FLACCID SPASTIC ATAXIC HYPOKINETIC HYPERKINETIC

(CVA, LMN, TBI, ALS) (CP, UMN, CVA, TBI, ALS) (MS, TBI) (PD) (Huntington’s)
- weakness - increased muscle tone - dysmetria - rigidity/hypokinesia - quick, involuntary
- hypotonia - spasticity - hypotonia - slow/bradykinesia movement
Hallmarks
Physical

- diminished reflexes - hyperreflexia (gag & stretch) - intention tremor - resting tremor - chorea
- fasciulations - lower facial weakness - biting tongue while - freezing, ‘mask’ - dystonia
- recovery w/rest - tongue weakness talking - micrographia

- breathiness - strained/strangled - drunk speech - breathiness - effortful

- hypernasality - low, monopitch - harsh - repeated phonemes - voice stoppages
Perceptual

- audible inspiration - distorted vowels - vocal tremor - short rushes of speech - harsh
- hoarse/harsh - pitch breaks - hypernasality - strange/strangled
- imprecise artic - continuous breathiness - irregular artic breakdown - transient breathiness
- hypernasality - imprecise artic

- breathiness - reduced in/exhale volume - irregular chest wall - difficulty altering auto - sudden/forced in/exspiration
Respirat

 short phrases movement breath patterns - unpredictable breath support

ion

 excess stress  equal/excess stress - inappropriate silences - involuntary movement

- Imprecise consonants - reduced ROM - irregular breakdowns - reduced ROM - imprecise consonants
Artic

- tongue weakness - prolonged phonemes - rigidity - distorted vowels

- incomplete lingual contacts - slow artic movements - irregular breakdowns

- reduced VP movement - slow VP movement - reduced VP movement - irregular VP movement

- reduced pharyngeal
VP

wall movement

- hypoadduction - hyperaddition - voice tremor - arytenoid flutter - abnormal involuntary

Laryngeal

- vocal fold immobility - bowing movements

- incomplete glottal
closure

- monopitch - bursts of loudness - equal/excess stress - monostress - alternating loudness

Prosody

- excess stress - excess loudness variation - monopitch

- monopitch - monoloudness
- monoloudness

- slow - fast, short rushes - variable

Rate

- inappropriate silences - inappropriate silences