DYSARTHRIA
What is dysarthria?
Dysarthria is a motor speech disorder typically caused by some sort of accident or illness that has attacked or injured the brain (i.e., stroke, traumatic brain injury, brain tumor, etc.) The accident or illness damages the portions/nerves of the brain that control the tongue, lips, vocal cords, and diaphragm (many of which are typically just referred to as the ‘articulators’). Dysarthria is typically characterized by muscles weakness and imprecise movements of said articulators.
Because it follows some sort of trauma or illness to the brain, a speech-language pathologist will typically conduct an assessment while the patient is still in the early stages of recovery. The sooner treatment begins, typically, the better the outcome. The outcome of treatment is also influenced by how extensive the damage to the brain is (i.e., the severity of the stroke or the traumatic brain injury). Unfortunately, dysarthria does not always present itself physically, but can also cause emotional distress for the individual with dysarthria. This can be due to frustration, sadness, or even anxiety and depression surrounding their inability to communicate effectively with loved ones and strangers.
There are several types of dysarthria that can be caused by different localized damage to the brain. The type a patient may have is dependent on where in the brain the damage has occurred and the severity of the damage to the brain. This is because more severe damage can cause more than one dysarthria to be present if several portions of the brain are damaged. Some of these different types of dysarthria include:
Flaccid: Breathy/nasally voice. Attributed to lower motor neuron damage.
Spastic: Strained voice with a slow rate of speech. Attributed to bilateral motor neuron damage or unilateral upper motor neuron damage.
Ataxic: Excessive stress. Attributed to cerebellum damage.
Hypokinetic: Rapid rate of speech. Attributed to extrapyramidal damage.
Hyperkinetic: Voice stoppages/inappropriate pauses. Similar to hyperkinetic, in that it is also typically attributed to extrapyramidal damage.
Spastic and Flaccid: Hypernasality and harsh vocal quality. Attributed to both upper and lower motor neuron damage.
DYSARTHRIA CAUSES
What causes dysarthria?
Several contributing factors can cause dysarthria or just one overarching issue can cause it as well. Some of the most common causes of dysarthria include:
Traumatic Brain Injury (TBI): A TBI can be caused by a variety of accidents or illnesses. Car accidents, falls, anoxic brain injury, etc. can all be attributed to dysarthria caused by a TBI.
Cerebrovascular Accident (Stroke): A CVA or otherwise known as a stroke, is when blood flow to the brain is disrupted in some manner.
Illness: Certain illnesses that attack the brain can cause dysarthria in some individuals. This could include certain types of cancers or degenerative diseases (i.e. brain tumor, Parkinson’s disease, multiple sclerosis, etc.)
The severity and specific symptoms of dysarthria can vary depending on the underlying cause and the extent of the damage. In some cases, dysarthria may be temporary and improve over time with appropriate treatment. In other cases, it may be a permanent condition that requires ongoing management and support.
DYSARTHRIA DIAGNOSIS
How is dysarthria diagnosed?
Dysarthria is usually diagnosed while an individual is still recovering from the accident or illness that has caused the dysarthria. An individual may be referred for a speech-language evaluation, either through inpatient or outpatient services depending on where they are in their recovery.The diagnosis usually involves a comprehensive evaluation by a speech-language pathologist (SLP):
Case History & Background: The SLP will review the patient’s medical history, as well as gather their own background from the individual/the individual’s family. Once this background is collected, and the speech-language pathologist has a grasp on where the patient was, speech-wise, prior to the event, they may follow up with an in-depth assessment.
Physical Examination: The SLP will examine the patient's mouth, tongue, and throat to look for any physical abnormalities or signs of weakness.
Speech Assessment: The SLP will listen to the patient speak and assess their speech intelligibility, voice quality, and articulation.
Depending on the results of this assessment and the background collection, the speech-language pathologist will suggest an individualized treatment plan that addresses the patient's specific needs and goals.
DYSARTHRIA TREATMENT AND THERAPY
How speech language pathologists treat patients with dysarthria?
Dysarthria treatment looks different for every individual, and is also dependent on the type of dysarthria/the location and severity of damage to the brain. A speech-language pathologist will try to individualize the speech therapy in order to most benefit the patient, while including the patient’s wants/needs as well as the goals of their caregivers. Some focuses of dysarthria treatment include:
Motor exercises: Muscular weakness is often associated with dysarthria, so motor exercises are often utilized to restrengthen said muscles as well as relearn coordination for speech.
Alternative forms of communication: An individual may need to learn alternative forms of communication, whether it be temporarily or long term. Some of these alternative forms of communication can include an AAC device (i.e., an iPad) or they can include a communication board or even just a notebook.
Speech drills: Another form of treatment for dysarthria can include speech drills. Similarly, to motor exercises, speech drills assist in the relearning and restrengthening of the articulators/muscles.
A speech-language pathologist can also offer emotional support as well as refer patients to professionals to assist in counseling, if that is something the patient is interested in and in need of.
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