presented by Michelle Troche
Acquired motor speech disorders in persons with Movement Disorders can have a devastating impact to patients and their families. The management of motor speech issues in persons with Movement Disorders is complicated by the diffuse deficits across the neuroaxes which often result from these disorders. The goal of this course is to provide participants with the tools needed to develop holistic motor speech management plans for these complicated disorders.
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 briefly address principles of neuroplasticity, specific treatment approaches, and the specific challenges of these populations to develop the treatment plan. We will then bring all previous concepts together to address the development of the holistic motor speech management plan in Movement Disorders.
In this chapter, we will discuss specific challenges in the management of motor speech disorders in Movement Disorders. These will be highlighted through the use of patient cases.