Dysarthria or Apraxia of Speech

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Dysarthria or Apraxia of Speech?

• Dysarthria Apraxia
• Speech distortions Speech substitutions
• Consistent errors Inconsistent errors
• Little groping for sounds Groping for sound
  targets
• All speech affected Island of fluency
• Little difference in speech Fluent automatic
• types speech

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Types of dysarthria

• Flaccid dysarthria
• Spastic dysarthria
• Ataxic dysarthria
• Unilateral upper motor neuron dysarthria
• Hyperkinetic dysarthria
• Hypokinetic dysarthria
• Mixed dysarthria

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Flaccid dysarthria

• Hypotonia breathy voice, hypernasal
• Lesions to lower motor neurons
• LMN are located in cranial and spinal nerves
• Cranial nerves important to speech
• V. Trigeminal nerve jaw movement
• VII. Facial nerve lower half of face
• IX. Glossopharyngeal nerve velum
• X. Vagus nerve larynx (closure and lengthening)
• VII. Hypoglossal - tongue
• Myasthenia gravis

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Spastic Dysarthria

• Stiff, rigid muscle tone
• Strained, strangled speech
• Most commonly caused by stroke affecting the
  brainstem
• Must have bilateral damage

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Ataxic Dysarthria

• Poor muscle coordination
• Weak muscle tone
• Caused by damage to cerebellum

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UUMN Dysarthria

• Caused by damage to upper motor neurons on one
  side
• Speech difficulties are minimal usually and often
  only during early stage following brain injury
• Usually caused by single stroke affecting Middle
  Cerebral Artery
• Can co-occur with Brocas aphasia or RHS,
  depending on hemisphere of damage

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Hyperkinetic Dysarthria

• Damage to the extrapyramidal system
• Tremors present
• Tics present
• Involuntary movement can be quick or slow
• Dystonia slow movements
• Chorea quick movement

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Hypokinetic Dysarthria

• Caused by lesions to extrapyramidal tract
• Muscles become rigid and stiff
• Most common cause is Parkinsons Disease

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Treatment

• Treatment is provided according to process of
  speech that is affected
• Articulation
• Intelligibility drills placement cues
• Resonance
• prosthesis medical intervention
• Prosody
• Contrastive stress drills
• Phonation
• Hypoadduction or hyperadduction exercises
• Respiration
• Controlled respiration/phonation tasks chunking