortion
Disorder of motor programming results in...
- impairment of rate, tone, direction, range
- Repeated initiation and feedforward of co-occurring and successive motor programs
- Behaviors-sound distortions, speech rate, difficult with initiating movements (consistency)
- Sequencing motor programs for muscle mvmt
- **Says dysarthria due to programming disorder, not execution*** (hypo kinetic, hyperkinetic, ataxic, spastic)
What type of dysarthria is the effect of motor execution impairment?