NYU – STEINHARDT SCHOOL OF CULTURE, EDUCATION, AND HUMAN DEVELOPMENT

DEPARTMENT OF COMMUNICATIVE SCIENCES AND DISORDERS

2010 SUMMER ABROAD PROGRAM IN LUND, SWEDEN

MOTOR SPEECH DISORDERS (E34.2016) Section 1

Morning Course 10:00 to 12:00

Schedule is subject to change due to availability of guest speakers

Objectives: To compare and contrast normal and disordered motor speech production including dysarthria and speech dyspraxia. To develop hypotheses, rationales and priorities for evaluation and treatment procedures. To develop guidelines for prognosis determination and identification of appropriate management. Information about credentials, ethical practices, and multi-cultural issues will be addressed.

Required Texts:

Freed, D. (2000). Motor Speech Disorders. Africa: Singular (F)

recommended Texts:

 Bhatnagar, S. C., & Andy, O. J. (1995). Neuroscience for the Study of Communicative Disorders. Baltimore, MD: Williams and Wilkins. (B)

Week 1(2 hours per class)

Tuesday, May 25Introduction to course; definitions; scope; requirements; and assessment. Readings: Chapters 1and 2 in For Chapter 1 and 3, Appendix A-B in D; Review: Chapters 1, 2, 3, 5, 11, 12, 13, 14, 15, 19, and 20 in B. (The information in the chapters from Bhatnagarwill be referred to frequently throughout the course.)

Wednesday, May 26Assessment (continued) -. Readings: Chapters3 in F orPages 17-28 in D.

Thursday, May 27*Class extended ½ hour **Interarticulator programming in speech production, A Löfqvist

Week 2

Tuesday, June 1*Class extended ½ hour **Flaccid dysarthria: neuroanatomy; motor symptoms; speech symptoms associated with damage to lower motor neuron. Readings: Chapters 4 in ForChapter 4 and pages 28-45 in D. Review: Chapters11, 13, and 15 in B

Wednesday, June 2*Class extended ½ hour **Spastic dysarthria: neuroanatomy; motor symptoms; speech symptoms associated with damage the upper motor neuron, Readings: Chapters 5 and 6 in F or Chapters 5 and 9 and pages 45-54 in D. Review: Chapter 14 and 19 in B. Clinical managementReadings: Chapter 7 in F or Chapter 16 in D.

Thursday, June 3Trip to Copenhagen

Sunday, June 6In class motor, sensory, and speech exam on the TRAIN

Week 3

Thursday, June 10Neurological Motor Exam, H Widner

Week 4

Tuesday, June 15Differential Diagnosis of PD & Related Disorders, H Widner

Due Today: Motor, Sensory, and Speech Exam - This project will not be accepted late

Wednesday, June 16*Class extended ½ hour **First 1 ½ hours we will have the MIDTERM EXAM.

Second hour we will have a lecture Ataxic dysarthria: neuroanatomy; motor symptoms; speech symptoms associated with damage the cerebellum;Readings: Chapter 8 and pages 264-266 in F orChapter 6 and pages 54-57 in D.

Thursday, June 17*Class extended ½ hour **Hyperkinetic Dysarthria: neuroanatomy; motor symptoms; speech symptoms associated with damage the Extrapyramidal System Readings: Chapter 9 in F; Review: Chapter 13 in B

Week 5

Monday, June 21*Class extended ½ hour ** Hypokinetic dysarthria: neuroanatomy; motor symptoms; speech symptoms associated with damage to extrapyramidal system. Readings: Chapter 7, 10, and 8 in F and ; Chapter 9 in D and Review:Chapters 13 and 14 in B. and Mixed Dysarthria: disorders of multiple motor systems; neuroanatomy; motor symptoms; speech symptoms. Readings: Chapter 10 in F

Research Paper - This project will be accepted on this date or on July 2 in New York

Tuesday, June 22*Class extended ½ hour **Apraxia of speech: the motor speech disorder associate with aphasia

Readings: Chapter 11 in F

Wednesday, June 23Final - Cumulative

Evaluation of Student Success:

1.Performance on examinations

2.Excellence of the projects

3.Performance on extra credit items

Missing a test without receiving explicit verbal permission from me personally beforehand automatically drops your grade 10%, and makeups will be given only at my discretion and convenience, provided that there is a good and compelling reason for your absence. Leaving a message on my voice mail or sending me an e-mail does not constitute receiving verbal permission unless I have responded to you.

Procedures: Class time will be devoted to presenting information and the textbook was selected to reinforce the lectures and to offer another viewpoint. There will be many handouts for this class, and many topics will be covered in greater detail in class than in your textbooks. Thus, it would behoove you to attend class promptly and regularly and to obtain promptly any class notes fro sessions you miss. I encourage you to speak to me outside of class if you are having particular difficulties.

ASHA/CAA KASA Goals addressed in this course:

Standard III-C - The applicant must demonstrate knowledge of the nature of speech and communication disorders including the etiologies, characteristics, anatomical/physiological, acoustic, psychology, developmental, and linguistic and cultural correlates.

Standard III-D: The applicant must possess knowledge of the principles and methods of prevention, assessment, and intervention for people with communication and swallowing disorders, including consideration of anatomical/physiological, psychological, developmental, and linguistic and cultural correlates of the disorders.

Students with disabilities: Students with physical or learning disabilities are required to register with the Moses Center for Students with Disabilities, 719 Broadway, 2nd floor, and are required to present a letter from the Center to the instructor at the start of the semester in order to be considered for appropriate accommodation.

In Class Motor, Sensory, and Speech Exam (10 points)
Students will practice the skills learned in this course by performing motor examinations on each other. You will write-up the examination using the framework and model provided in class and incorporating all aspects of motor control of speech production including respiration, laryngeal function, velopharyngeal function, and oral function. The paragraph must comment on the following factors: strength, speed, range of excursions, accuracy of movement, motor steadiness, muscle tone, coordination, and symmetry. If a student requests, he/she can rewrite the paragraph with a 5-point deduction for each additional submission.
Motor, Sensory, and Speech Exam Objectives:
  1. To develop knowledge of normal motor function
  2. To develop skill with motor, sensory and speech examination
  3. To develop professional writing skills
The examination will be graded based on the following criteria:
_____ (1) Followed model
_____ (2) Short well-organized paragraph
_____ (2) Appropriate and complete motor analysis with complete information for describing the normal structure and function for the respiratory, phonatory, resonatory, and articulatory subsystems: strength, speed, range of excursions, accuracy of movement, motor steadiness, muscle tone, coordination, and symmetry
_____ (2) Appropriate and complete sensory analysis
_____ (2) Appropriate and complete diagnostic analysis
_____ (1) Professional writing, grammar, and conciseness
_____ (10) Total possible
Due Thursday, June 3, 2010 - This project will not be accepted late

Model for Motor, Sensory, and Speech Examination for Individuals with Normal Structure and Function

This __year old __has not experienced any change in his/her speech.

All speech functions, including respiration, phonation, resonation, articulation, and prosody are appropriate for non-speech movements and speech production. Motor assessment: Structures are symmetrical and steady at rest, during movements, and speech. Strength, range, steadiness, and tone are unimpaired. Rate, coordination, regularity, and precision both in speech and non-speech tasks are within normal limits. Instrumental assessment: All motor endurance tests are within normal limits. A mean duration of expiratory drive of 5 cm of H2O is __ seconds. The mean vocal endurance for /a/ is __seconds. The mean s/z ratio is __, with /s/ =__ seconds and /z/ =__ seconds. Diadochokinesis is within normal limits with a mean of __ repetitions of /pΛ/, __ /tΛ/, __ /kΛ/ per five seconds. The mean rate for rapid alternating sequences of /pΛtΛkΛ/ is within normal limits with__ repetitions per five seconds. Rate of oral reading (Grandfather’s passage) is _____words per minute. Sensory testing: Light touch and kinesthetic touch findings are appropriate. Speech assessment: All components of speech production are appropriate. The most salient features of his/her speech production include normal pitch, loudness and quality with appropriate fluency and precise articulation. Phonation: His/her voice production is characterized by normal pitch, loudness and voice quality. Articulation: His/her articulation is appropriate for his/her age and sex. Fluency/Prosody: His/her speech rate is normal and rhythm is preserved. Intelligibility: His/her speech is intelligible and natural.

Instructions for Research Papers(40 points)

To help each student develop a better understanding of dysarthria and apraxia and to allow for more in-depth research on specific speech disorders, each student will select four neurological disorders from the list below and describe the overall pathology including the common etiologies, symptoms and medical management for the pathology. In addition, the specific speech disorders associated with each one of the pathologies should be described in detail including the typical speech symptoms and characteristics, cognitive/language characteristics, typical SLP goals and procedures. Be sure to include information in all of the areas. Submit the papers on the dates specified in the syllabus. Each paper should be no longer than two pages. No papers will be accepted late.

Akinesia

Amyotrophic Lateral Sclerosis

Generalized dystonia

Cerebral anoxia

Cerebrovascular accident

Brain Stem Stroke

Charcot Marie Tooth Syndrome

Wilson’s disease

Parkinson’s disease

Essential tremor

Friedreich’s ataxia

Gilles de la Tourettes

Guillian-Barre

Hemifacialspasm

Huntington’s disease

Ideational apraxia

Ideomotor apraxia

Multiple systems atrophy

Muscular dystrophy

Myasthenia gravis

Myoclonus

Polio

Progressive Bulbar Palsy

Progressive supranuclear palsy

Shy-Drager syndrome

Spasmodic torticollis

Sydenham’s chorea (St. Vitus dance)

Tardive dyskinesia