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Speech disorders

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Clinical approach to a patient with speech disorder

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Speech disorders

  1. 1. SPEECHDISORDERS Page 1
  2. 2. TYPES OF SPEECH DISORDERSAPHASIADYSPHONIADYSARTHRIAFUNCTIONAL/PSYCHOGENICMISCELLANEOUS Page 2
  3. 3. PROCESS OF ABNORMALITIES SPEECH HEARING DEAFNESS UNDERSTANDING APHASIA THOUGHT & APHASIAWORD PROCESSING DYSPHONIAVOICE PRODUCTION DYSARTHRIA ARTICULATION Page 3
  4. 4. APHASIA• Aphasia is defined as an acquired impairment in the use of language due to damage to certain parts of the brain• This damage could be caused by injury, stroke, or seizures• The language deficits include difficulties in language comprehension and execution Page 4
  5. 5. Page 5
  6. 6. MAJOR DIVISIONS OF APHASIA• Fluent aphasias/Receptive aphasia – The inability to understand the language of others and the production of less meaningful speech then normal. eg; wernicke”s, transcortical sensory,conduction,anomic• Non-fluent aphasias/expressive aphasia – Difficulty producing fluent, articulated, or self-initiated speech.eg; Broca”s, transcortical motor,global• Pure aphasia – are selective impairments in reading, writing, or the recognition of words. These disorders may be quite selective. For example, a person is able to read but not write, or is able to write but not read. Examples of pure aphasias are – : Pure Alexia, Agraphia,Pure word deafness Page 6
  7. 7. Types of Fluent Aphasias• Wernicke’s aphasia – People with this type of aphasia- JARGON APHASIA, have difficulty or inability understanding others speech, and produce meaningless speech – FLUENT,VOLUMINOUS SPEECH – NEOLOGISMS – SYMANTIC-”sister for mother” – Insight is ABSENT – produced by damage to Wernicke’s area of the brain-division of middle cerebral artery Page 7
  8. 8. WERNICKE”S APHASIA Page 8
  9. 9. More Types of Fluent Aphasia• Conduction aphasia – The main symptom of this type of aphasia is difficulty repeating something someone has just said – FLUENT SPEECH, but paraphasic – COMPREHENSION INTACT.. – REPETITION,NAMING,WRITING IMPAIRED – FILLED PAUSES-Aaaa….Aaaaa – damage to the ARCUATE FASICULUS Page 9
  10. 10. More Types of Fluent Aphasia• Anomic aphasia/minimal dysfunction syndrome/nominal aphasia – This aphasia is characterized by difficulty finding names and difficulty substituting indefinite nouns and pronouns with substantive words. For instance, people with this affliction will use words like, thing, stuff, or it instead of automobiles, groceries, or furniture. – Primary deficit is WORD FINDING AND NAMING – SINGLE MOST COMMON LANGUAGE DISTURBANCE IN HEAD TRAUMA AND ALZHEIMER”S D/S Page 10
  11. 11. FLUENT TRANSCORTICAL/ TRANSCORTICAL SENSORY APHASIA• Similar to WERNICKE”S APHASIA but REPETITION IS INTACT• They can repeat but cant understand it Page 11
  12. 12. Non-Fluent Aphasias• Broca’s aphasia – This type of aphasia manifests with difficulties initiating well-articulated conversational speech – NON FLUENT, EFFORTFUL,slow, labored, and agrammatical speech, which means words like a, an, or the and verb tense is left out of their speech…incomplete speech – Insight is PRESENT – Additional defects? – damage to Broca’s area of the brain..superior div. of middle cerebral artery Page 12
  13. 13. BROCA”S APHASIA Page 13
  14. 14. More Types of Non-Fluent Aphasia’s– Transcortical motor aphasia– Similar to BROCA”S APHASIA but REPETITION is INTACT– People with this aphasia do not speak unless they are strongly encouraged to do so and when they do speak it is labored and non-fluent– damage to the premotor cortex anterior and superior to Broca’s area… anterior cerebral artery Page 14
  15. 15. More Types of Non-Fluent Aphasia’s• Global aphasia – As the name suggests, this type of aphasia is characterized by a severe depression of all language functioning – NON FLUENT, naming, repetition, comprehension all impaired – damage around and to Broca’s and Wernicke’s areas of the brain …entire middle cerebral artery Page 15
  16. 16. Other Interesting Facts About AphasiaThe handwriting of a person with an aphasia reflects their speech impediment.There was an experiment done where people with Broca’s and Wernicke’s aphasias were presented with a picture and then asked to write down a description of what they say in the picture. Page 16
  17. 17. This is the picture Page 17
  18. 18. A patient with Broca’s aphasia wrote this Notice the use of very few words, but the words do make some sense Page 18
  19. 19. A patient with Wernicke’s aphasia wrote this Notice here that there are many, less forced, words, but they don’t make much sense. Also because they’re not struggling to find their words, the handwriting is better Page 19
  20. 20. Type of aphasia Repetition Naming Auditory Fluency comprehension Wernicke’s mild– fluent mild–mod defective aphaia severe paraphasic Conduction poor poor relatively good fluent aphasia Nominal or mod– mild mild fluentAnomic aphasia severe non-fluent, mod–Broca’s aphasia mod–severe mild difficulty effortful, severe slowGlobal aphasia poor poor poor non-fluent Page 20
  21. 21. DYSARTHRIA• Is due to defect IN ARTICULATION.• LANGUAGE CONTENT IS NORMAL• TYPES- 4 Page 21
  22. 22. TYPES OF DYSARTHRIA TYPE SITE CHARACTERISTICS MYOPATHIC MUSCLES OF SPEECH MYASTHENIC MOTOR ENDPLATE BULBAR BRAINSTEM{LMN} INDISTINCT,NASAL SLURRING,SING-SONG SCANNING CEREBELLUM QUALITY SPASTIC/ PYRAMIDAL TRACTS INDISTINCT/PSEUDOBULBAR {UMN} BREATHY,MUMBLINGPARKINSONIAN BASAL GANGLIA STAMMERING DYSTONIC BASAL GANGLIA Page 22
  23. 23. DYSPHONIA• Is due to defect in the production of soundCAUSES1) Laryngeal diseases-eg;laryngitis2) Vocal cord lesions3) Xth cranial nerve palsy4) hysterical Page 23
  24. 24. OTHERS1) Cluttering2) Stammering3) Dysprosody-in parkinsonian disease4) Scanning5) Staccato-each syllable is uttered seperately Page 24
  25. 25. THANK YOU!!!! Page 25

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