Management of dysarthria

Lowit, A. and Kent, R. D. (2016) Management of dysarthria. In: Aphasia and Related Neurogenic Communication Disorders. Jones and Bartlett, Burlington, MA, pp. 527-556. ISBN 9781284077315

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Abstract

Dysarthria is a disturbance in the sensorimotor processes of speech production associated with damage to the central and/or peripheral nervous system. Together with apraxia of speech (AoS; see Chapter 21, this volume), the dysarthrias comprise the motor speech disorders. In their classic text, Darley, Aronson, and Brown (1975) defined dysarthria as a speech disorder resulting from a weakness, paralysis, or incoordination of the speech musculature that is of neurological etiology. As will be discussed later in this chapter, this definition does not align completely with current concepts in neurology, especially in regard to the various syndromes in the category of movement disorders. Many dysarthrias are not accompanied by obvious weakness or paralysis, and incoordination is difficult to assess clinically. A more contemporary definition is from Duffy (2013): “A group of neurologic speech disorders resulting from abnormalities in the strength, speed, range, steadiness, tone, or accuracy of movements, required for control of the respiratory, phonatory, resonatory, articulatory, and prosodic aspects of speech production” (p. 4). Duffy expands this definition to indicate etiology (abnormalities of the central or peripheral nervous system) and associated motor signs or symptoms (weakness, spasticity, incoordination, involuntary movements, or excessive, reduced, or variable muscle tone). An alternative definition is given in a later section of this chapter following discussion of several background issues.