Dysarthria and Aphasia
Dysarthrias or commonly known as Dysarthria, refers to a group of
speech problems where sounds may be slurred, and speech may be slow or
effortful. Noticeable changes in pitch, volume, and tempo of speech
occur. Speech can become nasal, and the voice can sound either breathy
Dysarthria occurs in both children and adults. Yorkston, Strand,
Miller, Hillel, and Smith (1993) found reduction in speaking rate to
be the strongest predictor of decrease in speech intelligibility.
Dysarthria is related to neuromuscular diseases such as cerebral
palsy, Parkinson's, Lou Gehrig's disease, or later stages of multiple
sclerosis. It can also occur from stroke, brain injury, and tumors.
The exact speech problem that occurs depends on the part of the
nervous system that is affected. Degenerative disease due to the
effects of upper and lower motor neuron changes; the speech of
individuals with ALS is classified as mixed (spastic and flaccid)
dysarthria (Duffy, 1995).
A number of subsystems must work together, for speech to be clear. A
weakness in any of the systems or lack of coordination between systems
can result in dysarthria.
If the respiratory subsystem is fragile, then speech may be quiet and
formed one word at a time. If the laryngeal system is weak, speech may
be breathy, too quiet and slow. If the velopharyngeal subsystem is not
working, speech may sound too nasal or nasal sounds may be missing. If
the articulatory subsystem is not working, speech may sound slurred,
may have many errors and may be slow and labored.
Treatment varies depending on the source, category, and intensity of
the problem. The main objective of treatment by a speech-language
pathologist is to help a person be able to communicate as clearly and
efficiently as possible. Treatment may involve teaching a person ways
to compensate for restrictions in muscle movement by techniques such
as talking in short sentences or emphasizing key sounds in words.
Changes in positioning of the body also may increase clearness.
For some people, speech is not a viable option. Substitutes or
augmentative systems are frequently used.As speech intelligibility
begins to decline, intervention focuses on maintaining functional
communication versus attempting to reduce speech impairment (Yorkston,
Miller, & Strand, 1995). Direct speech intervention is not recommended
for a number of reasons. First, exercise to fatigue may hasten
neurological deterioration. Speech drills may be so tiring that speech
adequacy for functional use in other settings would be compromised.
Finally, speech exercises emphasizing optimum performance can only
prove to be a discouraging reminder of increasing loss of ability.
Therapy for dysarthria focuses on maximizing the...