Dysarthria and Aphasia.

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Dysarthria and Aphasia      


Dysarthria and Aphasia

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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 or harsh.
        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.

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Therapy for dysarthria focuses on maximizing the function of all systems. Compensatory strategies are often used. Individuals with dysarthria may be advised to take frequent pauses for breath, to over-articulate, or to pause before important words to make them stand out. If there is muscle weakness, they may benefit from performing oro-facial exercises. This helps to strengthen the muscles of the face and mouth that are used for speech.

Most dysarthric speakers need more time to get their message across. It helps to allow them extra time and to listen face to face. When you have not understood what ...

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