Dysarthria

About: Dysarthria is a research topic. Over the lifetime, 2402 publications have been published within this topic receiving 56554 citations.

Speech therapy and communication device: Impact on quality of life and mood in patients with amyotrophic lateral sclerosis

Abstract: Dysarthria has a drastic impact on the quality of life of ALS patients. Most patients suffering from dysarthria are offered speech therapy. Communication devices are prescribed less frequently. In the present study we investigated the impact of these therapeutic arrangements on quality of life in ALS patients. Thirty-eight ALS patients with dysarthria or anarthria, who underwent speech therapy and/or used communication devices answered three standardized questionnaires (Beck Depression Inventory - II (BDI), SF-36 Health Survey questionnaire (SF-36) and ALS Functional Rating Scale-revised (ALSFRS-R)) and were further interviewed about their experience with and benefit of speech therapy and communication devices. Most of the patients described a high impact of the communication device on their quality of life while the influence of speech therapy was rated less. By multiple regression analysis we confirmed an independent positive effect of communication device use on depression and psychological distress. In conclusion, communication systems improve or at least stabilize quality of life and mood in dysarthric ALS patients, and should be provided early in the disease course.

Guidelines for Speech Recording and Acoustic Analyses in Dysarthrias of Movement Disorders.

Abstract: Most patients with movement disorders have speech impairments resulting from sensorimotor abnormalities that affect phonatory, articulatory, and prosodic speech subsystems. There is widespread cross-discipline use of speech recordings for diagnostic and research purposes, despite which there are no specific guidelines for a standardized method. This review aims to combine the specific clinical presentations of patients with movement disorders, existing acoustic assessment protocols, and technological advances in capturing speech to provide a basis for future research in this field and to improve the consistency of clinical assessments. We considered 3 areas: the recording environment (room, seating, background noise), the recording process (instrumentation, vocal tasks, elicitation of speech samples), and the acoustic outcome data. Four vocal tasks, namely, sustained vowel, sequential and alternating motion rates, reading passage, and monologues, are integral aspects of motor speech assessment. Fourteen acoustic vocal speech features, including their hypothesized pathomechanisms with regard to typical occurrences in hypokinetic or hyperkinetic dysarthria, are hereby recommended for quantitative exploratory analysis. Using these acoustic features and experimental speech data, we demonstrated that the hyperkinetic dysarthria group had more affected speech dimensions compared with the healthy controls than had the hypokinetic speakers. Several contrasting speech patterns between both dysarthrias were also found. This article is the first attempt to provide initial recommendations for a standardized way of recording the voice and speech of patients with hypokinetic or hyperkinetic dysarthria; thus allowing clinicians and researchers to reliably collect, acoustically analyze, and compare vocal data across different centers and patient cohorts. © 2020 International Parkinson and Movement Disorder Society.

FOXP2-Related Speech and Language Disorders

Abstract: Clinical characteristicsAll FOXP2-related speech and language disorders, regardless of the underlying genetic alteration, have a core phenotype: childhood apraxia of speech (CAS), a disorder of speech motor programming or planning that affects the production, sequencing, timing, and stress of sounds, syllables, and words. All individuals with CAS – whether caused by an alteration of FOXP2 or of an unknown cause – have difficulties in automatically and accurately sequencing speech sounds into syllables, syllables into words, and words into sentences with the correct prosody. Additional findings in FOXP2-related speech and language disorders can include oral motor dyspraxia (difficulty planning or programming oral movements on command); dysarthria (a neuromuscular-based speech disorder that may affect nasal resonance, voice quality, prosody, and breath support for speech); moderate to severe receptive and expressive language disorder; and reading and spelling impairments. The underlying genetic cause of FOXP2-related speech and language disorders is either disruption of FOXP2 only (referred to in this GeneReview as FOXP2-only-related speech and language disorder) or large copy number variants (i.e., contiguous gene deletions), structural variants (i.e., chromosome translocation or inversion), or maternal uniparental disomy of chromosome 7 (UPD7) involving FOXP2 (here referred to as FOXP2-plus speech and language disorders). The genetic alteration determines if only speech and language problems are present (FOXP2-only-related speech and language disorder) or if more global developmental and behavioral issues are likely to be present as well (FOXP2-plus speech and language disorder). In FOXP2-only-related disorders, nonverbal (performance) IQ is typically more preserved compared to verbal IQ. Fine motor skills may be impaired (e.g., buttoning clothes, tying shoelaces), yet gross motor skills are normal. Autistic features and dysmorphic findings have been reported in a few affected individuals. In FOXP2-plus-related disorders oral motor deficits, global developmental delay, and autism spectrum disorder are common.Diagnosis/testingThe diagnosis of a FOXP2-related speech and language disorder is established in a proband by detection of one of the following: A large non-recurrent contiguous gene deletion that includes FOXP2 (52% of affected individuals). A sequence variant within FOXP2 (~29%). Maternal uniparental disomy of chromosome 7 (UPD7) that reduces FOXP2 expression (~11%). A structural variant (e.g., chromosome translocation, inversion) that disrupts FOXP2 (~8%).ManagementTreatment of manifestations: Optimally management of the speech and/or language disorder is determined by a speech pathologist based on the individual's findings (typically: presence and severity of CAS, dysarthria, language deficits, and literacy impairments). A clinical psychologist or neuropsychologist may provide strategies to help manage deficits in specific cognitive domains and an occupational therapist and physiotherapist can provide strategies to help with fine and gross motor deficits, respectively. Surveillance: Follow-up evaluations with standardized tests by a speech and language pathologist. Evaluation of relatives at risk: Clarification of the genetic status of pre-symptomatic relatives at risk identifies as early as possible those who would benefit from prompt evaluation for speech and language disorders and initiation of treatment.Genetic counselingRecurrence risk for sibs of proband with a FOXP2-related speech and language disorder depends on the genetic alteration: Non-recurrent contiguous gene deletions (80% are de novo and the remainder are inherited in an autosomal dominant manner) FOXP2 sequence variants (~70% are de novo and the remainder are inherited in an autosomal dominant manner) Maternal UPD7 (no increased risk to sibs) A structural variant (e.g., chromosome translocation, inversion. If one parent has a structural variant, the risk to sibs is increased and depends on the specific structural variant.) Prenatal testing and preimplantation genetic diagnosis are possible if the causative genetic alteration has been identified in an affected family member.

The grief response in neuropathologies of speech and language

Abstract: Loss and the feelings associated with it permeate all significant occurrences of aphasia, apraxia, and dysarthria. In aphasic, apraxic and dysarthric patients there is a painful separation from loved ones and valued objects, and reduced levels of functioning. Neurogenic communication disorders, and concomitantly occurring pathologies are frequently the source of many real and symbolic losses. They occur rapidly, with little time to prepare. Often the aware patient is overcome by loss and the human reaction to it: the grief response. This paper addresses the dimensions of loss and reactions typically observed in patients with neuropathologies of speech and language.

Frequency of consonant articulation errors in dysarthric speech

Abstract: This paper analyses consonant articulation errors in dysarthric speech produced by seven American-English native speakers with cerebral palsy. Twenty-three consonant phonemes were transcribed with diacritics as necessary in order to represent non-phoneme misarticulations. Error frequencies were examined with respect to six variables: articulatory complexity, place of articulation, and manner of articulation of the target phoneme; and change in articulatory complexity, place, and manner resulting from the misarticulation. Results showed that target phonemes with high articulatory complexity were most often misarticulated, independent of intelligibility, but low-intelligibility speakers reduced the complexity of target consonants more frequently. All speakers tended to misarticulate to the adjacent place of the target place, but this pattern was most prominent for high-intelligibility speakers. Low- and mid-intelligibility speakers produced more manner errors than high-intelligibility speakers. Based on these results, a two-part model of consonant articulation errors is proposed for CP-associated spastic dysarthia.