Motor Speech Disorders
Kaup valmöguleikar
Cutting-edge content helps you understand and manage motor speech disorders! Using the latest evidence-based research, Motor Speech Disorders, 5th Edition, covers everything from the neurologic bases and causes of disorders to examination, diagnosis, and rehabilitation. Chapters address the different types of dysarthria as well as apraxia of speech and other disorders. New to this edition are enhanced illustrations, revised case studies, and key points highlighting the most important information.
Written by noted speech pathology educator Joseph R. Duffy, this text provides the foundational knowledge needed to diagnose and manage speech disorders even as it supports clinicians and researchers across related fields. Cutting-edge research with an emphasis on evidence-based practice ensures that this book contains the most comprehensive and up-to-date look at the state of motor speech disordersLogical three-part organization first covers the neurologic underpinnings of speech, then the various disorders resulting from problems in different parts of the nervous system, and then basic principles and disorder-specific management strategiesSummary boxes and tables offer easy access to important information such as the causes and characteristics of a disorder, aiding in differential diagnosis and managementChapter summaries highlight each chapter’s most important informationMore than 400 literature references update clinically important information for each major part of the textbookNEW! Revised case studies are included at the end of each chapterNEW! Enhanced illustrations throughout the text enhance your understanding of key conceptsNEW! Key Points within each chapter concisely restate, amplify, or comment on the most critical informationNEW! Enhanced eBook version — included with print purchase — allows you to access all of the text, figures, and references with the ability to search, customize your content, make notes and highlights, and have content read aloud from the book on a variety of devices.
Nánar um bókina
- Elsevier Health Sciences (US)
- 9780443110863
- 9780443110313
- ePub
- 5
- Joseph R. Duffy
- English
- 2026-02-09
- 10
- 2
- 2
Kaflar
- Motor Speech Disorders: Substrates, Differential Diagnosis, and Management
- Cover image
- Title page
- Table of Contents
- Copyright
- Preface
- Acknowledgments
- List of Illustrations
- List of Tables
- PART 1. Substrates
- 1. Defining, understanding, and categorizing motor speech disorders
- The neurology of speech
- The neurologic breakdown of speech
- Basic definitions
- Motor speech disorders
- Speech differences that are distinguishable from motor speech disorders
- Other neurologic disorders
- Functional speech disorders
- Nonneurologic disturbances
- Normal variations in speech
- Prevalence and distribution of motor speech disorders
- Methods for studying motor speech disorders
- Perceptual methods
- Instrumental methods
- Artificial intelligence
- The clinical salience of the perceptual analysis of motor speech disorders
- Categorizing motor speech disorders
- The perceptual method of classification
- Summary
- References
- 2. Neurologic bases of motor speech and its disorders
- Gross neuroanatomy and major neurologic systemsa
- Bony boundaries—the skull and spinal column
- Coverings—the meninges and spaces between them
- Major anatomic levels of the nervous system
- Major functional longitudinal systems
- Primary structural elements of the nervous system
- The neuron and neurotransmitters
- Supporting (glial) cells
- Nerves, tracts, and pathways
- Pathologic reactions of structural elements
- Clinicopathologic correlations
- Localizing nervous system disease and determining its course
- Broad etiologic categories
- The speech motor system
- The final common pathway—basic structures and functions
- The final common pathway and speech
- The upper motor neuron pathways and speech
- Indirect UMN activation pathways
- Control circuits
- The cerebellar control circuit and speech
- The basal ganglia control circuit and speech
- Other contributors to speech planning, control, and execution
- Higher-level planning and programming
- Conceptualization
- Language planning
- Motor speech planning and programming
- Summary
- References
- 3. Examination of motor speech disorders
- Purposes of motor speech examination
- Description
- Establishing diagnostic possibilities
- Establishing a diagnosis
- Establishing implications for localization and disease diagnosis
- Specifying severity
- Guidelines for examination
- History
- Salient features
- Confirmatory signs (Part II of accompanying website: Samples 58–80)a
- Interpretation of findings—diagnosis
- The motor speech examination
- History
- Examination of the speech mechanism during nonspeech activities
- Assessment of speech characteristics
- Assessment of intelligibility, comprehensibility, and efficiency
- Rating scales
- Rating scales of functional communication, communication effectiveness, and psychosocial impact
- Summary
- Speech Characteristics Associated With Motor Speech Disorders
- Reading Passages
- Grandfather passage
- The caterpillar
- Rainbow passage
- Apraxia of Speech Rating Scale
- Apraxia of speech rating scale 3.5
- References
- PART 2. The Disorders and Their Diagnoses
- 4. Flaccid dysarthrias
- Clinical characteristics of flaccid paralysis
- Weakness
- Hypotonia and reduced reflexes
- Atrophy
- Fasciculations and fibrillations
- Progressive weakness with use
- Etiologies
- Some common terminology
- Some associated diseases and conditions
- Speech pathology
- Distribution of etiologies in clinical practice
- Patient observations and concerns
- Trigeminal nerve (V) lesions
- Facial nerve (VII) lesions
- Glossopharyngeal nerve (IX) lesions
- Vagus nerve (X) lesions
- Accessory nerve (XI) lesions
- Hypoglossal nerve (XII) lesions
- Spinal nerve lesions
- Multiple cranial nerve lesions
- Distribution of speech cranial nerve involvement in flaccid dysarthrias
- Clusters of abnormal speech features
- Cases
- Summary
- References
- 5. Spastic dysarthria
- Anatomy and basic functions of the direct and indirect activation pathways
- Clinical characteristics of upper motor neuron lesions and spastic paralysis
- The relationship of spastic paralysis to spastic dysarthria
- Etiologies
- Vascular disorders
- Degenerative disease
- Congenital disorders
- Inflammatory disease
- Speech pathology
- Distribution of etiologies, lesions, and severity in clinical practice
- Patient observations and concerns
- Clinical findings
- Acoustic and physiologic findings
- Cases
- Summary
- References
- 6. Ataxic dysarth ria
- Anatomy and basic functions of the cerebellar control circuit
- Localization of speech within the cerebellum
- Clinical characteristics of cerebellar lesions and ataxia
- Etiologies
- Degenerative diseases
- Vascular disorders
- Trauma
- Demyelinating diseases
- Neoplastic disorders
- Toxic or metabolic conditions
- Other causes
- Speech pathology
- Distribution of etiologies, lesions, and severity in clinical practice
- Patient observations and concerns
- Clinical findings
- Clusters of abnormal features and prominent speech characteristics
- Acoustic and physiologic findings
- Are there subtypes of ataxic dysarthria?
- Cases
- Summary
- References
- 7. Hypokinetic dysarthria
- Anatomy and basic functions of the basal ganglia control circuit
- Clinical characteristics of basal ganglia control circuit disorders associated with hypokinetic dysarthria
- Etiologies
- Degenerative diseases
- Vascular conditions
- Toxic-metabolic conditions
- Trauma
- Infectious conditions
- Other causes
- Speech pathology
- Distribution of etiologies, lesions, and severity in clinical practice
- Patient observations and concerns
- Clinical findings
- Acoustic and physiologic findings
- Cases
- Summary
- References
- 8. Hyperkinetic dysarthrias
- Anatomy and basic functions of the basal ganglia control circuit
- Clinical characteristics of basal ganglia control circuit disorders associated with hyperkinetic dysarthrias
- Dyskinesias
- Myoclonus
- Tics
- Chorea
- Ballismus
- Athetosis
- Dystonias
- Spasm
- Tremor
- Causes
- Degenerative diseases
- Toxic-metabolic conditions
- Infectious processes
- Vascular disorders
- Physical trauma
- Neoplasm
- Other causes
- Speech pathology
- Distribution of etiologies, lesions, and severity in clinical practice
- Patient observations and concerns
- Chorea
- Action myoclonus
- Tics and tourette syndrome
- Dystonias
- Laryngeal dystonia (spasmodic dysphonia)
- Spasmodic torticollis (cervical dystonia)
- Athetosis
- Palatal tremor (palatopharyngolaryngeal myoclonus) (Samples 23, 24, 73, and 74)
- Essential (organic) voice tremor (Samples 17–19, 70, and 83, and a case among those in Part IV of the accompanying website)
- Cases
- Summary
- References
- 9. Dysarthria associated with unilateral upper motor neuron impairment
- Anatomy and basic functions of the upper motor neuron system
- Clinical characteristics of unilateral upper motor neuron lesions
- Etiologies
- Speech pathology
- Distribution of etiologies, lesions, and severity in clinical practice
- Patient observations and concerns
- Clinical findings
- Acoustic and physiologic findings
- The perceptual distinctiveness of unilateral upper motor neuron dysarthria: Conclusions and clinical suggestions
- Cases
- Summary
- References
- 10. Mixed dysarthrias
- Etiologies
- Degenerative diseases
- Vascular disorders
- Demyelinating disease
- Toxic-metabolic conditions
- Trauma
- Neoplasm
- Infectious and autoimmune diseases
- Speech pathology
- Distribution of etiology, types, and severity in clinical practice
- Motor neuron disease—amyotrophic lateral sclerosis
- Progressive supranuclear palsy syndrome
- Corticobasal syndrome (CBS)
- Multiple system atrophy
- Multiple sclerosis
- Friedreich ataxia
- Wilson disease
- Traumatic brain injury
- Cases
- Summary
- References
- 11. Apraxia of speech
- Anatomy and basic functions of the motor speech programmer
- Functions of the motor speech programmer
- The motor speech programmer network
- Nonspeech, nonoromotor, and nonlinguistic characteristics of patients with apraxia of speech
- Etiologies
- Stroke
- Neurodegenerative conditions
- Other causes
- Speech pathology
- Terminology and classification issues
- Distribution of etiologies, lesions, and severity, and associated deficits in clinical practice
- Patient observations and concerns
- Clinical findings
- Acoustic and kinematic findings
- Cases
- Summary
- References
- 12. Neurogenic mutism
- Motor speech disorders and mutism
- Anarthria
- Locked-in syndrome
- Biopercular syndrome
- Cerebellar mutism (posterior fossa syndrome)
- Apraxia of speech and mutism
- Aphasia and mutism
- Disorders of arousal, responsiveness, and diffuse cortical functions
- Coma
- Vegetative state
- Minimally conscious state
- Akinetic mutism
- Etiology-specific neurogenic mutism
- Speech arrest
- Drug-induced mutism
- Mutism after corpus callosotomy
- Cases
- Summary
- References
- 13. Other neurogenic speech disturbances
- Other speech disturbances associated with unilateral, bilateral, multifocal, or diffuse central nervous system abnormalities
- Acquired neurogenic stuttering
- Palilalia
- Echolalia
- Other cognitive and affective disturbances
- Other speech disturbances associated with left hemisphere lesions
- Aphasia—language-related disturbances
- Foreign accent syndrome
- Other speech disturbances associated with right hemisphere damage —aprosodia
- Assessing prosodic production
- Definition and clinical characteristics
- Associated clinical characteristics and supporting data
- Anatomic correlates
- Nature of the problem
- Cases
- Summary
- References
- 14. Functional and related speech disorders
- Functional neurologic disorders—some basics
- Background, definitions, and terminology
- Demographic and clinical features
- Explanatory mechanisms
- Neurophysiologic correlates
- Conditions that may be associated with functional speech disorders
- Conversion disorder
- Somatization disorder
- Stress and stress reactions
- Volitional disorders
- Factitious disorders
- Malingering
- Psychiatric conditions that can alter speech in predictable ways
- Depression and manic-depression
- Schizophrenia
- Speech pathology
- Distribution of functional speech disorders in clinical practice
- Examination
- Functional voice disorders
- Acquired functional stuttering
- Other manifestations of functional speech disorders
- Functional mutism
- Cases
- Summary
- References
- 15. Clinical differential diagnosis
- General guidelines
- Distinguishing among the dysarthrias
- Anatomy and vascular distribution
- Etiology
- Oral mechanism findings
- Speech characteristics
- Distinguishing dysarthrias from apraxia of speech
- Anatomy and vascular distribution
- Etiology
- Oral mechanism findings
- Speech characteristicsa
- Distinguishing motor speech disorders from aphasia
- Dysarthrias versus aphasia
- Apraxia of speech versus aphasia
- Distinguishing among forms of neurogenic mutism
- Anarthria
- Apraxia of speech
- Aphasia
- Cognitive-affective disturbances
- Distinguishing motor speech disorders from other neurogenic speech disorders
- Neurogenic stuttering
- Palilalia
- Echolalia
- Other cognitive and affective disturbances (abulia)
- Aprosodia
- Distinguishing neurogenic from functional and related speech disorders
- Depression and schizophrenia
- Functional speech disorders
- Summary
- References
- PART 3. Management
- 16. Managing motor speech disorders: Broad overview
- Management issues and decisions
- The territory
- Goals
- Factors influencing decision making
- Treatment focus
- Treatment duration and intensity
- Approaches to management
- Medical intervention
- Prosthetic management
- Behavioral management
- Augmentative and alternative communication
- Counseling and support
- Foundations for behavioral management
- Rationale
- Principles
- Other considerations
- Treatment efficacy
- Evidence-based practice
- Summary
- References
- 17. Managing the dysarthrias
- Speaker-oriented treatment
- Respiration (speech breathing)
- Phonation
- Resonance
- Articulation
- Rate
- Prosody and naturalness
- Speaker-oriented treatment for specific dysarthria types
- Flaccid dysarthrias
- Spastic dysarthria
- Ataxic dysarthria
- Hypokinetic dysarthria
- Hyperkinetic dysarthrias
- Unilateral upper motor neuron dysarthria
- Mixed dysarthrias
- Communication-oriented treatment
- Speaker strategies
- Listener strategies
- Interaction strategies
- Summary
- References
- 18. Managing apraxia of speech
- General perspectives
- Management territory and goals
- Factors influencing management decisions
- Focus and duration of treatment
- Management approaches
- Medical intervention
- Prosthetic management and augmentative and alternative communication
- Behavioral management
- Principles and guidelines for behavioral treatment
- Baseline data and stimulus selection and ordering
- Physiologic support and nonspeech movements
- Principles of motor learning
- Behavioral treatment approaches
- Articulatory-kinematic approaches
- Rate and/or rhythm approaches
- Additional approaches and techniques
- Neurodegenerative apraxia of speech
- Efficacy
- Summary
- References
- 19. Managing other neurogenic speech disturbances
- Neurogenic stuttering
- Medical management
- Behavioral management
- Palilalia
- Echolalia
- Cognitive and affective disturbances
- Aphasia
- Foreign accent syndrome
- Aprosodia
- Summary
- References
- 20. Managing functional speech disorders
- General principles, guidelines, and strategies
- Many people with a functional speech disorder should receive speech therapy
- Clinician attitude and manner are crucial
- Recovery is possible
- Explanation of the diagnosis is the first step in treatment
- Symptom treatment should be attempted within the diagnostic session whenever possible
- Debriefing—when therapy succeeds, the patient should have an explanation for it
- The future must be discussed
- Not everyone wants, is ready for, or can benefit from speech therapy
- Practical considerations
- When to begin
- Psychological and psychosocial issues
- Symptomatic therapy
- Symptomatic treatment for specific functional speech disorders
- Functional voice disorders
- Functional stuttering
- Other functional speech disorders
- Other treatments
- Summary
- Information Resources About Functional Neurologic Disorders
- References
- Index