Motor Speech Disorders

Question: Discuss about theMotor Speech Disorders. Answer: Introduction The 48-year-old Putonghua speaking male had suffered a stroke almost two months ago which has resulted him into developing speech impairment. In order to provide treatment to the patient, a session plan has been drawn providing the treatment goals. The rationale of the goals has been discussed and the implementation approach. An evaluation method has also been suggested to find the effectiveness of the treatments. Diagnosis The client has been diagnosed with moderate spastic dysarthria. The condition was diagnosed at a phonatory, resonatory, prosodic and articulatory level. The client had symptoms of connected speech, hypernasality, imprecise articulation, reduced rate, short phrases, monopitch as well as monoloudness. The client has also been diagnosed with non-speech characteristics too, namely, pseudobulbar effect, spasticity of fingers at resting condition, reduced range and rate of finger movement. The damage to the pyramidal tract has led to the patient in developing spastic dysarthria (Clark et al., 2014). Dysarthria has been defined as a disorder involving speech, which results due to the CNS (Central Nervous System) or PNS (Peripheral Nervous System) from having received damage. The patient had reported to suffer a stroke 2 months ago and possibly might have damaged his CNS or PNS during then. Setting of Goals (Session Plan) As a part of the session plan for the first 30 minutes of the treatment session, the patient should be subjected to three treatment methods, which would help him to deal with his speech impairment issue. The three treatment goals that have been chosen to treat the patient are (Wu, Tan Wan, 2012): Phonetic Treatment Modification of Prosody Speech Therapy These goals has been designed to increase the efficiency of the patient in facilitating normal communication. Rationale for Treatment Phonetic Treatment has been suggested as one of the treatment goals because it will help the patient in having a normal communication with the help of verbal, visual as well as tactile cues, which is necessary for increasing functional speech (Lousada et al., 2013). Since the patient was diagnosed with spastic dysarthria at prosodic and phonetary level, the treatment meted at this level is important. Modification of Prosody has been suggested as one of the treatment goals because spastic dysarthria does not respond to behavioral treatment (Falk, Chan Shein, 2012). Therefore, augmentative communication based treatment will be used which would help in the induction of hypoadduction. Speech therapy has been suggested as one of the treatment goals as the patient has been diagnosed with hypernasality. He will require the therapy to increase the lateral pharyngeal wall based movement (Beijer et al., 2014). Treatment Methods Phonetic treatment method of treatment will be implemented on the patient where he will be taught to moderate the pitch of his speech to make it intelligible. Techniques such as contextual based utilization can be used where recognition methods of common words in relation to a connected speech will be taught. Therapies such as, distinctive feature based therapy and metaphon therapy can be applied to develop in the patient the elemental phonemes so that he may adapt to the idea of the property of sound. Prosody modification method of treatment will be implemented on the patient where he will be asked to practice head rolls and throat based breathing in order to reduce the stress on the supralaryngeal tension. The patient will also be taught to reduce stress on the vocal cord so that the fold adduction has been reduced. Contrastive as well as lexical based stress exercises will be taught to the patient in order to practice various intonations. Speech therapy method of treatment will be implemented on the patient where he will be taught techniques such as yawn technique, auditory feedback, visual feedback, manipulation of the tongue blade so that he can speak normally (Sakai Momosaki, 2016). He will be taught to use glottal stops and pharyngeal plosives, which will help him in pronouncing several words without any difficulty. Visual as well as tactile feedback will be used to teach the patient to use his words efficiently to form a sentence. Treatment Outcome Measurements In order to evaluate the treatment goals, the following steps can be adhered to. The patient will be subjected to speech based intelligibility tasks to determine how well the patient is being able to pronounce the words properly in order to evaluate the speech therapy. The patient will be made to repeat sentences to determine the pitch and clarity of the speech. The patient will be made to sustain the vowels in order to determine the phonation treatment. Conclusion The above-mentioned treatment goal will be helpful in treating the patient from his speech disorder. It is necessary for the patient to continue attending the sessions as long as it takes to facilitate normal communication. The patient must make an utmost effort to participate actively in the sessions to make swifter progress. References: Beijer, L. J., Rietveld, A. C. M., Ruiter, M. B., Geurts, A. C. H. (2014). Preparing an E-learning-based Speech Therapy (EST) efficacy study: Identifying suitable outcome measures to detect within-subject changes of speech intelligibility in dysarthric speakers.Clinical linguistics phonetics,28(12), 927-950. Clark, H. M., Duffy, J. R., Whitwell, J. L., Ahlskog, J. E., Sorenson, E. J., Josephs, K. A. (2014). Clinical and imaging characterization of progressive spastic dysarthria.European journal of neurology,21(3), 368-376. Falk, T. H., Chan, W. Y., Shein, F. (2012). Characterization of atypical vocal source excitation, temporal dynamics and prosody for objective measurement of dysarthric word intelligibility.Speech Communication,54(5), 622-631. Lousada, M., Jesus, L. M., Capelas, S., Margaa, C., Simes, D., Valente, A., ... Joffe, V. L. (2013). Phonological and articulation treatment approaches in Portuguese children with speech and language impairments: a randomized controlled intervention study.International Journal of Language Communication Disorders,48(2), 172-187. Sakai, K., Momosaki, R. (2016). Real-world Effectiveness of Speech Therapy Time on Cognitive Recovery in Older Patients with Acute Stroke.Progress in Rehabilitation Medicine,1, 20160004. Wu, H. K., Tan, F., Wan, S. Y. (2012). The curative effect of early intervention of electro-acupuncture combined with functional electric stimulation on the treatment of spastic dysarthria in acute cerebral infarction patients.Chinese Journal of Rehabilitation Medicine,27(12), 1116-1119. 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