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GENERAL OVERVIEW DYSARTHRIAS - Coggle Diagram
GENERAL OVERVIEW
DYSARTHRIAS
WHAT?
= a group of neurologic speech disorders that reflect abnormalities in the strength, speed, range, tone,
or accuracy of movements required for respiratory, phonatory, resonatory, articulatory,
or prosidic aspects of speech production
A Core Motor Speech Disorder
Largest portion of speech impairments
in 60% patients after a stroke
TYPICAL COMPONENTS
Speech Examination
Different types of speech samples (connected speech, words sampling most phones, low semantic predictability)
Multiple areas are targeted (e.g. phonation, intelligibility)
Phonation
(atypical voice quality, changing pitch and loudness)
Articulation
(stress-testing, repetition of simple and complex, multisyllabic words/phrases, to check timing, direction, force, placement)
Prosody: use of variation
(questions, contrastive stress, reading statements)
Intelligibility: comprehensibility, efficiency
(in %, not very reliable, filling in gaps!)
Standardised + audioperceptual approaches
Nonspeech
Examination
Cranial nerve exam
Observation of dentition appearance of
oral mucosa and secretion management
Assessment sustained vowel prolongation
(to determine lung and larynx function)
Assessment of overall body posture and breathing pattern
Diadochokinesis task
(to check motor performance based automation)
Case History
Education, vocation, and background
Patient and family report
Review of status (e.g. mental health)
Communication facilitators and barriers (e.g. anxiety)
Medical diagnosis and history
(etiology, onset and course, associated deficits, medical procedures, hospitalisations, medical and rehabilitation referrals, medications and their potential side effects)
Other Domains
Cognitive communication
Swallowing function
Language
Fluency
DIFFERENTIAL DIAGNOSIS
With Aphasia
Dysarthria affects speech production
Aphasia also affects language!
(comprehension and production)
Speech delays and revised content
are more common in Aphasia
With Apraxia of Speech
AOS mostly affects articulation and prosody
Dysarhria also affects phonation
Dysarthria has more consistent error patterns
and less variety in articulatory erros
No muscle weakness in AOS
MAIN CHARACTERISTICS
Disorder of movement
Categorised into different types
Neurologic origin
LOCALISATION
Hypokinetic
(basal ganglia control circuit, control, rigidity)
Hyperkinetic
(basal ganglia circuit, control, involuntary movement)
Ataxic
(cerebellar control circuit, control, incoordination)
Unilateral Upper Motor Neuron
(unilateral UMN, execution/control,
weakness, spasticity, and incoordination)
Spastic
(Bilateral UMN, execution, spasticity)
Mixed
(e.g. spastic-flaccid)
Flaccid
(LMN, execution, weakness)
ASSESSMENT
Contextual factors
Impact on communication and quality of life
Limitations in activity and perception
Impairments in body structure and function