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Intro 2 SLP Project

Melinda Fonseca

on 4 December 2012

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Transcript of Disarthria

What is dysarthia? Janice Traumatic Brain Injury Often the little things are what we take for granted. Shirley Courtney Celina Disarthria Conclusion Melinda Flaccid
damage to the lower motor neurons involved with speech
damage to the pyramidal tract
damage to the cerebellum or it's connections
damage to the basal ganglia
damage to the substantia nigra Traumatic Brain Injury
Dysarthria Courtney Cochefski, Jaimie Ecklund, Melinda Fonseca, Janice Kwon, Shirley Mitchell, Celina Nigo Reference American Speech-Language Hearing Association. (1997-2012). Dysarthia. Speech, Language and Swallowing › Disorders and Diseases. Retrieved on World Wide Web: http://www.asha.org/public/speech/disorders/dysarthria.htm Bartle, C., Goozée, J., Scott, D., Murdoch, B., & Kuruvilla, M. (2006). EMA assessment of tongue-jaw co-ordination during speech in dysarthria following traumatic brain injury. Brain Injury: [BI], 20(5), 529-545. Persistent link to this record (Permalink): http://ezproxy.twu.edu:2048/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=16716999&site=ehost-live&scope=site Guo, Y., & Togher, L. (2008). The impact of dysarthria on everyday communication after traumatic brain injury: a pilot study. Brain Injury: [BI], 22(1), 83-97. Persistent link to this record (Permalink): http://ezproxy.twu.edu:2048/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=18183512&site=ehost-live&scope=site Morgan, A., Mageandran, S., & Mei, C. (2010). Incidence and clinical presentation of dysarthria and dysphagia in the acute setting following pediatric traumatic brain injury. Child: Care, Health & Development, 36(1), 44-53.doi:10.1111/j.13652214.2009.00961.x
Persistent link to this record (Permalink): http://ezproxy.twu.edu:2048/login?url=http://search.ebscohost.com/login.
aspx?direct=true&db=rzh&AN=2010519598&site=ehost-live&scope=site Brain Injury Association of America. (2009-2012). Pediatric Brain Injury. Link to this record: http://www.biausa.org/brain-injury-children.htm Youtube. (2002) Brain Injury Association "Bully". Youtube. link to this record: http://www.youtube.com/watch?feature=player embedded&v=HNoo9ZekHbs “Every case is can be different depending on the cause, type and severity of the symptoms. Speech Language Pathologist works with individuals to improve communication abilities" (ASHA, 2012) What are some resources? How does it happen?
Adults How is it diagnosed? Speech Jaimie Melinda How does it happen?
•Dysarthria in children refers to a child who has a motor speech disorder characterized by difficulty forming and expressing words that is the result of injury to or pathology of the nervous system.

•Child with dysarthria will have trouble with their speech because of the damage done to their brain. Conversations are difficult for the child and parent/listener

•The speech-language pathologist / speech and language therapist assesses the child's or young person's speech (in the speech assessment), observes the child eating and drinking (in the feeding assessment), and performs a structural/functional examination

•This sub-group of children may place a significant burden on acute SLP services due to their complex co-morbidity and their often extended periods of hospitalization, ventilation, and supplementary feeding

•The high co-morbidity of speech, language and swallowing disorders signal a need for integrated rather than isolated SLP services in the acute setting Adults Types of Dysarthria Janice Melinda Shirley Symptoms * Slurred Speech
* Speaking softly or barley able to whisper
* Rapid rate of speech with a mumbling quality
* Limited tongue. lip, jaw movement
* Abnormal intonation when speaking
*Changes in vocal quality
* Hoarseness
* Breathiness
* Drooling or poor control of saliva
* poor chewing and swallowing quality Treatment What is dysarthria?

Dysarthria is a motor speech disorder. The muscles of the mouth, face, and respiratory system may become weak, move slowly, or not move at all after a stroke or other brain injury. The type and severity of dysarthria depend on which area of the nervous system is affected.

Some causes of dysarthria include stroke, head injury, cerebral palsy, and muscular dystrophy. Both children and adults can have dysarthria.

ASHA.2012 Tips for the Person With Dysarthria

Introduce your topic with a single word or short phrase before beginning to speak in more complete sentences
Check with the listeners to make sure that they understand you
Speak slowly and loudly; pause frequently
Try to limit conversations when you feel tired, when your speech will be harder to understand
If you become frustrated, try to use other methods, such as pointing or gesturing, to get your message across, or take a rest and try again later

Children may need additional help to remember to use these strategies. Conclusion Cont... Tips for the Listener

Reduce distractions and background noise
Pay attention to the speaker
Watch the person as he or she talks
Let the speaker know when you have difficulty understanding him or her
Repeat only the part of the message that you understood so that the speaker does not have to repeat the entire message
If you still don't understand the message, ask yes/no questions or have the speaker write his or her message to you Does It Hit Home? • More than 144,000 Texans sustain a Traumatic Brain Injury (TBI) each year. That's one every four minutes.

• More than 5,700 Texans are permanently disabled every year from a TBI, and an estimated 440,000 Texans live with a disability caused by a TBI.
Note: These figures do not include veterans or military service members. A speech-language pathologist (SLP)
evaluate persons with speech difficulties
determine the severity of speech difficulties
examine the movement of the tongue, lips, face
examine breath support for speech and voice quality Our Role Note: Apraxia is also a motor speech disorder.

Our job as SLP's is to decide if a clients speech difficulties are caused by Apraxia or Dysarthria or possibly both. Jaimie • The most common incidences of TBI for both males and females peaks between the ages of 15–24

• The most common cause of traumatic brain injury involves automobile or motor vehicle accidents and account for nearly ½ of all cases

• TBI, occurs in three general ways; the head being struck with force, the head striking an object, and/or the brain undergoing movement within the skull yet without visual trauma to the exterior of the head.

• TBI is sometimes broken down into two categories: closed head injury (CHI) and open head injury (OHI). CHI refers to damage to the brain that does not involve exterior trauma to the head. OHI is a visible injury where damage to the head and brain is much more evident. McCaffrey, P. (2008). Chapter 14. dysarthria: Characteristics, prognosis, remediation. Retrieved from http://www.csuchico.edu/~pmccaffrey//syllabi/SPPA342/342unit14.html Marieb, E. N. (2004). Human anatomy & physiology. (6th ed.). San Francisco : Benjamin-Cummings Pub Co. Treatment Cont. ASAH has provided possible goals for treatments such as:
slowing the rate of speech
improving the breath support so the person can speak more loudly
strengthening muscles
increasing mouth
tongue and lip movement
improving articulation so that speech is more clear
teaching caregivers
family members
teachers strategies to have better communication Severe cases may lead to learning to use alternative means of communication such as:
simple gestures
alphabet bards
electronic or computer based equipment
ASAH.2012 • Dysarthria occurs in approximately 1/3 of individuals diagnosed with TBI within 5 years post-injury

• Theodoros tested 20 adults with TBI and the results indicated a high incidence of articulatory disturbances. Consonant and vowel imprecision were apparent in 95% and 65% of individuals with TBI, respectively, and phoneme prolongation occurred in 75% of individuals

• Two main tests for assessing the degree of dysarthia are the Standardized perceptual measures like the Assessment of Intelligibility of Dysarthric Speech (ASSIDS) and the Frenchay Dysarthria Assessment (FDA) Celina FYI:
Children suffering from dysarthria is characterized by early sucking, chewing and swallowing problems. Traumatic brain injury (TBI) is the leading cause of disability and death in children in the U.S., the two age groups at greatest risk are age 0-4 and 15-19.

Approximately 1,300 U.S. children experience severe or fatal head trauma from child abuse every year. CDC. (2004). leading Causes and Risk Groups. Tramatic Brain Injury Center. Retrieved on World Wide Web: http://www.cdc.gov/traumaticbraininjury/causes.html James. (2012). Speech Impairment: Dysarthria. Youtube. http://youtube./UF0G-u0hBns
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