ASSESSMENT OF SPEECH

Georgina GriggDaniel MichalikAmna Ghafoor

SPEECH & LANGUAGE Speech:

Articulation & pronunciation Physical ability to form words Bulbar muscles

Language: Process by which thoughts & ideas become spoken Semantics Syntax

DYSARTHRIA

DYSPHASIA

NEUROANATOMY

ASSESSMENT OF SPEECH & LANGUAGE Simple conversation

Assess throughout history taking

3 main areas to assess Quality: dysarthria, dysphonia Content: expressive function – Broca’s area Understanding: receptive function – Wernicke’s area

Baseline orientation Time, place, person

WHAT IS DYSPHASIA? Disorder of language

Comprehension Expression

Causes Acute

- CVD- Head injury

Progressive- Space-occupying lesion- Degenerative

TYPES OF DYSPHASIAFluent (receptive) Non-fluent (expressive)Wernicke’s Broca’sConduction GlobalTrans-cortical sensory Trans-cortical motorNominal

HOW DO WE TEST FOR IT? Fluency

- Familiar conversation Comprehension

- Command (progressive difficulty) Naming

- Name 3 common objects Repetition

- ‘no ifs ands or buts’ Reading & writing

DYSPHONIA Inability to produce sounds using the vocal organs – harsh voice

Air expelled through glottis Pressure drop across larynx Vocal fold oscillation

Vocal fold paresis Myasthenia gravis Test:

“cough for me” – tests co-ordinated adduction and abduction of vocal chords

“Say aaaahhhhh” – Requires vocal cord tension

DYSARTHRIA Motor speech disorder Dysfunction in the muscles needed to produce

speech Chest, neck, jaw, tongue, lips CN V, VII, IX, X, XII

Parkinsonism, Huntington’s, stroke, traumatic brain injury, ataxia

Abnormal rate and stress Slurring of speech

‘m’ ‘p’ ‘t’

PSEUDOBULBAR & BULBAR PALSY

Bulbar LMN CN X, XI, XII Diminshed gag Tongue fasciculation,

wasting Jaw jerk normal Unilateral – raspy voice Bilateral – nasal speech GBS, Stroke, MND

Pseudobulbar UMN CN V, VII Facial expression,

mastication Bilateral degeneration of

corticobulbar tracts Gag reflex, tongue

spasticity Spastic dysarthria

“Daffy Duck” MS, MND

THANK YOUQUESTIONS?