Observation: conversational speech
Spontaneous Speech: "Tell
me about this picture."
Observation: vocal quality
Observation: Ability to vary:
L. (1979). Apraxia Battery for Adults. Austin, Texas: PRO-ED, Inc.
Duffy, J. R. (1995). Motor Speech Disorders: Substrates, Differential Diagnosis, and Management. St. Louis: Mosby - Year Book Inc.
Enderby, Pamela M. (1983). Frenchay Dysarthria Assessment. Austin, Texas: PRO-ED, Inc.
Hartman, D.E. & Dworkin, J. P. (1994). Aphasia, Apraxia of Speech, and Dysarthria. San Diego: Singular Publishing Group, Inc.
Robertson, S.J. (1987). Dysarthria Profile. Tuscon, Arizona: Communication Skill Builders, Inc.
|DISORDER||SITE OF LESION||ARTICULATION||PHONATION||RESONATION||RESPIRATION||PROSODY|
* Adapted from Hartman & Dworkin,
3. Well rehearsed utterances better than spontaneous utterances
4. Struggling behaviors to self correct articulatory errors
5. Initial phonemes more in error than final phonemes
Dysarthria: A specific disorder
of speech in which the muscles controlling articulation,
respiration, phonation, prosody, and resonation are affected, while basic language remains
in tact (White, 1997).
Ataxic Dysarthria: Damage of bilateral or unilateral cerebellar
hemispheric lesions or
damage to the cerebellar outflow tracts produce discoordination and dysmetria in the oral
speech musculature as well as the muscles of the axial and appendicular skeleton.
Speech Characteristics: Consonantal imprecision, omissions, and distortions
at word, phrase, and sentence endings. Speech has an intoxicated quality.
Diadichokinesis is slow and irregular, speaking rate and intonation patterns
are irregular, and voice quality is harsh.
Non-Speech Characteristics Signs of cerebellar disease include intention tremor, broad
based gait, nystagmus, and dysphagia.
Unilateral Upper Motor Neuron (UUMN) Dysarthria: Damage resulting from a focal
corticobulbar tract lesion of an isolated lacunar, internal capsule.
Speech Characteristics: Imprecise consonants, decreased loudness,
range, low pitch, short phrases and slow rate.
Non-Speech Characteristics: Contralateral central facial and tongue
hemiparesis, and hyperreflexia.
Spastic Dysarthria: Damage resulting from bilateral corticibulbar
bihemispheric disease along with involvement of periventricular white matter and
Speech Characteristics: Imprecise articulation, slow diadochokinesis, variable
hypernasality, nasal emissions, strain-strangled phonation, frequent lapses of laughing or
crying, decreased rate, and reduced breath support.
Non-Speech Characteristics: Hypertonicity, weakness, slowness of
hyperreflexia, "primitive" signs of sucking, jaw jerk, biting, grasping, increased palatal
reflexes, and Babinski responses. Weak oropharyngeal musculature places patient at
risk for dysphagia and aspiration.
Hypokinetic Dysarthria: Damage caused by unilateral or bilateral
lesions of the
substantia nigra or its projections. Characteristic of Parkinson's Disease
Speech Characteristics: Decreased loudness, reduced pitch inflections,
breathy-harsh voice. Variable articulatory precision and rapid diadochokinesis,
decreased loudness, silent intervals or inappropriate pausing followed by short rushes
of rapid speech.
Non-Speech Characteristics: Masked facial expression, positive glabellar
tremor, festinating bradykinteic gait, and flexed truncal posture. Dysphagia is an early
sign and dementia is a later one.
Hyperkinetic Dysarthria: Results from a lesion in the basal
ganglia or biochemical
Speech Characteristics: Imprecise articulation, irregular diadochokinesis,
prolongations of sounds, inappropriate silences between and among words, variable or
fast rate, vocal harshness, reduced pitch and loudness variations, phonatory arrest, and
tremor. When there is velopharyngeal and respiratory involvement, variable
hypernasality with nasal emission, and reduced and discoordinated respiratory support
is also evident.
Non-Speech Characteristics: Uncontrolled quick, slow, or tremulous
of the orofacial, trunk, and limb musculature. Palatopharyngeal myoclonus presented
in strap muscles of the neck, base of the tongue, posterior pharyngeal wall, soft palate,
and laryngeal musculature.
Flaccid Dysarthria: Damage caused by neuropathy (e.g., progressive
infarct, trauma), myoneuropathy (e.g., myastenia gravis, Eaton-Lambert syndrome), or
myopathy (e.g., myotonis dystrophy, polymyositis).
Speech Characteristics: Severity and extent of speech involvement depends
on the number of and degree to which the cranial nerves/ muscles and spinal
nerves/muscles are involved.
Bilateral IX and X nerve lesions - continuous hypernasality and nasal emission due
to velopharyngeal involvement; hoarse, gurgly voice, weak or absent cough,
dysphonia, decreased loudness and unstable pitch, short phrases, reduced
stress, decreased respiratory support for speech, inspiratory and/or expiratory
V, VII, and XII nerve lesions - imprecise, slow-labored articulation, reduced
Non-Speech Characteristics: muscle atrophy, fasciculations,
diminished or absent
reflexes, paralysis, paresis and limitation of movements.
Mixed Dysarthria: There are various combinations of dysarthria.
Listed below are
some disorders/diseases and the resultant mixed dysarthrias:
Amyotrophic Lateral Schlerosis
Multiple Schlerosis spastic-ataxic
Wilson's Disease ataxic-spastic and hypokinetic
Progressive Supranuclear Palsy spastic-hypokinetic-ataxic and flaccid