1 Motor Speech Disorders Etiologic Agents of Motor Speech Disorders Apraxia of Speech The Dysarthrias Spastic Dysarthria Ataxic Dysarthria Hypokinetic Dysarthria Hyperkinetic Dysarthria Flaccid Dysarthria Mixed Dysarthria Suggested Readings 2 The Treatment Game: The Basics Clinical Step s Differential Diagnosis Specific Neuromuscular Impairments Etiologic Agents Medical Course Prognosis Physician Referral Speech Therapy Intervention Plan Therapy Intervention Design Treatment Tools Treatment Preview Types of Treatment Designs Treatment Objectives and Outcomes Charting Progress Baseline Behaviors Great Expectations Criteria for Treatment Advancement and Discontinuation Rationale for the Treatment Approaches to Speech Neuromotor Rehabilitation Guidelines for Selection and Sequence of Dysarthria Treatments Guidelines for Selection and Sequence of Apraxia Treatments Patient Resources Suggested Readings 3 Treatment of the Respiration Subsystem General Rules of Thumb Precursors to Intervention Treatment Approaches Treatment Materials Relaxation and Postural Support Techniques Relaxation Exercises Postural Exercises Pressure-Generating Exercises Prolonged Inhalation/Exhalation Exercises Inhalation Exhalation Quick Breathing Exercise Inhalatory/Exhalatory Synchronization Exercises Isolated Sound Production Exercises Connected Speech Breathing Exercises Final Comments and Illustrative Case Sample Illustrative Case Air Pressure- Generating Therapy Inspiratory/Expiratory Prolongation Exercises Suggested Readings 4 Treatment of the Resonation Subsystem Candidates for Treatment Indications for Treatment Precursors to Treatment Treatment Procedures Prosthetic Appliances Surgical Intervention Behavioral Management Techniques Conclusion Suggested Readings 5 Treatment of the Phonation Subsystem Potential Patients Group 1 Patients Group 2 Patients Primary Focus and General Principles 'of Voice Therapy Surgical Intervention Vocal Fold Augmentation Nerve Resection Pharmaceutical Intervention Voice Therapy Techniques Treatment Materials Patterns of Vocal Fold Vibration Abnormalities Treatments of the Hyperadductory Laryngeal Mechanism Treatments of the Hypoadductory Laryngeal Mechanism Treatments of the Abnormally Fluctuating Laryngeal Mechanism Suggested Reading s 6 Treatment of the Articulation Subsystem When to Begin Characteristic Differences between Patients Method to Follow When Employing the Articulation Subsystem Exercises Treatment Materials , Treatment of Hypertonicity Jaw Hypertonicity Treatment of Weakness Crossbar for Tongue, Lip, and Jaw Strengthening Treatment of Abnormal Force Physiology Treatment of Articulatory Imprecision Phonetic Simulation Techniques Notes on Treatment of Articulatory Imprecision Treatment of Motor Speech Planning Deficits Nonspeech Oral Motor Planning Exercises Speech Motor Planning Exercises Comments on Treatment of Speech Motor Planning Illustrative Case No. 1 Illustrative Case No.2 Suggested Readings 7 Treatment of the Prosody Subsystem When to Begin Therapy Treatment Materials Treatment of Pitch Alteration Abnormalities Treatment of Loudness Control Abnormalities Treatment of Speaking Rate Disturbances Treatment of Intonation Disturbances Treatment of Stress Control Disturbances Suggested Readings

Motor Speech Disorders A Treatment Guide

James Paul Dworkin

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Motor Speech Disorders A Treatment Guide