Motor speech disorders : diagnosis and treatment

393 Pages·2020·21.861 MB·English

by  Donald B. Freed

THIRD EDITION
Motor Speech Disorders
DIAGNOSIS AND TREATMENT

T H I R D E D I T I O N
Motor Speech Disorders
D I A G N O S I S A N D T R E A T M E N T
Donald B. Freed, PhD
5521 Ruffin Road
San Diego, CA 92123
e-mail: [email protected]
website: http://www.pluralpublishing.com
Copyright © 2020 by Plural Publishing, Inc.
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Library of Congress Cataloging-in-Publication Data:
Names: Freed, Donald B., author.
Title: Motor speech disorders : diagnosis and treatment / Donald B. Freed.
Description: Third edition. | San Diego, CA : Plural Publishing, [2020] |
Includes bibliographical references and index.
Identifiers: LCCN 2018017022| ISBN 9781635500950 (alk. paper) | ISBN
1635500958 (alk. paper)
Subjects: | MESH: Dysarthria--diagnosis | Dysarthria--therapy
Classification: LCC RC423 | NLM WL 340.2 | DDC 616.85/5--dc23
LC record available at https://lccn.loc.gov/2018017022
Contents
Preface ix
About the Author xiii
Chapter 1 a Brief historical review of Motor Speech Disorders 1
Case Reports from Ancient Greece 3
Case Reports from the Middle Ages and Renaissance 6
Two Early Theories on the Localization of Reason 7
From the 19th Century to Today 9
Chapter 2 the Motor System 15
Components of the Motor System 16
Structure and Function of the Motor System 27
Summary of the Motor System 53
Study Questions 53
Chapter 3 evaluation of Motor Speech Disorders 55
Goals of a Motor Speech Evaluation 57
Speech Production Components and Disorders 58
Standardized Tests for Dysarthria 63
Standardized Tests for Apraxia of Speech 64
Conducting a Motor Speech Evaluation 67
Instructions for the Motor Speech Evaluation 70
Auditory-Perceptual Evaluations of the Motor 78
Speech Mechanism
v
vi Motor Speech DiSorDerS: DiagnoSiS anD treatMent
Summary of the Evaluation of Motor Speech Disorders 84
Study Questions 85
Appendix 3–1: Motor Speech Examination 86
CHApTER 4 Flaccid Dysarthria 99
Definitions of Flaccid Dysarthria 100
Neurologic Basis of Flaccid Dysarthria 101
Causes of Flaccid Dysarthria 114
Speech Characteristics of Flaccid Dysarthria 118
Key Evaluation Tasks for Flaccid Dysarthria 122
Treatment of Motor Speech Disorders 123
Treatment of Flaccid Dysarthria 126
Summary of Flaccid Dysarthria 139
Study Questions 140
CHApTER 5 Spastic Dysarthria 141
Definitions of Spastic Dysarthria 142
Neurologic Basis of Spastic Dysarthria 142
Causes of Spastic Dysarthria 146
Speech Characteristics of Spastic Dysarthria 148
Spastic Dysarthria Versus Flaccid Dysarthria 153
Key Evaluation Tasks for Spastic Dysarthria 154
Treatment of Spastic Dysarthria 155
Summary of Spastic Dysarthria 163
Study Questions 164
CHApTER 6 Unilateral Upper Motor Neuron Dysarthria 165
Definitions of Unilateral Upper Motor Neuron 166
Dysarthria
Neurologic Basis of Unilateral Upper Motor Neuron 166
Dysarthria
Causes of Unilateral Upper Motor Neuron Dysarthria 170
Speech Characteristics of Unilateral Upper Motor 173
Neuron Dysarthria
Key Evaluation Tasks for Unilateral Upper Motor 177
Neuron Dysarthria
contentS vii
Treatment of Unilateral Upper Motor Neuron 177
Dysarthria
Summary of Unilateral Upper Motor Neuron 179
Dysarthria
Study Questions 180
CHApTER 7 Ataxic Dysarthria 181
Definitions of Ataxic Dysarthria 182
Neurologic Basis of Ataxic Dysarthria 182
The Cerebellum and Speech 187
Causes of Ataxic Dysarthria 188
Speech Characteristics of Ataxic Dysarthria 192
Key Evaluation Tasks for Ataxic Dysarthria 196
Treatment of Ataxic Dysarthria 197
Summary of Ataxic Dysarthria 203
Study Questions 203
CHApTER 8 Hypokinetic Dysarthria 205
Definitions of Hypokinetic Dysarthria 206
Neurologic Basis of Hypokinetic Dysarthria 206
Causes of Hypokinetic Dysarthria 211
Speech Characteristics of Hypokinetic Dysarthria 214
Key Evaluation Tasks for Hypokinetic Dysarthria 219
Treatment of Hypokinetic Dysarthria 219
Summary of Hypokinetic Dysarthria 234
Study Questions 235
CHApTER 9 Hyperkinetic Dysarthria 237
Definitions of Hyperkinetic Dysarthria 238
Neurologic Basis of Hyperkinetic Dysarthria 239
Causes of Hyperkinetic Dysarthria 242
Key Evaluation Tasks for Hyperkinetic Dysarthria 259
Treatment of Hyperkinetic Dysarthria 260
Summary of Hyperkinetic Dysarthria 265
Study Questions 266
viii Motor Speech DiSorDerS: DiagnoSiS anD treatMent
CHApTER 10 Mixed Dysarthria 267
Definitions of Mixed Dysarthria 268
Neurologic Basis of Mixed Dysarthria 268
Causes of Mixed Dysarthria 271
Treatment of Mixed Dysarthria 281
Summary of Mixed Dysarthria 284
Study Questions 285
CHApTER 11 Apraxia of Speech 287
Definition of Apraxia of Speech 288
Overview of the Apraxias 290
Neurologic Basis of Apraxia of Speech 294
Causes of Apraxia of Speech 296
Speech Characteristics of Apraxia of Speech 297
Assessment of Apraxia of Speech 301
Differential Diagnosis of Apraxia of Speech 302
Additional Diagnostic Considerations 305
Treatment of Apraxia of Speech 310
Summary of Apraxia of Speech 324
Study Questions 324
References 327
Glossary 339
Index 353
p reface
It is exciting to have this third edition of Motor Speech Disorders:
Diagnosis and Treatment move to Plural Publishing. Although
it has a new publisher, the overall goals of this book have not
changed. It is still an introductory textbook for a complicated col-
lection of disorders. This bulleted list from the second edition is
also valid for this new edition:
n An orientation for students and beginning clinicians
n An emphasis on presenting the neurologic bases of these
disorders in a direct, uncomplicated manner
n An easy-to-read writing style
n A nearly identical organization of most chapters, with all the
critical information (e.g., causes, characteristics, assessment,
and treatment) presented in single chapters that are devoted to
individual disorders
n The inclusion of clinical examples and videos to enhance
understanding of what these disorders look and sound like
n Descriptions of treatment procedures that are detailed enough
for beginning clinicians to use them successfully in their
clinical practice
Organization
The overall organization of the book has not changed. Chapter 1
is a review of ancient case reports that seem to involve speech or
language disorders. It is designed as a historical introduction to
the study of motor speech disorders. Chapter 2 is an introduction
to the human motor system, an absolutely amazing part of the
ix