Dysarthria Treatment

Posted by | January 27, 2011 | Dysarthria Treatment

DYSARTHRIA TREATMENT

Treatment partly depends on the type of dysarthria the individual presents with.  Go to the dysarthria diagnosis page to learn more about diagnosis.  However, many treatments can be applied to almost any dysarthria type.

No single approach is effective for every individual.  The treatment must be tailored toward each person.

Effective communication is the overall goal, not speech.  This is because someone with a very severe dysarthria may need to use alternative means.  This includes gestures, writing, or speech devices.  See the alternative means of communication tab for more information.  For an individual with a moderate dysarthria, the goal would be to compensate.  This is knowing that full restoration of speech will not occur.  The goal of mild dysarthria is to restore all of the lost function.

Treatment should only start after the patient is neurologically stable.  Treatment will focus on one or all of the parts of speech. This includes respiration, phonation, resonance, articulation, and prosody.

Respiration

Only work directly on respiration if the individual cannot sustain subglottal air pressure of 5cm of water for 5 seconds.  Maximizing vowel prolongation is a good goal for this and feedback can be provided by using a tape recorder or a Visipitch device.  Some patients need to work on practicing inhaling and exhaling deeply to improve coordination of their breathing.

Establish an optimal breath group, which is the number of syllables a patient can comfortably produce on one breath.  This can help a patient keep their utterances at the amount of syllables that makes their speech the most intelligable.  Try increasing the length of pharases or sentences that the individual can produce without the patient having to reduce the loudness or accelerate the rate of speech.

Pushing, pulling and bearing down during speech can help increase respiratory drive.  Also controlling exhalation by slowly producing a voicing uniformly can increase control of exhalation for speech.  The patient may need to stop speech earlier if they speak at the lower levels of the lung volume.  Increasing inhalation control may also be important if the patient is not initiating speech at the highest vital capacity.

Using appropriate posture techniques also aids in improving respiration.  A supine position is usually better for patients with an expiratory weakness.  Patients with inspiratory problems usually do better in a sitting up position.

Phonation
There are some medical interventions available for certain types of dysarthria.

Resonance
Velopharyngeal incompetance can be improved by pharyngeal flap surgery or palatal lift prosthesis.  There are some behavioral techniques that can be used to improve velopharyngeal function for patients with mild to moderate velopharyngeal dysfunction.

Overarticulation, reducing rate of speech, and increasing loudness can improve intelligibility.  Show overarticulation by opening the mouth more during speech.  Exaggerated movements increases oral opening for reduced nasality.  Reducing the rate of speech allows the velum more time to close the velopharyngeal port.  Also light articulatory touch on phonemes that have increased oral pressure such as stops, fricatives and affricates helps to reduce nasality.

Use feedback from a mirror under the nares to demonstrate nasality versus reduced nasality or clear speech.

Articulation

Determine which speech sounds your client has trouble producing. Slowing down the client’s rate of speech is one of the best ways to improve speech intelligability with individuals who have articulation errors.

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