damage in/near cortex of language dominant hemisphere.

Damage in premotor cortex

abnormal articulation, prosody, and sequencing

Distortions, Omissions, Substitutions, Additions

Consistent error patterns; automatic speech=better

lower motor neurons (cranial & spinal)

often CN 9, 10 & 12 (muscles for speech)

Weakness/paralysis in actual axons from brainstem to muscles

resonance, phonation, articuation

breathy, hypophonia (reduced pitch range), hypernasality, imprecision

bilateral damage to upper motor neurons or extra/pyramidal tracts

anterior lesions where motor axons come down

phonation, resonance, respiration, articulation

pyramidal--reduced fine motor movements

extrapyramidal--hypertonicity (tires out muscles eventually)

*axon sends out hypertonic message to muscle

reduced range & force, slow, weak, hypernasal, mono-pitch/loudness, harsh vocals

resonance, articulation, respiration

incoordination--errors in force, speed, timing, range, direction of movement

failure to coordinate sensory data with motor performance

reduced respiratory-laryngeal control, mono-pitch/loudness, articulation

phonation, resonance, articulation

rigidity, slow, lomited ROM, hypophonia, mono-pitch/loudness, poor vocal timing with respiration, short rushes of speech

articulation, phonation

dystonia, abnormal movements, involuuntary movemements (peak then subside)

MS 

type of dysarthria and speech subsystems affected

Spastic-ataxic mix

phonation, atriculation, resonance, and prosody affected

MS

intervention 

-energy conservation

-appropriate speaking rate and respiratory pattern 

-alphabet board

for dysphagia:

-deep paryngeal neuromuscular stimulation

-neuromuscular electrical stimulation

-expiratory muscle strength trainer

ALS

type of dysarthria and speech subsystems affected

spastic-flaccid

respiration, articulation, resonance, prosody

(repiratory failure= common cause of death)

unknown etiology involving upper and lower motor neurons of brain & spinal cord.

corticobulbar tracts, spinal symptoms, respiration, corticospianl tract, anterior horn cells, anterior roots, peripheral nerves, nuclei of CN 5, 7, 9, and 12.

ALS 

intervention

AAC device

for swallowing:

-chin tuck

-drink through straw

-no caffeine

-double swallow

diet:

-PEG tube

-hihg-calorie foods

-increase tast, texture, and temperature (cooler) of    liquids

HD 

intervention

-prosody drills

-maintain appropriate speech rate

-reduce phonatory stenosis

-alphabet board

-calendar/memory aids

-conversational starters

-yes/no questions

-AAC

PD 

intervention

-hyper articulate

-prosody exercise

-pronounce word endings

-increase respiratory/vocal pressure (LSVT)