presented by Michelle Troche
Acquired motor speech disorders in persons with Movement Disorders can cause significant decrements to quality of life, social isolation, and depression. Movement Disorders often cause deficits across the neuroaxis and for that reason result in marked difficulties when it comes to management. The goal of this course is to provide participants with the tools needed to complete a comprehensive assessment of motor speech dysfunction in the most complex Movement Disorders patients. It is recommended that this course be followed-up with the Motor Speech Management of Complex Movement Disorders Patients course.
Dr. Michelle S. Troche is currently an Assistant Professor in the Communication Sciences and Disorders Program, Department of Biobehavioral Sciences at Teachers College, Columbia University. Additionally, she holds adjunct positions in the departments of Neurology and Otolaryngology. She completed her doctoral studies at the University of Florida, where she also served as a faculty member prior to joining Columbia University. She is director of the Laboratory for the Study of Upper Airway Dysfunction. Her research is aimed at improving health outcomes and quality of life associated with disorders of airway protection (i.e., swallowing and cough). To that end, she employs a two-pronged approach including both basic science and clinical research. Basic science research goals focus on developing a better understanding of the mechanisms underlying airway protection and its disorders. Clinical research goals are the development of novel and robust evaluation and treatment techniques for dystussia (deficits of cough function) and dysphagia (deficits of swallowing function). Current projects focus on multiple behaviors contributing to airway protection and the ability to modify those behaviors via non-pharmacological treatment paradigms. Research participants include healthy volunteers, people with Parkinson’s disease, other movement disorders, ischemic stroke, and motor neuron disease. Her research has been funded by the National Institutes of Health, Michael J Fox Foundation, and CurePSP Foundation. She directs a collaborative, multidisciplinary, and productive laboratory which creates a rich environment for trainees of all levels. Her clinical work has mainly been in the area of Movement Disorders where she has evaluated and treated the motor speech and airway protective function of hundreds of patients. She has expertise and has mentored students and taught in the areas of: cognitive-motor relationships, neural/myogenic adaptations to exercise and training, with emphasis on the swallowing, coughing and respiratory systems, and clinical disorders of motor speech, voice, and airway protection. Her research, teaching, and mentorship have been recognized by several awards and in her academic record.
In this chapter, we will begin with an introduction to what motor speech disorders are and what their impact is. We will also establish a shared framework of motor speech disorders, which will guide us throughout the course.
In this chapter, we will discuss several movement disorders. We will discuss the underlying pathophysiology and factors which will influence speech outcomes and management in these patient groups.
In this chapter, we will discuss the role of a comprehensive and hypothesis-driven approach to motor speech assessment in Movement Disorders. We will focus on the perceptual assessment of speech function.