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Motor Speech Disorder and AAC Cheat Sheet (DRAFT) by

Motor Speech Disorders… and AAC

This is a draft cheat sheet. It is a work in progress and is not finished yet.

What is “motor speech”?

➢ Learning to speak, requires indivi­duals to learn how to plan, sequence,
and/ or control movements of muscle groups used to generate speech
➢ BUT for children who experience impair­ments in neurol­ogical
develo­pment may have difficulty planning, coordi­nating, and
executing speech sounds moveme­nts...
➢ Similarly, adults with different ‘condi­tions’ (diseases, disorders
etc.) that impact the nervous (central and /or periph­eral) systems,
which in turn, affect speech components (respi­ration, phonation, prosody, and articu­lat­ion...)

Motor Speech

➢ First you need to retrieve the words and inform­ation you want to say
➢ If you don’t have the inform­ation you will not know how to produce the sounds and the words

Speech Program Inform­ation

➢ Brain tells us we need to move our lips first
➢ Tongue needs to move, the soft palate
➢ This needs to happen in the right order
➢ Articu­lators are muscles so the brain will send signals to our muscles to tell them when and how to move to articulate the sounds to produce words
➢ Is something going wrong with the green circle etc? Processing step or when articu­lators should move then we are dealing with a motor speech disorder.

Different conditions can impact speech

The following conditions include: what they are, speech charac­ter­istic and treatments

Motor Neuron Disease

➢ it is a progre­ssive condition and the cause of the condition is unclear
➢ 5% of cases have a family history, which is called familial motor neuron disease
➢ If there is no family history it is called sporadic motor neuron disease

Speech charac­ter­istics include:
➢ Faint speech
➢ Slurred or unclear speech
➢ Muscle weakness
➢ Spastic speech
➢ Slow rate

Treatment for MND:
➢ No cure so the point of treatment is to provide comfort and the highest quality of life
➢ Loss of functions = mobility, commun­ica­tion, swelling and breathing are all affected
➢ Breathing masks may be used to help with the breathing aspect
➢ Feeding tube used to help patients who cannot feed themselves
➢ Some medica­tions can help with survival rate but cannot decrease the progre­ssion of the disease

Inform­ative websites:
➢ Show where to get support and give care, how to talk to children about the disease, talking about the condition, helping to bring light to the disease

Commun­ication aids for MND:
➢ MND impacts the muscle strength in the lips, tongue, vocal folds and chest, and can also weaken muscles for facial gestures
➢ Recording messages early on in the disease so you can play them when you need to explain something further on when you cannot express speech, device used.
➢ Record words or phrases
➢ Eye gaze techno­logy, eye movement can correspond to certain statements or letters. Yes or no questions etc.

Parkinsons Disease

➢ Decreased breath support
➢ Change in vocal quality
➢ Mumbled speech
➢ Decrease in volume of speech
➢ Short utterances
➢ Voice tremors
➢ Hoarse/ gravely

➢ Parkin­sons' disease is a progre­ssive disorder which affects the central nervous system and heavily affects movement and uncont­rol­lable tremors. This is caused by decreased dopamine levels in the system because there is dead dopamine cell which is in charge of automatic and motor movement

➢ Cannot be cured
➢ Medication helps to control symptoms
➢ Exercise
➢ Trying to increase their quality of life because it is progre­ssive
➢ There are medicines which are used to replace the dopamine cells that died and increase dopamine levels as dopamine is in charge of the automatic and motor movement
➢ Physical and occupa­tional therapy
➢ AAC to make commun­ication easier

➢ Speaking slowly
➢ Quite a space
➢ Make sure the patient can see your face
➢ Short phrases

Advanced Multiple Sclerosis

➢ A progre­ssive demyel­inating disease where the protective cover of nerve cells in the brain and spinal cord are damaged. This results from the immune system not recogn­izing the cells and attacking the body's cells
➢ Affects movements so then also affects speech and swallowing

Common speech charac­ter­istics include:
➢ Speech pattern disrupted, normality
➢ Long pauses between words, single syllables
➢ Words can be slurred, due to weakness or incoor­din­ation of the speech muscles

➢ No cure
➢ Treatments and medicines to help to manage the condition
➢ Treatment varies depending on the stage of the disease
➢ Medicines which relieve muscle spasms Or relax muscles
➢ Plasma exchange
➢ Fatigue: regular sleep, exercise and diet help

➢ Repetition when speaking and speaking slower help
➢ Patients may have trouble with word retrieval so using similar words or describing the word they are trying to say is important for a commun­ication partner

Childhood apraxia of speech

➢ Uncommon speech disorder where children have diffic­ulties creating accurate speech movements
➢ The brain struggles to develop plans for speech movements and it is non-pr­ogr­essive
➢ Most cases are unknown but can be caused by damage to the brain or genetic disorders or stroke or traumatic brain injury

Speech charac­ter­istics:
➢ Trouble moving smoothly from one sound, syllable or word to another
➢ Groping, movements with the jaw, lips or tongue to make the correct movement for speech sounds
➢ Vowel distor­tions, such as attempting to use the correct vowel, but saying it incorr­ectly
➢ Repeated production of vowels

Treatment: three approaches
➢ Motor based approach, based on motor learning
➢ Cues and stimulus
➢ Linguistic approa­ches, address language impair­ments
➢ Multi-­model commun­ication approach, AAC to help them commun­icate

Three features:
➢ Incons­istency
➢ Diffic­ulties transi­tioning between different sounds and syllables
➢ Prosody, stresses, pitch and rhythm of speech
➢ Practice and encour­agement from family can help patients with apraxia