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2204 AOS – Flashcard

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define intrasystemic
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instrasystemic is a type of speaker-orientated approach to apraxia of speech. it involves use of automatic or primitive functions such as counting, and higher order activities such as reading or imitation
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what are speaker orientated approaches?
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a type of behavioural approach. the aim is to improve speech itself – increase ability to program speech or compensate for residual inadequacies
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what are communication orientated approaches?
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a type of behavioural approach. the aim is to improve communication as a whole – speech per se is not treatment focus and may not improve
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what can intrasystemic intervention be viewed as?
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microstructural or macrostructural
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what is macrostructural?
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Approaches that enhance suprasegmentals and which are applied at the phrase and sentence level aid the impaired system to help re-establish an underlying melody and rate for speech production
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what are the different therapy techniques for apraxia of speech?
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1. phonetic derivation and placement techniques 2. Key word technique – multiple input phoneme therapy – voluntary control involuntary utterances 3. Betty hill program 4. Imitation of contrasts 5. Rate control 6. Contrastive stress tasks 7. 8 step task continuum 8. Prompt 9. Melodic intonation therapy 10. Speech sounds on cue 11. Metrical pacing therapy
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Define promt macro or micro?
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tactile cues provide touch pressure, kinaesthetic and proprioceptive cues to facilitate speech finger placements on patients neck and face programming motor control microstructural
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define melodic intonation therapy macro or micro?
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relies on singing and variations teach hand tapping rhythms with simultaneous humming – gradual fade add meaningul linguistic material macrostructural
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define speech sounds on cue
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computer based therapy videos of phonetic placement for all consonants
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define metrical pacing therapy
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15 utterances of length and complexity tailored to the individuals level
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Explain Phonetic derivation and placement techniques macro or micro?
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phonetic derivation – build on orofacial skill already in the patients repertoire phonetic placement – use of descriptors and how sounds are made, use of fingers, models, imagery, manipulation of muscles microstructural
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explain key word technique
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1. Patient repeats/reads words from their existing repertoire that are uttered accurately and automatically – reading, naming, answering questions 2. New utterances are developed from the initial phoneme of the practiced word 2a- multiple input phoneme therapy 2b- voluntary control of involuntary utterances
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describe multiple input phoneme therapy Macro or micro?
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for severely aphasic and apraxic patients – severe repetition deficits and repetivie verbal stereotypes purpose – to shape a variety of utterances from verbal stereotypes or involuntary utterances. Macrostructural
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what are the steps of multiple input phoneme therapy?
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1. Identify most frequently occuring utterance 2. Clinician slowly produce utterance 10 times emphasis on initial phoneme, tap at the same time with good arm 3. Patient joins in 4. Clinician fades but mimes 5. repeat for other utterances 6. new single syllable words created two- tie, tea 7. phonemes- clusters- multisyllabic words, phrases and short sentences 8. Repetitions faded – responses elicited by reading cues, picture naming ect
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describe voluntary control of involuntary utterances macro or micro?
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clients with intact comprehension, nonfluent speech, no response to integral stimulation Relies on patient utterances to establish stimuli for treatment macrostructural
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describe the betty hill program
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uses auditory, visual and graphic approach to teach phonetic placement Carrier phrases to facilitate word production
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What are the stages of the betty hill program?
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1. Auditory discrimination 2. Chart produced – articulographs 3. Establish single phoneme using various cues (phonetic derivation and placement) 4. Drills and facilitating phrase to produce single words – rhyme drills – phrase completion
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describe imitation of contrasts macro or micro?
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facilitates articulatory control across syllables minimum differences in voicing, manner, place, vowels and single vs clusters Microstructural
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describe rate control macro or micro?
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– pacing board patients touch each square on the board for each unit of speech – metronome pair with reading passages – hand or finger tapping macrostructural
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describe contrastive stress tasks micro or macro?
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question answer dialogue with stress on target word different target locations, multiple stressed targets macrostructural
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describe 8 step task continuum micro or macro?
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stimulus prompts maximally used initially, then gradually fade cues emphasises drill meaningful and useful communication Microstructural
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define prompt
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what are the steps to the 8 step task continuum?
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1. c presents target stimulus, p imitates 2. P imitates c after a delay, c mime response with p 3. P imitates response without auditory or visual cues from c 4. C produces stimuli once, p produces it several times consecutively 5. P produces response, written stimuli 6. Written stimuli – delayed production, after removal of stimuli 7. response elicited with appropriate questioning 8. Response elicited in roleplay