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CE Courses / Speech and Voice Disorders

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Ethical Considerations for Voice and Upper Airway Clinicians
Format(s): SIG Perspectives and Exam
These Perspectives (SIG 3) articles address ethical considerations for voice and upper airway clinicians. Speech language pathologists are responsible to conduct clinical and business activities ethically, legally, and with a high level of integrity. Billing questions and reimbursement issues that often arise related to ever-changing insurance regulations and Medicare guidelines will be addressed. Additionally, factors that guide ethical decision-making to determine what comprises medically necessary voice therapy that involves or targets singing voice will be presented.
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Considerations for Academic and Clinical  Training in Craniofacial Anomalies
Format(s): SIG Perspectives and Exam
These Perspectives (SIG 5) articles focus on the status of academic and clinical training related to cleft and craniofacial conditions, a module training series for addressing the gaps in current educational roadmaps, and resources and best practice recommendations are provided.
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Perception, Technology, and Clinical Applications
Format(s): SIG Perspectives and Exam
These Perspectives (SIG 19) articles focus on perceptual considerations and the use of a system to investigate lingual coordination as a clinical tool. In the first article Rakerd et al. review the resonant effects of performers, resonance associated with nasality, and resonant voice for both normal and disordered populations. In the second article Grover et al. use the bubble noise method, which places noise randomly in time and frequency with “holes” or “bubbles” that give glimpses into the target signal, to determine what is perceptually important in the speech signal for native/first language listeners versus nonnative/second language listeners. In the final article, Dugan et al. review TonguePART, an image processing system used to track the tongue surface, as a reliable, fast method to track articulatory movement of the tongue for syllables
Voice and Laryngeal Manifestations of Autoimmune Diseases
Format(s): SIG Perspectives and Exam
This Perspectives (SIG 3) article provides a thorough review of the literature regarding autoimmune disease and effects on voice and laryngeal function. To maximize patient outcomes, guidelines for differential diagnosis and referral patterns are highlighted.
Use of Technology to Assess  Speech Production and Voice
Format(s): SIG Perspectives and Exam
These Perspectives (SIG 19) articles provide with information relevant to speech science research and education. Lulich and Pearson present two demonstrations in this technical report to illustrate the utility of 3D/4D ultrasound technology. First, the authors report that “not only can structures be imaged which previously were impossible to identify from 2D ultrasound alone (e.g., piriform sinuses and posterior pharyngeal wall), but questions involving non-sagittal structures and asymmetrical tongue shapes, such as the pervasiveness and extensiveness of lateral contact between the tongue and the palate-teeth, can now be addressed non-invasively.” Second, they also conclude that “the fusion of ultrasound data with MRI images further enhances the utility of 3D/4D ultrasound, since it combines the strengths of ultrasound with the complementary strengths of the other modality, while mitigating the weaknesses of each.” Richardson et al., compare various acoustical measures of sustained vowels obtained using the Multidimensional Voice Program (MDVP) by Computerized Speech Lab, Praat, and TF32. Results show that the MDVP yield significantly higher values of standard deviation of fundamental frequency, jitter, and shimmer, and significantly lower values of noise-to-harmonics ratio compared to the other programs. They discuss the variation of numerical values across programs and the resulting clinical implications. Hagedorn et al. discuss the benefits of a collaboration among engineers, speech scientists, and clinicians which yield “the development of biologically inspired technology that has been proven useful for both small- and large-scale analysis,” a better understanding of speech production, and the development of assessment tools with a clinical benefit and interdisciplinary reach. They also review the use of real-time magnetic resonance imaging across clinical populations and discuss the challenges associated with collaborative work. Lee and Fischer reveal an association between acoustic vowel space and the severity of dysarthria. They review sex differences, factors that may affect formant-related measures, and clinical implications.
Refining Assessment and Treatment of Childhood Apraxia of Speech
Format(s): Journal (Online)
This journal self-study updates clinicians on advances in the field that can refine current diagnostic and therapeutic strategies for childhood apraxia of speech (CAS). Two articles address assessment: One examines how type of stimuli can affect differential diagnosis of CAS, and the other identifies possible red flags in young children by examining characteristics of speech production in infants and toddlers who were later diagnosed with CAS. Two additional articles address advances in intervention for CAS: One looks at the efficacy of adding prosody as a treatment component, and the other explores a model-based treatment protocol.
Updates on Vocal Fold Paralysis SIG 3
Format(s): SIG Perspectives and Exam
These Perspectives (SIG 3) articles provide a comprehensive update on evaluation and management of unilateral vocal fold paralysis. Multidisciplinary evaluations are addressed in addition to various medical and behavioral treatment options.
Speech, Surgical, and Psychosocial Considerations for 22Q Deletion Syndrome SIG 5
Format(s): SIG Perspectives and Exam
These Perspectives (SIG 5) articles focus on 22q11.2 deletion syndrome and the associated communication, feeding/swallowing, psychosocial, and surgical factors associated with this condition.
Cleft Palate Speech: What Do I Hear? What Do I Do? (On Demand Webinar)
Format(s): On Demand Webinar
Children with cleft palate often require speech intervention post-surgical repair to normalize their phonological learning of the high intraoral pressure consonants. In many cases, SLPs may find it challenging to differentiate between speech characteristics that are a result of persisting velopharyngeal insufficiency and those that are learned, habituated speech behaviors. This webinar will address both structural and speech challenges that can co-exist in children with repaired cleft palate so that SLPs in all clinical settings can help these children achieve their best outcomes for speech production.
A Language-Based Approach to Managing Echolalia (On Demand Webinar)
Format(s): On Demand Webinar
This webinar will discuss all aspects of echolalia, a complex and often misunderstood language phenomenon. The speaker will discuss the origins of echolalia and review the evidence that supports it as a positive indicator of language development. The speaker will describe how to perform ongoing assessment before and during mitigation, and share intervention strategies to facilitate the transition to self-generated language.
Clinical and Research Topics in Voice SIG 3
Format(s): SIG Perspectives and Exam
These Perspectives (SIG 3) articles provide learners with diverse information including valuable insight on considerations for the role of the speech-language pathologist in working with trans youth, keys to build a successful telepractice, and a review of the electrolarynx (past and present).
Stuttering: Addressing Child and Parent Attitudes and Behaviors
Format(s): Journal (Online)
Stuttering can have a negative effect on a child’s self-esteem and self-confidence. It also affects parents, who may not understand how to support their child. This journal self-study contains a selection of articles from the October 2018 American Journal of Speech-Language Pathology special issue based on sessions and posters from the 11th Oxford Dysfluency Conference. The conference, held every 3 years, seeks to integrate research and clinical practice in fluency disorders. Clinicians will be able to use the specific techniques and activities described in these articles to help parents and children approach stuttering differently and improve outcomes.
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Selecting Complex Intervention Targets for Children With Phonological Disorders (On Demand Webinar)
Format(s): On Demand Webinar
Children with phonological disorders make up a large portion of the caseload for school-based SLPs who work with students ages 3–7. But SLPs rarely use the complexity approach in treating these children due to a lack of familiarity with the approach, despite the evidence to support its use. This webinar walks clinicians step-by-step through how to apply the complexity approach so they can feel confident in this addition to their clinical toolbox. Presenter Holly Storkel uses case studies to illustrate how to select complex treatment targets.
 Perspectives, SIG 5, Vol. 3, Part 2, 2018
Format(s): SIG Perspectives and Exam
The articles address the coding system for health care billing relevant to speech-language pathology practice. Articles also address the role of the speech-language pathologist during velopharyngeal imaging assessments and implementation of a quality of life scale. Imaging methods, articulation analysis, speech sampling techniques, and clinical evaluation of velopharyngeal insufficiency-specific quality of life are outlined. Case studies are used to guide learning and illustrate how information from the evaluation impacts billing, patient quality of life, and collaboration between professionals for the assessment of velopharyngeal dysfunction.
Perspectives, SIG 5, Vol. 3, Part 1, 2018
Format(s): SIG Perspectives and Exam
The articles address the anatomy and physiology of the velopharyngeal mechanism and the development of velopharyngeal closure. Identification of muscle morphology related to velopharyngeal closure and velopharyngeal dysfunction is described. Additionally, assessment of the orofacial structures is outlined and a clinical checklist is provided.
Perspectives, SIG 15, Vol. 3, Part 1, 2018
Format(s): SIG Perspectives and Exam
Authors identify peer-reviewed academic and medical journal articles that examine typical neuroanatomical aspects and characteristics of the different types of dementia. The authors reinforce the importance of a thorough understanding of these neuroanatomical characteristics for differential diagnosis of dementias. Additionally, authors identify best practices for interprofessional education (IPE) for improving services provided to older adults. Studies have also shown that IPE activities may elicit positive changes in student perceptions toward older adults and other professions.
Improving Speech Skills Using Curriculum Content
Format(s): Streaming Video
Clinicians frequently find that children with speech sound disorders progress in intervention more slowly than desired, or they may make expected progress within sessions but not carry over or generalize improved speech skills to their daily activities. There is some evidence that using normalized speech sound intervention – treatment activities that reflect the real-world activities and interactions in which children communicate – can lead to more rapid increases in intelligibility. This course will provide participants with the knowledge and skills to implement normalized speech sound intervention using age and developmentally appropriate curriculum-based learning activities in which the production of speech sound targets is integrated in meaningful verbal and social interactions.
Perspectives, SIG 19, Vol. 3, Part 1, 2018
Format(s): SIG Perspectives and Exam
The article provided affiliates with novel information relevant to speech science, specifically room acoustics. In both practicing audiology and speech language pathology, as well as in speech and hearing science research, the space where the work is done is an integral part of the function. Hence, for all of these endeavors it can be important to measure the acoustics of a room. This article provided a tutorial regarding the measurement of room reverberation and background noise, both of which are important when evaluating a space’s strengths and limitations for speech communication. As the privacy of patients and research participants is a primary concern, the tutorial also describes a method for measuring the amount of acoustical insulation provided by a room’s barriers (walls, windows, and doors). Several room measurement data sets—all obtained from the assessment of clinical and research spaces within the authors’ department—are presented as examples in the article.
Perspectives, SIG 3, Vol. 3, Part 3, 2018
Format(s): SIG Perspectives and Exam
The articles provide readers with various perspectives ranging from outcomes in pediatric voice therapy, postural impacts on voice production, muscle tension dysphonia and multidisciplinary care, and how to apply basic exercise physiology principles to special populations.
Perspectives, SIG 3, Vol. 3, Part 2, 2018
Format(s): SIG Perspectives and Exam
The articles provide affiliates with information about pediatric instrumental examination and variations in vocal fold vibratory parameters and voice therapy approaches in the pediatric population. From there, authors explore the knowledge of the speech-language pathologist regarding how hormones effect voice function and concepts related to motor learning and voice rehabilitation.
Assessment and Treatment of Age-Related Voice Disorders (On Demand Webinar)
Format(s): On Demand Webinar
Voice disorders are a prevalent and persistent problem in older adults. As the number of people over age 65 continues to increase, SLPs likely will see a growing demand for their services to treat age-related communication problems, including disorders related to the “aging voice.” This webinar will explore the typical age-related changes in each of the three major subsystems involved with voice production (respiratory, laryngeal, and resonatory) and explain how these changes affect vocal quality and ability. The presenters also will discuss appropriate assessment and intervention options, providing an overview of medical, surgical, and behavioral treatments.
Advancements in Pediatric Single-Word Speech Assessment
Format(s): Journal (Online)
As caseloads grow and diversify, clinicians may question whether they are equipped with the necessary tools to address changing demands when it comes to working with children with speech sound disorders. The single-word naming task is a basic component of pediatric speech production assessment, but is there an adequate evidence base behind the use of single-word naming tools for all populations served? Are the items found in these assessments necessary and sufficient to diagnose speech sound disorders? The four articles in this journal self-study address such questions. The first article uses item response theory to examine which single-word items in a standardized assessment are most clinically informative. The second article is a systematic review of current speech sound production practices for children with autism spectrum disorder and ends with recommendations for assessment with this population. The third article examines whether assessments that are normed on monolingual kindergarteners are diagnostically sensitive for bilingual children with suspected speech sound disorders. Lastly, the fourth article reviews the relatively new literature on polysyllable assessment and provides detailed procedures for implementation.
Remediating Rhotic Distortions: Moving Beyond Traditional Approaches
Format(s): Journal (Online)
School-based clinicians generally agree that /r/ is one of the most challenging speech sounds to remediate. Despite research showing how persistent rhotic distortions can affect students’ social, academic, and even future employment prospects, some children are discharged from services because traditional approaches simply fail to work. This journal self-study offers a response to the frustration often experienced by clinicians and clients struggling with persistent errors by showcasing some exciting new methods in /r/ intervention. Three articles describe promising results of different types of biofeedback-visual-acoustic, ultrasound, and electropalatographic interventions that are gradually becoming more accessible to clinicians. These articles also explore how biofeedback methods and other intervention modifications can adapt the principles of motor learning to increase efficacy of articulation intervention. The fourth article is an exploration of self-entrainment theory to promote speech sound change through the use of hand gestures.
Perspectives, SIG 3, Vol. 3, Part 1, 2018
Format(s): SIG Perspectives and Exam
This Part of Perspectives provides readers with a new framework to consider voice training to offset vocal fatigue, how to use pathophysiology to choose therapy techniques, and an explanation of the characteristics of presbyphonia, along with the use of behavioral intervention to treat and prevent age-related voice changes.
Perspectives, SIG 5, Vol. 2, Part 2, 2017
Format(s): SIG Perspectives and Exam
This Part includes a paper addressing the study of the velopharynx using magnetic resonance imaging (MRI). The advantages and disadvantages of MRI as a clinical tool are discussed, as well as an overview of the underlying principles and standard assessment protocol using MRI.
Assessing School-Age Children With Speech-Sound Disorders (On Demand Webinar)
Format(s): On Demand Webinar
SLPs often assess school-age children for speech-sound disorders using a single, standardized test. However, this "one-size-fits-all" approach can yield results that do not account for the impact of speech-sound disorders on other aspects of academic performance. This webinar will describe steps to help SLPs develop clear rationales and clinical decision-making strategies to assess speech-sound skill areas more effectively and facilitate intervention planning.
Early, Persistent, and Remediated Speech Sound Disorders: There Is More to the Story (On Demand Webinar)
Format(s): On Demand Webinar
Do you wonder why you have children on your caseload who have had the same speech sound production errors for years? Do you wonder what you can do to help the 5th grader who continues to have trouble with the /r/ sound? Do you wonder what happens to these children after they are off your caseload? This webinar will discuss these and other questions that the presenter herself had as a practicing school-based SLP and that she now attempts to solve as a researcher. In this webinar, she will explore the factors that influence language, literacy, and cognitive skills for children with early, persistent, and remediated speech sound disorders. Discussion will include how SLPs can help these children more quickly as well as assessment considerations for ensuring the best outcomes from intervention.
Evidence-Based Assessment and Intervention for Cleft Lip and Palate
Format(s): Journal (Online)
The articles included in this journal self-study include evidence-based assessment and intervention practices for children with cleft lip and/or palate, a specialized population with which many SLPs have limited experience. The first article describes a clinical measure for quantifying nasal air emission using a nasal accelerometer. The second article illustrates the developmental timeline of typical velopharyngeal function in speech production and then compares it to what is seen in toddlers with repaired cleft. The third article offers treatment efficacy data for a naturalistic intervention with phonological emphasis for toddlers with cleft lip and/or palate. The final article examines a number of factors that can influence language development in internationally adopted children with cleft lip and/or palate.
Social and Vocational Impacts of Voice Disorders
Format(s): Journal (Online)
This journal self-study explores a variety of issues related to adult vocal health and how voice disorders affect social and work-related interactions. Articles examine prevalence rates of voice disorders among college students; self-reports of vocal use; issues that school workers confront that may affect vocal health; the impact of common workplace issues, such as heating and air conditioning levels, on vocal functioning; and how voice disorders may affect listener processing and comprehension.
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Speech Sound Disorders in Preschool and School-Age Children
Format(s): Journal (Online)
Children with speech sound disorders make up a large part of the caseload for many SLPs who work with preschool and school-age children. Speech sound disorders not only affect a child’s ability to communicate at a young age but also may lead to later speech and literacy difficulties. This journal self-study explores issues related to managing speech sound disorders, including assessment and treatment options. It also includes articles that identify predictors of future speech and literacy problems. Clinicians can use this information to help identify appropriate assessment tools and potential treatment options, as well as counsel parents and teachers of children who may be at risk for continuing speech and academic difficulties.
Beyond Cleft Palate: Differential Diagnosis and Treatment of Velopharyngeal Dysfunction
Format(s): On Demand Webinar
A history of cleft palate is the most common cause of velopharyngeal dysfunction (VPD), but there are many other causes, including other structural anomalies of the velopharyngeal valve, neurophysiological disorders that result in inadequate velopharyngeal movement, and even faulty placement of the articulators due to mislearning. Differential diagnosis of the cause of these VPD speech characteristics and the contributing factors is essential to determine appropriate treatment, whether it be velopharyngeal surgery, a prosthetic device, and/or intervention with an SLP. In this webinar, the presenter will show videos and discuss various causes of abnormal resonance and nasal emission due to non-cleft velopharyngeal dysfunction. The presenter will also discuss a variety of treatment options that are appropriate for various causes of VPD.
Discriminating Childhood Apraxia of Speech From Speech Delay
Format(s): Journal (Online)
Since the first description of a childhood speech disorder similar in presentation to adult onset apraxia of speech, much research has gone into identifying characteristics to help make diagnosis more accurate and reduce the known over-identification of childhood apraxia of speech (CAS). However, to date, there has been no conclusive diagnostic marker identified to differentiate CAS from other speech delays. The goal of the articles in this self-study is “to develop and validate a diagnostic marker that discriminates early and persistent CAS from speech delay.” The articles introduce the pause marker (PM) and discuss support for the PM as well as possible clinical and research uses with the development of an assessment tool, the Pause Marker Index (PMI). While the PMI is not yet ready for clinical application, the articles provide clinicians with information about the PM that they can begin to incorporate into assessment and treatment to better serve their clients.
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Treating Childhood and Adolescent Voice Disorders
Format(s): Streaming Video
Childhood and adolescent voice disorders are observed in multiple clinical settings, with many professionals having limited background or education to properly treat them. Pediatric voice disorders can have adverse effects on children and teens in classroom and social situations. This video course provides a plethora of practical information based on research and practice in a major pediatric hospital setting. Vocal hygiene, vocal function exercises, semi-occluded vocal tract exercises, and other specific techniques are discussed.
Aspects of Speech Sound Disorders
Format(s): eWorkshop
This course includes five recorded sessions from the 2016 online conference “Improving Intelligibility in Children With Speech Sound Disorders.” These sessions provide SLPs with new strategies to promptly treat children with unintelligible speech and describe a range of evidence-based treatment techniques to get to the heart of speech sound disorders quickly. Practitioners will be able to confidently make decisions about treatment planning, implementation, and modification.
Speech Sound Disorders in Schools
Format(s): eWorkshop
This course includes four recorded sessions from the 2016 online conference “Improving Intelligibility in Children With Speech Sound Disorders.” These sessions focus on treating speech sound disorders in public schools, providing intervention in an MTSS framework, developing curriculum-based speech sound intervention, and innovative approaches to service delivery.
Speech Sound Disorders in Special Populations
Format(s): eWorkshop
This course includes three recorded sessions from the 2016 online conference “Improving Intelligibility in Children With Speech Sound Disorders.” These sessions focus on speech sound interventions for special populations, including children with cochlear implants, autism spectrum disorder, cerebral palsy, Down Syndrome, and bilingual children.
Speech Sound Disorders: Impact on Language and Literacy
Format(s): eWorkshop
This course includes two recorded sessions from the 2016 online conference “Improving Intelligibility in Children With Speech Sound Disorders.” These sessions focus on the role of phonological representations, vocabulary, and working memory in assessment of children with speech sound disorders, as well as the importance of evidence-based phonological awareness intervention to enhance literacy success.
Treatment for Acquired Apraxia of Speech: Understanding the Evidence
Format(s): Journal (Online)
Acquired apraxia of speech (AOS) is a motor speech disorder caused by brain damage, such as from a stroke, and can range from only slight difficulty saying sounds and words to a complete inability to produce sound. Speech-language pathologists working with people with AOS often struggle to determine which treatments will work best to help those with this frustrating disorder. This journal self-study explores the research behind AOS treatment through an updated systematic review of the literature on AOS and exploration of outcomes of treatment for AOS that has been described in single-subject research. In addition, a discussion of a treatment using auditory masking is included, which builds upon and adds to the research on speech motor control. Clinicians will be able to apply the information in these articles to the treatment they provide and add to their arsenal of evidence-based treatment tools with confidence.
Elements of a Comprehensive Voice Evaluation (On Demand Webinar)
Format(s): On Demand Webinar
A comprehensive voice evaluation to create a complete profile of an individual’s voice capabilities and limitations requires both instrumental and non-instrumental methods. But many speech-language pathologists do not have access to the sophisticated equipment used to conduct voice evaluations in large, national voice centers. This webinar presents the objectives and a recommended methodology for completing a comprehensive voice evaluation with and without instrumental procedures. The speaker offers guidance to SLPs across work settings on approaches for achieving a comprehensive voice evaluation, making the most of your available resources.
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Evaluating and Enhancing Children’s Phonological Skills: A Systematic Approach
Format(s): Streaming Video
This session will examine how SLPs can better manage children with highly unintelligible speech who are making very slow progress. This presentation will provide a framework for evaluating and enhancing optimal phonological patterns.
Concepts in Voice Therapy
Format(s): Journal (Online)
Individuals with voice disorders present with a variety of symptoms that require both direct and indirect interventions, often from many disciplines. Behavioral treatment from SLPs has been shown to be both a useful adjunct to medical intervention and an effective primary treatment, depending upon the specific causes and symptoms each individual experiences. This journal self-study addresses issues in voice therapy, starting with an attempt to develop a classification system that captures all of the nuances of voice treatment so that researchers, clinicians, and others involved in treating voice issues can describe what occurs during treatment and identify how those components influence treatment outcomes. Additional articles contribute to the knowledge base of voice treatment by addressing the efficacy of long-used techniques such as phonation through thin tubes and straws, determining the state of the evidence for a specific voice disorder—paradoxical vocal fold motion, studying ways to improve adherence to voice treatment, and exploring the use of mobile biofeedback for learning and carryover. Clinicians treating individuals with voice disorders will benefit from this “hot off the presses” research that provides insight into the effectiveness of what they do and encourages new ways of thinking about and approaching treatment.
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Treatment Options for Childhood Apraxia of Speech (CAS)
Format(s): Journal (Online)
Childhood apraxia of speech (CAS) is a complex motor speech disorder that oftenrequires lengthy treatment and may contribute, like many other speech disorders inchildren, to academic and social difficulties. Speech-language pathologists treatingchildren with CAS need a solid understanding of motor learning principles and howtreatment for CAS differs from that of other speech sound disorders. This journal self-study addresses what is currently known about treatment outcomes for CAS andexplores specific treatment programs that have been shown to benefit children with CASand are supported by evidence. Information about incorporating biofeedback, which isnot commonly used in the treatment of CAS, is also discussed, with preliminary studiesshowing promising results. In addition to specific treatment programs and tools, adiscussion of how to structure and vary treatment tasks is included, with all studiesproviding recommendations that can be incorporated immediately int
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Treating Dysarthria in Adults
Format(s): eWorkshop
Using videos and case studies, this session demonstrates how to identify, assess, and document appropriate treatment goals, strategies, and outcomes for adults with dysarthria. The session uses the World Health Organization’s International Classification of Functioning, Disability, and Health classification system to evaluate clinical treatment approaches—including motor learning concepts—that address impairments of function, communication activity, and participation.
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Assessing Dysarthria in Adults
Format(s): eWorkshop
Using videos and case studies, this session explores clinical methods for using physical and behavioral observations to evaluate adults for dysarthria. Accurate differential diagnosis of dysarthria can help clinicians diagnose neurological conditions and aid speech-language pathologists and patients in managing these conditions.

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