Ch. 12 Hcom 242 Part 1 (Tx Goals Focused)

- they may produce a given sound clearly

and accurately in one word, but

not in another and performance may

vary depending on the context in which sound is elicited

- examines the individual's prosodic variations in different types of language use

- such as producing a declarative verses an

interrogative sentence highlighting

contrastive information in response to a question and indicating different emotional states

Interrogative: Is this new?

Declarative: This is new.

- professionals use acoustic measures to

provide important information about which

aspect of prosody is impaired

(i.e. loudness , duration, pitch and rhythm)

- Differential Diagnosis

- Spastic dysarthria vs Flaccid Dysarthria

- perceptual findings

- And judgement of the clinician ,

which are derived from extensive experience

true

-because the type of treatment depends on the nature of the disorder and

what may be effective for one disorder may not be effective for another

- inpatient or outpatient therapy

- clear identification of therapy goals

- the goal is to learn and relearn accurate

production of speech for improved speech

intelligibility

temporary performance enhancement

performed in treatment

- to achieve maximal progress with limited resources

(time , money , staff)

- as the way in which practice or experience leads to relatively permanent changes in the capability

- but also maintain that skill over time to

show evidence of permanent changes

- Temporary Performance Enchancements =

observed during treatment (acquisition)

- Lasting Performance Enhancements =

are maintained after treatment has ended (retention)

False;

- improvements during acquisition do not

necessarily result in improvements during

retention tests

*in fact factors that enhance acquisition

performance may have negative effects on retention

- must be included to determine whether a

treatment leads to permanent improvement

- application or transfer of a skill to related but untrained movement patterns

*2nd important goal of treatment

- to facilitate an individual's underlying

capability so that untrained tasks also

improve

- response generalizations

- stimulus generalizations

- brings improvement in untrained behaviors

(i.e. speech sounds)

- which brings improvements in

targeted behaviors in different context , tasks or settings

i.e. conversational speech vs repetition tasks

- address improvements & treatment

effectiveness in terms of retention and

generalization

- not simply measure temporary performance

enhancements observed during acquisition

- activities targeting the latter

- will not likely improve speech intelligibility

*evidence suggests that practicing oral motor exercises will not result in improved speech production

- after an acute incident such as stroke

- for instance , if an individual is not

able to produce any speech sounds, the

clinician may select specific speech sounds to target (/b/ , /m/)

- speech targets should be included as early as possible

- should be considered in the selection of

treatment targets

- For instance , producing sounds intelligibly in a phrase " I want some milk " is clearly is more complex than producing sounds in isolation

(m-m-m)

- results in greater learning than does focusing on simpler targets

- leads to improvements in these targeted items and in simpler , but untrained items

True

- complex item (consonant clusters as in stuck) , will improve both simple and complex items

(i.e. stuck , truck , and tuck) , whereas targeting the simple item (i.e. tuck) will improve only that simple items

- often present with co-occuring dysfunctions , particularly when etiology is related to

widespread damage to the brain

(i.e. stroke or TBI)

treat all domains of impairment

true

* in such a case , the clinician will want to

focus on the behaviors that will have the

biggest impact on effectiveness

- may benefit less from interventions that are

typically effective for those whose cognitive

function is intact

- may limit the effectiveness of

AOS treatments because the production of speech requires the buffering of individual units of action

False; treatments aimed at producing

units of action will less effective

- to improve accuracy , stability , and

intelligibility of speech and its naturalness or fluency

- to improve the impaired systems

- to teach compensatory strategies

- focusing on specific functions in relevant speech tasks

*for example , by emphasizing the

modification of speech breathing patterns , using intonation in utterances or saying words with specific speech sounds that are difficult

- may focus on the individual with a motor speech disorder or on the environment and

communication partners

- slowing down the rate of speech

- using gestures , writing , or alternative and augmentative communication devices such as communication books and handheld computers

- activity / participation

- and contextual factors by working with family members and other communication partners as well by making environmental adaptations

- may involve environmental modifications

(i.e. noise reduction)

- and training of communication partners

(i.e. they may be instructed to say yes or no questions)

- on motor learning

* in particular some conditions of practice have been shown to enhance acquisition but

impede learning (as measured by retention and transfer)

- whereas other conditions enhance learning but may not facilitate acquisition to the same extent

- these conditions can be divided into those

related to practice and those related to feedback

- the number of different targets practiced

- the order in which different targets are

practiced

- the number of practice trials

- how close in time the practice sessions are spaced

- Practice Variability

- Practice Schedule

- Practice Amount

- Practice Distribution