Structural & Neurogenic Speech Disorders

Speech requires the integrity and integration of what numerous activities?

• neurocognitive

• neuromotor

• neuromuslular

• musculoskeletal activites

How can we summarize the integrity and integration of neurocognitive, neuromotor, neuromuscular, and musculoskeletal activities?

• 1. When thoughts, feelings, and emotions generate an intent to communicate verbally, they must be organized and converted into a code that abides by the rules of language. These combined activities are referred to as cognitive-linguistic processes.

• 2. The intended verbal message must be organized for neuromuscular execution. These activities include the selection , sequencing, and regulation of sensorimotor "programs" that activate speech muscles at appropriate coarticulated times, durations, and intensities. These combined activities are referred to as motor speech planning, programing, and control.

• 3. Central and peripheral nervous system activity must combine to execute speech motor programs by innervating breathing, phonatory, resonatory, and articulatory muscles in a manner that generates an acoustic signal that faithfully reflects the goals of the programs. The neural and neuromuscular transmission and subsequent muscle contractions and movements of speech structures are referred to as neuromuscular execution.

• The combined processes of speech motor planning, programming, control and execution are referred to as motor speech processes.

These combined activities are referred to as cognitive-linguistic processes.

• When thoughts, feelings, and emotions generate an intent to communicate verbally, they must be organized and converted into a code that abides by the rules of language.

• 2. The intended verbal message must be organized for neuromuscular execution. These activities include the selection , sequencing, and regulation of sensorimotor "programs" that activate speech muscles at appropriate coarticulated times, durations, and intensities. These combined activities are referred to as motor speech planning, programing, and control.

• 3. Central and peripheral nervous system activity must combine to execute speech motor programs by innervating breathing, phonatory, resonatory, and articulatory muscles in a manner that generates an acoustic signal that faithfully reflects the goals of the programs. The neural and neuromuscular transmission and subsequent muscle contractions and movements of speech structures are referred to as neuromuscular execution.

• The combined processes of speech motor planning, programming, control and execution are referred to as motor speech processes.

These combined activities are referred to as motor speech planning, programing, and control.

• When thoughts, feelings, and emotions generate an intent to communicate verbally, they must be organized and converted into a code that abides by the rules of language.

• The intended verbal message must be organized for neuromuscular execution. These activities include the selection, sequencing, and regulation of sensorimotor "programs" that activate speech muscles at appropriate coarticulated times, durations, and intensities.

• 3. Central and peripheral nervous system activity must combine to execute speech motor programs by innervating breathing, phonatory, resonatory, and articulatory muscles in a manner that generates an acoustic signal that faithfully reflects the goals of the programs. The neural and neuromuscular transmission and subsequent muscle contractions and movements of speech structures are referred to as neuromuscular execution.

• The combined processes of speech motor planning, programming, control and execution are referred to as motor speech processes.

The neural and neuromuscular transmission and subsequent muscle contractions and movements of speech structures are referred to as neuromuscular execution. Which of these describes the details of this?

• When thoughts, feelings, and emotions generate an intent to communicate verbally, they must be organized and converted into a code that abides by the rules of language.

• The intended verbal message must be organized for neuromuscular execution. These activities include the selection, sequencing, and regulation of sensorimotor "programs" that activate speech muscles at appropriate coarticulated times, durations, and intensities.

• Central and peripheral nervous system activity must combine to execute speech motor programs by innervating breathing, phonatory, resonatory, and articulatory muscles in a manner that generates an acoustic signal that faithfully reflects the goals of the programs.

• The combined processes of speech motor planning, programming, control and execution are referred to as motor speech processes.

The neural and neuromuscular transmission and subsequent muscle contractions and movements of speech structures are referred to as neuromuscular execution. Which of these describes the details of this?

• When thoughts, feelings, and emotions generate an intent to communicate verbally, they must be organized and converted into a code that abides by the rules of language.

• The intended verbal message must be organized for neuromuscular execution. These activities include the selection, sequencing, and regulation of sensorimotor "programs" that activate speech muscles at appropriate coarticulated times, durations, and intensities.

• Central and peripheral nervous system activity must combine to execute speech motor programs by innervating breathing, phonatory, resonatory, and articulatory muscles in a manner that generates an acoustic signal that faithfully reflects the goals of the programs.

• The combined processes of speech motor planning, programming, control and execution are referred to as motor speech processes.

Recognizing and understanding predictable patterns of speech disturbance and their underlying neurophysiological bases are valuable for at least these four reasons:

• 1. Understanding nervous system organization for speech motor control. The predictable association of patterns of speech deficit with localizable pathology can contribute to our understanding of the nervous system's anatomic and physiologic organization for speech. Just as the study of motor speech disorders informs us about the organization of aphasia teaches us something about the neurologic organization of the sensorimotor system as it relates to speech production.

  In other words: aphasia teaches us about neurologic organization of cognitive-linguistic processes that support THE USE of language. The study of motor speech disorders informs us about the organization of the sensorimotor system as it relates to SPEECH PRODUCTION.

• 2. Differential diagnosis and localization of neurologic disease. Speech changes can be the first or only manifestation of neurologic disease and their recognition and diagnosis can contribute to disease diagnosis and care.

• 3. Prevalence: Neurologic diseases are common and often chronic. They are a major cause of disability in the U.S.

• 4. Management: Identifying deviant speech characteristics and their localization to various levels of the speech system, plus an understanding of their neurophathophysiology, can provide important clues for management. For example, knowing an individual's articulatory distortions are primarily related to incoordination and not to weakness might lead to efforts to assist coordination (by modifying rate and prosody) rather than to increase strength through exercise)

Define: Motor speech disorders

• Speech disorders resulting from neurologic impairments affecting the planning, programming, control, or execution of speech. These include the dysarthrias and apraxia of speech.

• A collective name for a group of neurologic speech disorders that reflect abnormalities in the strength, speed, range, steadiness, tone, or accuracy of movements required for the breathing, phonatory, resonatory, articulatory, or prosodic aspects of speech production. The responsible neuropathophysiologic disturbances of control or execution are due to one or more sensorimotor abnormalities, which most often include weakness, spasticity, incoordination, involuntary movements, or excessive, reduced or variable muscle tone.

  This definition explicitly recognized or implies the following:

  1. dysarthria is neurologic in origin

  2. it is a disorder of movement.

  3. it can be categorized into different types, each type characterized by distinguishable perceptual characteristics and, presumably, a different underlying neuropathophysiology. The ability to categorize the dysarthrias, therefore, has implicaitons for the localizaiton of the causal disorder.

• neurologic speech disorder that reflects an impaired capacity to plan or program sensorimotor commands necessary for directing movements that result in phonetically and prosodically normal speech. Can occur in absence of physiologic disturbances associated with dysarthrias and in the absence of disturbances in any component of language.

• 4. Management: Identifying deviant speech characteristics and their localization to various levels of the speech system, plus an understanding of their neurophathophysiology, can provide important clues for management. For example, knowing an individual's articulatory distortions are primarily related to incoordination and not to weakness might lead to efforts to assist coordination (by modifying rate and prosody) rather than to increase strength through exercise)

Define: Dysarthria

• Speech disorders resulting from neurologic impairments affecting the planning, programming, control, or execution of speech. These include the dysarthrias and apraxia of speech.

• A collective name for a group of neurologic speech disorders that reflect abnormalities in the strength, speed, range, steadiness, tone, or accuracy of movements required for the breathing, phonatory, resonatory, articulatory, or prosodic aspects of speech production. The responsible neuropathophysiologic disturbances of control or execution are due to one or more sensorimotor abnormalities, which most often include weakness, spasticity, incoordination, involuntary movements, or excessive, reduced or variable muscle tone.

  This definition explicitly recognized or implies the following:

  1. dysarthria is neurologic in origin

  2. it is a disorder of movement.

  3. it can be categorized into different types, each type characterized by distinguishable perceptual characteristics and, presumably, a different underlying neuropathophysiology. The ability to categorize the dysarthrias, therefore, has implicaitons for the localizaiton of the causal disorder.

• neurologic speech disorder that reflects an impaired capacity to plan or program sensorimotor commands necessary for directing movements that result in phonetically and prosodically normal speech. Can occur in absence of physiologic disturbances associated with dysarthrias and in the absence of disturbances in any component of language.

• 4. Management: Identifying deviant speech characteristics and their localization to various levels of the speech system, plus an understanding of their neurophathophysiology, can provide important clues for management. For example, knowing an individual's articulatory distortions are primarily related to incoordination and not to weakness might lead to efforts to assist coordination (by modifying rate and prosody) rather than to increase strength through exercise)

Define: Apraxia of speech

• Speech disorders resulting from neurologic impairments affecting the planning, programming, control, or execution of speech. These include the dysarthrias and apraxia of speech.

• A collective name for a group of neurologic speech disorders that reflect abnormalities in the strength, speed, range, steadiness, tone, or accuracy of movements required for the breathing, phonatory, resonatory, articulatory, or prosodic aspects of speech production. The responsible neuropathophysiologic disturbances of control or execution are due to one or more sensorimotor abnormalities, which most often include weakness, spasticity, incoordination, involuntary movements, or excessive, reduced or variable muscle tone.

  This definition explicitly recognized or implies the following:

  1. dysarthria is neurologic in origin

  2. it is a disorder of movement.

  3. it can be categorized into different types, each type characterized by distinguishable perceptual characteristics and, presumably, a different underlying neuropathophysiology. The ability to categorize the dysarthrias, therefore, has implicaitons for the localizaiton of the causal disorder.

• neurologic speech disorder that reflects an impaired capacity to plan or program sensorimotor commands necessary for directing movements that result in phonetically and prosodically normal speech. Can occur in absence of physiologic disturbances associated with dysarthrias and in the absence of disturbances in any component of language.

• Management: Identifying deviant speech characteristics and their localization to various levels of the speech system, plus an understanding of their neurophathophysiology, can provide important clues for management. For example, knowing an individual's articulatory distortions are primarily related to incoordination and not to weakness might lead to efforts to assist coordination (by modifying rate and prosody) rather than to increase strength through exercise)