Simon Simonson

DOB: 8/1/22
Sex: M
Post-onset: ?
Referral: referred by family friend who is a speech pathologist
 
 

Pertinent Medical History (PMH):	HTN  AODM  DJD
Social history:	Tobacco: none  Alcohol: one glass of wine daily with dinner  Farmer and small businessman
Family history:	adopted
Surgical history:	none
Current complaints:	tongue isn't working

Interview: (Questions quoted from Duffy (1995) Motor Speech Disorders)
 

ONSET & COURSE
1. Do you have any difficulty with your speech? If not, has anyone else commented on a change or problem with your speech?	Ah, it’s not too bad but I think it used to be better. That Janie, she thought I should come see you.
2. When did the speech problem begin?  Did it begin suddenly or gradually?  Who noticed it first, you or someone else?	Well now let’s see. It was back before I sold the Rotheid 80 cuz I remember that lawyer asking me if I’d had a stroke. So I suppose maybe a year or so but I don’t really know.
3. Did you develop any other difficulties when your speech problem began?  Were other problems present before your speech problem began?  Did other problems develop after the speech problem began?	Well now my arthritis aint been getting no better but I don’t think you can get arthritis in your tongue can you?
4. Has the speech problem changed?  Better, worse, stable, better-than-stable, fluctuating?	Seems pretty much the same to me.
5. Has your speech ever returned to normal?  If so, when and for how long?	Oh I used to be quite a talker—president of the Lion’s club, you know. Now I let the young guys take care of that stuff.
ASSOCIATED DEFICITS
1. Have you had any difficulty with chewing? drooling?	Well now these plates of mine never did fit good so I usually just leave them out.
2. Is it difficult to move food around in your mouth? Why?	Oh I just reach right in and get it where its supposed to be.
3. Does food get stuck in your cheeks or in the roof of your mouth?  Do you have to remove it with your finger or a fork?	Nope, I just take care of it.
4. Do you have trouble moving food back in your mouth to get a swallow started?	can’t say that I do
5. Do you have trouble with swallowing?  Food or liquid?  Do you have trouble getting a swallow started?  Do you lose food or liquid out of your mouth?  Does food or liquid ever get into or out of your nose when you swallow?  Does food or liquid go down before you swallow and cause coughing or choking?  Do you gag or choke when swallowing?  Do you cough or choke when completing a swallow?  Have you had to modify your diet because of these problems?  Have you lost weight?	never been able to swallow those horse pills
6. Have you had any change in your emotional expression?  Do you cry or laugh more easily or less easily than in the past?	oh no no no
7. Are you taking any medications that seem to affect your speech?	no no
PATIENTS PERCEPTION OF THE PROBLEM:
1. What did your speech sound like when the problem began?  Did anything feel different when you spoke?	Well now my voice ain’t been the same since I was a young guy.
2. Describe your current speech difficulty. How does it sound to you?  How does it feel to speak?  Is it faster or slower?  Louder or slower?  Less precise?  Is speaking effortful?	Oh I suppose I sound like an old man, but I am old so why not?
3. Have you noticed any change in the appearance or feeling in your face or mouth?	no, don’t think so
CONSEQUENCES OF THE DISORDER:
1. Do people ever have trouble understanding you?  When? What do you do if that happens?	Well now Johnny Osowski hasn’t been able to hear for years—you gotta yell at him. And none of the rest of us are getting any younger.
2. Do you ever have to write to make yourself understood?  Has your speech problem affected your work?  Does it prevent you from doing anything?	Nope. Now I got myself a new computer and I’ve been doing that information highway with my daughter out in Kansas. She’s got two little girls in college now and they write to me now and then too.
MANAGEMENT
1. What have you done to compensate for your speech difficulty?  Have you had any help for your speech?  When?  For how long?  What was done?  Did it help?	I just thought I better come see you like Janie said. She keeps an eye on me ya know. Stops by every day pretty much.
2. Do you think you need help with your speech now?	Well now I’m pretty old but you’re never too old to learn
AWARENESS OF DIAGNOSIS AND PROGNOSIS:
1. What have you been told is the cause of this problem?	Well, you haven’t told me yet, have you?
2. In view of this diagnosis, what is going to happen?	n/a

Report of Handicap
(Adapted from Verdolini (1994) "Voice Disorders" in Tomblin et al. (Eds) Diagnosis in Speech-language Pathology
 

Area	No Impact	Very little impact	Some impact	Significant Impact	Profound (can't perform in this area)
Professional	x
Social	x
Communicative	x
Physical	x
Emotional	x

Name: Simon Simonson
DOB: 8/1/22
Medical Diagnosis: __________
Date of Testing: 10/31/96
 

Respiration:
 
 

- Good Good Normal Normal

Ability to sustain /s/ on exhalation (12 seconds) Ability to "crescendo" on /s/ Ability to "diminuendo" on /s/ Ability to repeat series of /s/  Ability to synchronize respiration with phonation

 

Descriptive information:

1. Respiration at rest is : Normal
2. Speed of respiration at rest is : Normal
3. Respiration during speech is: Normal
4. Speed of respiration during speech is: Normal
5. Patient speaks on: Exhalation, residual air
6. Respiration occurs: Without stridor

Phonation:
 
 

Normal - Good Good Good Normal Normal Normal Good Good Normal Good

Ability to initiate /a:/ Ability to sustain /a:/ (12 seconds) Ability to say /a:/ very loudly Ability to "crescendo" on /a:/ Ability to "diminuendo" on /a:/ Ability to repeat a series of /a:/ Ability to raise pitch on /a:/ Ability to lower pitch on /a:/ Ability to glide up scale on /a:/ Ability to glide down scale on /a:/ Ability to maintain adequate volume in speech Quality of voice

Descriptive Information:

1. Pitch of voice for speech is: Normal
2. Pitch breaks: Do not occur
3. Intonation for speech is: Normal
4. Tone of voice is: Normal
5. Voice quality is: Hoarse Intermittent

Facial Musculature:
 
 

Normal Normal  Normal Normal Normal Normal Normal Normal Normal Fair Fair Good Poor Fair Fair None Good Fair Normal Normal

Symmetry of facial expression at rest Ability to change expression to smile Ability to purse lips Ability to stretch. Ability to maintain lip closure at rest Ability to achieve lip closure during speech Ability to open and close moth Ability to move mandible to right Ability to move mandible to left Ability to protrude tongue Ability to retract tongue Ability to move tongue to the right Ability to move tongue to the left Ability to pass tongue over the teeth Ability to move tongue tip into the right cheek Ability to move tongue tip into the left cheek Ability to raise tongue tip in mouth Ability to raise tongue tip outside mouth Ability to elevate soft palate on /a:/ Ability to elevate soft palate on series of /a:/

Descriptive Information:

1. At rest face: -
2. During smile face: -
3. Tone of lips appears: Normal
4. At rest tongue appears: Fasiculating, deviating to right (Left)
5. Tone of tongue appears: Decreased (Left)
6. At rest soft palate is: Normal
7. During phonation soft palate is: Normal

Reflexes:
 
 

Good	All tasks for this section

 

VI. Articulation
 
 

Derive from descriptive information

Ability to repeat consonants Accuracy of vowel sounds Ability to repeat consonant clusters Ability to repeat polysyllabic words Ability to repeat phrases

 

VII. Intelligibility
 
 

Normal Normal Good Normal Normal Good

Intelligibility of reading to therapist Intelligibility of reading to relative/friend Intelligibility of reading to stranger Intelligibility of speech to therapist Intelligibility of speech to relative/friend Intelligibility of speech to stranger

VIII. Prosody/Rate
 
 

Good Normal Normal Normal Normal

Ability to maintain appropriate rate Ability to increase rate Ability to maintain appropriate rhythm Ability to use appropriate intonation Ability to imitate different stress patterns

Descriptive Information for section VI (Articulation)
 
 

Pie Boy Tar Day Car Go Four Via Thaw The Sea Zoo Shoe Chew Jar Lie Row We How You Me No  Total

+ + - - + + + + + + - - + + - + - + + + + +

Plate Bread Tree Clock Queen Grape Flower Frog Three Spoon Smoke Star Sky Slide Splash Straw Scream Finger Birthday Lamps  Total

- + + + + + + + - - - - - - - - - + - +

Calendar Peppermint Caterpillar Monotonous Examination Autobiography Total

- + + - + +

Open the door Come in and sit down Would you like a cup of tea? Do you take sugar ? Total

+ - +  -

Descriptive Information for Section VIII (Prosody/Rate)

Rate of speech is: Normal
Rhythm of speech is: Normal
 

Single Word Intelligibility Form: Key, Multiple Choice Answer Sheet
Speaker: Simon Simonson
Speaker task: Reading
Date: 10/31
Judge: Rodney (Work Study)
Judging format: Multiple choice

Number correct_________
Percent correct _________

25 items
Errors recorded:
 
 

Target	Judged
start sort shred sold side	spark sort shed soul sigh

 

Assessment of Intelligibility of Dysarthric Speech

(Sentence intelligibility/ transcription answer sheet)

 Speaker: Simon Simonson
Date: 10/31/96
Judge: Rodney (work study)

Duration: 1 minute 15 seconds
WPM:______
# of intelligible words: _________
Intelligibility (%): _______
Efficiency Ratio (IWPM  / 190): ________
# of unintelligible words: ________
IWPM: ___________
UWPM:________
 
 
 

Key     49 80 50 99 12 77 14 23 36 45 47 97 60 69 22 76 1 15 37 49 9  49

5A 5B 6A 6B 7A 7B 8A 8B 9A 9B 10A 10B 11A 11B 12A 12B 13A 13B 14A 14B 15A  15B

Number Correct

This is a family show It’s the way it was I mailed the package years ago You’ll never know until you try Being able to dance can help you Paper cups of jelly beans were shut out I was pleased with the way things went Can you paint a room or a portrait Can you hook up the stereo or mend clothes The mother bear reared up on her hind leg Important men in the party asked him to go It was a safe and effective drug when used properly Sometimes, I fear that it is no more than a historians dream For your work, you will earn a lot of money I ask people to be as careful as they are at home He reached in with his hook and clamped down on the grill For half the human race, it is as necessary as air or water It was our first sign of a _____ in a week of searching Well I’d like to know what it is that has three legs and flies. I was happy to come up with a good grade out of that class I figured on saying how much I respected him but I didn’t have a chance In order to win, we must put more points on the board than we have