128 Chapter 6
For a time, Barbara was angry at the disease, herself, her husband, her children, and even God.
The frustration of dealing with the slow loss of every thing she loved made her angry at the world.
Through no fault of her own, she was forced to deal with this devastating disease and the pain and
suffering associated with it. As often happens when people cannot defeat an all- power ful foe, she
bargained with God, praying and offering future good work and a life of dedication to the church
if she was spared. She tried several unorthodox medi cations, therapies, and treatments to gain
more time to be with her young children. But the anger and bargaining did nothing to stop the
disease, and Barbara became depressed. Saturated with the sad realities of the disease, she became
lethargic, hopeless, and helpless.
Toward the end, the depression gradually lifted, and Barbara accepted what had happened. Her
negative emotions fi nally dissipated, and she felt neither good nor bad. What is most impor tant,
Barbara found herself reveling in the good things that had happened to her rather than being sad-
dened by the coming end of her life.
Motor speech disorders impair the ability to program, sequence, and execute the neuromus-
cular movements necessary for speech production. They affect, to varying degrees, respiration,
phonation- resonance, articulation, and prosody. Apraxia of speech disrupts or eliminates the
ability to program speech movements and interferes primarily with articulation. Therapies exist
for apraxia of speech and for the aspects of motor speech disrupted by the dysarthrias. In addi-
tion, general therapies are available for motor speech disorders regardless of which motor system
is impaired. Most patients with motor speech disorders can improve their speech precision and
intelligibility, but full restoration of communication abilities is not always pos si ble.
- How are motor speech disorders classified? What are the symbolic and nonsymbolic disorders?
- Compare and contrast aphasia and apraxia of speech.
- Describe the symptoms of apraxia of speech. How does awareness of speech errors and the ability
to self- correct affect them? - Describe the effects of dysarthria and apraxia of speech on respiration.
- Describe the effects of dysarthria and apraxia of speech on phonation- resonance.
- Describe the effects of dysarthria and apraxia of speech on articulation.
- Describe the effects of dysarthria and apraxia of speech on speech prosody.
- List and discuss the therapies for apraxia of speech.
- List and discuss the general princi ples of dysarthria therapy.
- Compare and contrast oral apraxia and apraxia of speech.