Dysarthria is a speech disorder caused by nervous system damage, with symptoms including vocalization disturbances, breathing or swallowing problems. Testing procedures help clinicians evaluate dysarthria and determine treatment approaches.
Dysarthria is a speech disorder that can present with related symptoms. These possible additional symptoms, including breathing or swallowing problems, are important factors in the evaluation of dysarthria. The manifestation of core symptoms, such as vocalization disturbances, also provide key information in the assessment. Both causes and symptoms help create the categorization system for assessing dysarthria. Since damage to the nervous system often sets the stage for this condition, neurological testing should also be considered a primary factor.
Several forms of nervous system impairment can cause damage to the muscles that control speech, leading to dysarthria. An individual could have a congenital birth defect that damages the nerves. Other conditions arise during the critical developmental years of childhood, such as cerebral palsy. Degenerative disorders, on the other hand, usually manifest at some point during adulthood, and constitute a progressive deterioration of function. Traumatic injuries, infections, or sudden bodily deficits such as stroke can also impair nerve functioning and cause different types of dysarthria.
The location of the nervous system damage will influence the presentation of symptoms and the degree of severity when assessing for dysarthria. In general, damage to the motor neurons in the cerebral cortex of the brain can cause the majority of abnormalities. For example, spastic dysarthria is diagnosed when these central nerve cells are damaged. Symptoms include the following: a strained voice; an inability to vocalize long sentences; confusion of consonants; and a low, slow pace of speech. Damage to the lower motor nerve cells that connect to muscles characterizes flaccid dysarthria, which usually results in fewer symptoms.
Motor nerve cell damage can also occur in the cerebellum of the cerebrum or in the basal ganglia, manifesting as ataxia dysarthria and hypokinetic or hyperkinetic dysarthria, respectively. Damage in either area can create some of the above symptoms or additional symptoms such as incorrect use of vowels, unusual tones, or prolonged pauses in speech. While individuals may experience damage to one area, mixed dysarthrias affecting several areas of the brain and nervous system are perhaps more common in dysarthria evaluation. Depending on the origin and severity of the impairment, individuals may have occasional speech difficulties or may suffer from long-term chronic speech abnormalities.
Because affected areas of the brain control more speech actions, other associated conditions can develop alongside the speech difficulties. Afflicted individuals, for example, offer a nasal quality to the voice. This effect is largely due to impaired breathing. Additionally, symptoms such as a strained voice are often the result of impairment of the primary nerves that control swallowing. On a psychological level, depression due to speech difficulties can present another wrinkle in the assessment.
Testing procedures such as the Frenchay dysarthria assessment that focus on speech patterns help clinicians evaluate dysarthria. The doctor will collect a speech sample from the patient and carefully examine what characteristics are present in the patient’s speech. For example, the doctor may notice abnormalities in the patient’s vocalization of small sound units or phonemes. Additionally, a physical examination of the mouth and facial area will be performed and any aberrations noted, particularly when the patient is speaking. Brain imaging tests and blood tests can help find out the source of the problem.
Considering all of the above factors, doctors will use an evaluation to determine what type of treatment approach is best for the patient. A patient’s individual response to these conditions can determine whether she will need long-term treatment and how well the treatment will work. For cases where symptoms are less severe, strengthening the speech-related muscles through repeating the vocalization can often facilitate improvement. If the symptoms are pervasive and the damage is in different areas of the nervous system, voice assistive devices may be a better option for treating dysarthria.
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