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Treatment Efficacy Summary A MERICAN

SPEECH -LANGUAGE -
H EARING
A SSOCIATION

Dysarthria variety of augmentative/alternative


communication systems provide a Contributor:
(Neurological Motor Speech functional means of communication
Kathryn M. Yorkston, PhD
for individuals whose natural speech
Impairment) is not understandable.
University of Washington

Dysarthria is a neurological motor Information collected from ASHA’s


speech impairment characterized by National Outcomes Measurement
slow, weak, uncoordinated move- System (NOMS) reveals that outpa-
ments of the speech musculature. It tient speech-language pathology
results in reduced speech intelligibil- services are associated with
ity and reduced ability to function in improved intelligibility and commu-
communication situations, which nication functioning of patients.
can lead to social isolation and The data show that approximately
depression. Dysarthria can be two thirds of adults with diseases of
congenital (e.g., cerebral palsy) or the central nervous system (e.g.,
acquired (e.g., Parkinson’s disease, Parkinson’s, multiple sclerosis) who
brain injury, stroke). were unintelligible at the outset of
Effectiveness of speech treatment for treatment progressed to a level of
individuals with dysarthria has been increased communicative independ-
documented via group treatment ence and were intelligible to all
studies, single-subject studies, and listeners following speech-language
case reports. Study outcomes meas- pathology intervention.
ure improvements in muscle The role of the speech-language
strength and control, reduction in pathologist is to diagnose the severi-
consonant imprecision, and ty of the problem and develop and
improved speech intelligibility. implement a treatment plan to
Frequently, intervention focuses on improve speech. The speech-
specific components of the speech language pathologist will also coor-
production process. For example, dinate selection and use (via train-
recent reviews suggest that problems ing) of assistive technology. Staging
with the function of the soft palate of intervention is also crucial, partic-
can be treated effectively in individu- ularly for degenerative diseases such
als with traumatic brain injury and as amyotrophic lateral sclerosis,
stroke.i Effective treatments for because such diseases frequently
individuals with problems in respira- progress through a series of stages
tion or producing an adequate voice from mild speech impairment to loss
have also been reported.ii of vocal ability.
Effectiveness of speech treatment for
individuals with Parkinson’s
disease has recently been most
encouraging for intensive treatments
focusing on phonation, or the
production of vocal sounds.iii A

i Yorkston, K. M., Spencer, K. A., Duffy, J. R., Beukelman, D. R., Golper, L. tice guidelines for dysarthria: Management of velopharyngeal function.
A., Miller, R. M., Strand, E. A., & Sullivan, M. (2001). Evidence-based med- Journal of Medical Speech-Language Pathology, 9(4), 257–273.
icine and practice guidelines: Application to the field of speech-language iii Spencer, K. A., Yorkston, K. M., & Duffy, J. R. (in press, June 2003).
pathology. Journal of Medical Speech-Language Pathology, 9(4), 243–256. Behavioral management of respiratory/phonatory dysfunction from
ii Yorkston, K. M., Spencer, K. A., Duffy, J. R., Beukelman, D. R., Golper, L. dysarthria: A flowchart for guidance in clinical decision-making. Journal of
A., Miller, R. M., Strand, E. A., & Sullivan, M. (2001). Evidence-based prac- Medical Speech-Language Pathology.

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