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Abstract Speech is the final expresssion of concepts and emotions translated through linguistic pathways that involve lexical, syntactic, phonological, phonetic and prosody stages. While, Language is a human system of communication that uses arbitrary signals, Such as voice, sounds, gestures, or written symbols, The study of language is called linguistics. Motor speech disorders include: Dysarthria, Apraxia or Dyspraxia of speech, Developmental apraxia of speech, stuttering and Cluttering. Dysarthria is a motor-speech disorder. It causes the inability to coordinate or control the muscles in the face, mouth, and respiratory system. It usually occurs when a brain injury causes the muscles to become weak or immobile. People with dysarthria can’t control the muscles used to make normal sounds. Speech becomes slow or slurred. It becomes difficult for others to understand what the person is trying to say. Dysarthria can affect many aspects of speech. Patient may lose the ability to pronounce sounds correctly or speak at a normal level. Patient may also be unable to control the quality, intonation, and pace at which he speaks. Individual speech difficulties will vary depending on the location and severity of the brain injury, Dysarthria may be the result of a brain damage, Dysarthria may result from damage to the nerves that supply the muscles of articulation, or to the muscles themselves, Dysarthria may be caused by diseases that affect nerves and muscles (neuromuscular diseases). The types of dysarthriais: Flaccid dysarthria (bulbar, LMN dysarthria), Spastic dysarthria (pseudobulbar, UMN dysarthria), Ataxic dysarthria (cerebellar), Hyperkinetic dysarthria: (which is either Quick hyperkinetic dysarthria or slow hyperkinetic dysarthria), Quick hyperkinetic dysarthria include: Chorea, Myoclonic Jerks, Tics and Hemiballismus but Slow Hyperkinetic dysarthria include: Athetosis and Dystonia, Hypokinetic dysarthria (parkinsonian dysarthria), Mixed dysarthria which include: Amytrophic lateral sclerosis (ALS), Multiple sclerosis (MS), Wilson’s disease. Articulation problems resulting from dysarthria are treated by speech language pathologists, using a variety of techniques. There are several skills that are important to learn: Safe chewing and swallowing techniques, Avoiding conversations when feeling tired, Repeat words and syllables over and over in order to learn the proper mouth movements, Maintain a relaxed, calm environment, Reduce noise, music, and other stimuli during communication, Modification of muscle tone, posture and strength, Modification of resonance, Modification of prosody, Modification of articulation, Modification of respiration, Modification of phonatory deficits: (Pitch, Loudness, Vocal quality), Providing alternative methods of communication.Apraxia is defined as a deficit in the ability to perform an action in response to verbal command or imitation in the absence of sensory or motor impairment, Apraxia of speech is not the result of language disturbances or an impairment of neuromuscular system, but rather is an impairment of the ability to plan and program the relevant articulatory movements. Types of apraxia: Ideational or Conceptual apraxia, Ideomotor apraxia, Callosal apraxia, Dressing apraxia, magnetic apraxia, Limb-Kinetic apraxia, Apraxia of speech (AOS). Apraxia of speech can affect timing, rate, or range of movement of the articulators, and selection of articulatory contact points along the vocal tract. Features include disturbed articulation (inconsistent trial and error misarticulations) and prosody (hesitations, slowness, groping, difficulty initiating speech, dysprosody) with pockets of correct speech. Most offen, patients are aware of their errors and can become frustrated when they cannot correct themselves. The treatments fell into one of four categories according to the Committee of the Academy of Neurologic Communication Disorders and Sciences (ANCDS): Articulatory-Kinematic treatments, Rate/rhythm control treatments, Intersystemic facilitation/ reorganization treatments, Alternative and Augmentative communication approaches., Another programs for treatment of AOS: Articulatory Methods, Integral Stimulation, Multiple Input Phoneme Therapy (MIPT), Sound production treatment (SPT), Prosodic Approaches, Tactile/Gestural Methods. Prompts for Restructuring Oral and Muscular Phonetic Targets (PROMPT): This approach uses to improve sound production in children with speech impairments that uses tactile cues to support and shape movements of the oral articulators in order to improve the production of individual sounds, syllables, words, and eventually connected speech. Stuttering is an involuntary disruption in fluency, characterized by abnormal frequency or duration of interruptions in the flow of speech, namely repetitions, prolongations, and blocks, It more than likely has neurological deficit origins due to its involuntary and potentially socially problematic nature, stuttering has been found to have a potentially negative influence on emotional and mental health. Stuttering therapy is any of the various treatment methods that attempt to reduce stuttering to some degree in an individual, There are many different approaches to stuttering therapy, the successfulness of speech therapy depends on the combination of education, training, and individualized treatment provide: Fluency shaping, Stuttering modification (Motivation, Identification,Desensitization, Variation, Appproximation, Stabilization, Maintenance, Generalization), Integrative approaches, Regulated breathing therapy, Self therapy for the stutterer, Support groups, Camperdown program, Speech motor plan assembly, Speech construction concept in stuttering therapy, Phonological priming, Repetition priming, Cognitive behavioural therapy, Contemporary devices in treatment of stuttering, Pharmacologic therapy, Therapy for children, Lidcombe program. Cluttering refers to a speech disorder in which a person’s speech is either too fast, too jerky, or both, cluttered person fails to maintain normally expected sound, syllable, phrase, and pausing patterns, cluttering is caused by atypical brain structure or function as it relates to speech rate control, speech-language planning and execution, and other fluency-related behavior, Cluttering is a fluency disorder characterized by a rate that is perceived to be abnormally rapid, irregular, or both for the speaker (although measured syllable rates may not exceed normal limits). These rate abnormalities further are manifest in: (1) an excessive number of disfluencies, the majority of which are not typical of people who stutter; (2) the frequent placement of pauses and use of prosodic patterns that do not conform to syntactic and semantic constraints; and/ or (3) inappropriate (usually excessive) degrees of coarticulation among sounds, especially in multisyllabic words”.Therapy for cluttering should be tailored to the client’s unique difficulties since there are few data available suggesting standard procedures for treatment. Nevertheless, a number of therapeutic strategies have been recommended over the years, many of which might be effective with specific clutterers. Importantly, these include speech, language, and other skills that may affect the clutterer’s ability to communicate effectively: Slowing Rate, Heightening Monitoring, Using Clear Articulation, Using Acceptable, Organized Language, Interacting with Listeners, Speaking Naturally, Reducing Excessive Disfluencies. |