Ataxia and Speech Jennifer Legge M.S., CCC-SLP University of Chicago Medical

Ataxia and Speech
Jennifer Legge M.S., CCC-SLP
University of Chicago Medical
Speech and Swallowing
Department
Understanding the process of
Speech Production
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1.Anatomy-Figure 1
2.Respiratory System
3.Phonatory System
4.Articulatory System
5.Resonatory System
6.Auditory Feedback
7.Cerebellum
Anatomy-Figure 1
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http://english.marion.ohio-state.edu/behan/English271/midsagittal.jpg
Respiratory System
• Lungs to the larynx
• The power behind out speech
• Coordination of the respiratory system
(lungs to the larynx)
• Good respiratory support is key
• Timed release of air to support each
word
Phonatory System
• Larynx specifically the vocal cords
• Vocal cords vibrate when air passes
through them…producing a sound
• (E.x., /me/, feel your throat)
Articulatory System
• Mouth including jaw, lips, teeth, tongue,
and the palate
• Movement of the air passes through the
mouth and where movements of the
articulators modify the sound producing
different vowels and consonants
• (e.g., /l/, /m/, /k/)
Resonatory System
• Mouth and nasal passages
Auditory Feedback
• Discriminate one sound from another
• Monitor speech to make it more precise
• (e.g., deaf speech)
Cerebellum
• Tunes impulses coming in from brain for any
motor task…(i.e.,speech)
• Coordinates and refines planned motor
impulses, and modifies planned and ongoing
speech movements
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coordination
timing
measuring movement size
planning and incorporating feedback
How does ataxia effect ones
speech?
1.Respiration-decreased breath support, reduced coordination of
breath/speech leading to excessive or paradoxical movements.
Speaking on residual air…what happens?
1) increased rate, decreased volume, and hash voice
2.Phonation- harsh vocal quality due to decreased muscle tone
3.Articulation-decreased oral tone, oral coordination, irregular
break downs ,distorted vowels, prolonged phonemes,
4.Resonation-seldomly a problem
5.Prosody-equal and excess stress ,problems with motor learning,
mono pitch, mono loudness
Ataxic Dysarthria
• Speech characterized by
“drunkenness”, imprecise consonants
and vowels, slurred, distorted, irregular
breakdown, excess and equal stress,
slow rate of speech, mono pitch and
mono loudness, may display explosive
speech with poor control of pitch and
loudness
Evaluation and Treatment
• Evaluation by an SLP
• Treatment
– 1. Exercises
• Oromotor exercises targeting strengthening muscles (e.g.,
pucker/smile
• Improving breath support, and coordinating breathing and
speaking
• Increasing or controlling volume (e.g., Lee Silverman)
• Consonant/vowel drills, rate drills, over articulation practice
• Word, phrase, and sentence stress ( TODAY is a GREAT day!)
• Pitch control (e.g., How are you?)
Compensatory Strategies for the
Speaker
• Attempt to have conversations when you are
not tired
• Minimize distractions
• Have your listeners undivided attention
• Decrease rate of speech, feels slow
ALREADY!
• Focus on getting your point across utilize less
words, sentences.
• Use gestures when indicated
• Prep your listener if need be
Advice for loved ones, or the
listener
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Eye contact is crucial
Undivided attention
Be patient
Seek clarification
Provide support, encourage use of
strategies
Communication Aids
• Communication Board
• Computer-new software out there?
• Augmentative device, seek out an
experienced speech language
pathologist to help you explore your
options
What works, what doesn’t,
what is new?
• 1. Specific Questions
• 2. What has worked for you, hasn’t?
• 3. How many of you have had some
type of speech therapy? If so was it
helpful? If not why?
• 4. Try more than one therapist?
• 5. Best advice anyone gave you?
References
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Kent, R.D, Finley Kent, J, Duffy, J, Thomas, J, Weismer, G,
Stuntebeck, S (2000). Ataxic Dysarthria. Journal of Speech,
Language, and Hearing Research, 1275-1287.
Rangamani, G.N., J. (2006). Managing Speech and Swallowing
Problems: A Guidebook for People with Ataxia. National Ataxia
Foundation, 1-60.
Retrieved February 21, 2009, from Speech-Therapy-On-Video
website: http://www.speech-therapyonvideo.com/dysarthria.html
Retrieved February 21, 2009, from Asha.org website:
http://www.asha.org/public/speech/disorders/dysarthria.htm#dys
_tx
Contact Information
Jennifer Legge M.S., CCC-SLP
773-795-2579
[email protected]