Please enable JavaScript.
Coggle requires JavaScript to display documents.
Principles of Ax - Coggle Diagram
Principles of Ax
Case Hx
- Introduction, identification of whether they have speech disorder, aims for Tx (goal setting)
-
-
- Onset and course-when did it happen, gradual decline in speech overtime
- Associated difficulties-what settings are more challenging
- Pt's perceptions of difficulties-talk to fam members
- Conseq of disorder-WHO ICF
- Mgm-what kinds of Tx options
- Awareness of other medical diagnosis/prognosis-brain tumour vs. CVA
Clinical process
-
-
-
-
Tx ideas depending on areas of: strengths, weaknesses
-
Establishing diagnosis
Is the problem neurological in nature: for adult-acquired, for child: dev, acquired.
If not, is it still organic (dental, lesion on larynx) or is it psychogenic? Adults could have also had a developmental issue that was undiagnosed.
-
Is it a MSD or another neurogenic comm disorder (aphasia)-multiple diagnosis, lang comprehension +/- expression
If it is dysarthria, what type-MRI of where lesions occur, symptoms, lvls of subsystems impairment
Aims of Ax
-
-
To provide starting points, targets for Tx- needs to be challenging enough to keep them motivated, but easy for success-build confidence
-
Types of Ax
-
-
-
-
-
-
Rating scales
Speech sample-grandfather passage, record, analysis using 32-38 speech dimensions (RAPR+P)
-
-
-
For research purposes
Paired perceptual comparison ratings: Naive listeners listen to pairs of speech samples, rate which sample is easier to unds or if there is no difference. Can be used in clinic w other SLPs who X know about dysarthria
Direct magnitude estimation: Perceptual speech features rated, cf standard speech sample
-
-
What is it about: Fnal component analysis model, provides objective, quantifiable measures of physiological fn of each fnal component, SLP determines relative contributions of neuromuscular impairments to client's perceptual speech features, SLP decides hierarchy goals for Tx
Pros: objective data, standardised across settings, defines specific neuromuscular pathophysio X detected by perceptual analysis, defines subsystem impairment in dysarthric speakers w same aetiology, identifies interdependency among subsystems, clearer directions for Tx in more complex cases
Cons: $$, technical support needed, not portable, needs motor speech lab, dont always represent everyday communication, variable performance across tasks/sessions