Alterations in speech represent a very active field of research in neurosciences, speech therapy, psychology and medicine. These are alterations that prevent functional communication, so they deserve attention that improves the quality of life of those who suffer from them. Among these types of alterations we can find dysarthria, which although it is not one of the most disabling alterations, it does represent a problem for those who suffer from it. Therefore, its correct diagnosis and treatment will be important. But what is dysarthria and how can it be treated? Throughout the article we will find the answers!
- 1 dysarthria
- 2 Dysarthria in children
- 3 Treatment of dysarthria
Dysarthria is an alteration in the control of the muscles involved in speech control. As Gallardo and Gallego (1995) define, "it is an alteration of the joint of lesions in the central nervous system, as well as diseases of the nerves or muscles of the tongue, pharynx and larynx, responsible for speech" .
This alteration can be caused by different causes, for example: paralysis, paresis, muscle weakness, slowing or difficulties in motor coordination. All of it It can be the secondary result of different diseases types of diseases or accidents: Parkinson's disease, stroke, multiple sclerosis, head trauma, lateral aminotrophic sclerosis, motor neuron disease or Hungtinton disease, etc.
Types of dysarthria
Darley, Aronsony and Brown produced in 1969 a list with seven subtypes of dysarthria. In 1994, Theodoros, Murdoch and Chenery, reduced subtypes from seven to four. Each of the subtypes is the result of a different physical pathology. The subtypes are as follows:
- Flaccid It is characterized by the Bulbar paralysis and affects reflexes and muscle tone. It causes hypernasality and monotony in speech, while significantly reducing phonatory ability and resonance.
- Spastic. Take with pseudo-bulbar syndrome. It causes spasticity and muscle weakness that affect the mechanisms involved in breathing, phonation, joint and prosody. It is characterized by inaccurate articulation, reduced tonic emphasis, rough voice, mono-volume and mono-tone.
- Ataxic. He has cerebellar syndrome. It is caused by alterations of basic neurological functions such as balance and coordination. In patients with ataxic dysarthria, generalized hypotonia and imprecision are observed in the movements that affect prosody, joint and phonation. Among its main features are excessive or monotonous tonic emphasis, irregular articular changes, poor voice quality and distorted vowels.
- Hypokinetic He has Parkinson's disease. Alterations of the extrapyramidal system are seen in regions of the base ganglia and in the upper nuclei of the brainstem. These alterations cause muscle stiffness and hypokinesia, tremor at rest, and also articulatory, prosodic and phonatory defects.
Each of these subtypes have their own symptoms, however, in general, the general symptoms of dysarthria are characterized by alterations in:
- The tone.
- The ringer.
- Voice volume
- The prosodic accent.
- Little control over saliva.
- Difficulty chewing and swallowing.
Dysarthria in children
Dysarthria, as an articular disorder, can also affect the younger population. Dysarthria in childhood can occur as consequence of cranial nerve injuries and / or cerebral palsy in childbirth or in the early stages of development. It can also be a consequence of severe congenital neurological disorders. Following these lesions there is an alteration in the central and peripheral nervous system that intervenes in the articular motor pattern. It is common to find alterations in the voice, prosody and breathing.
The treatment of dysarthria is performed, above all, from the field of speech therapy. However, it is very important to note that it is a work between patient, family and speech therapist. There are different jobs that can be carried out in the treatment of dysarthria. The treatment should be adapted according to the type of dysarthria that each patient presents, there are still a series of general exercises that can be applied in different cases.
In this modality, we find facial massages with the purpose of achieving adequate muscle tone as well as greater sensitivity outside and inside the mouth. Facial massages include massages on the face, lips and tongue.
Orofacial oral gymnastics work
They consist of jobs for recover the strength and mobility of the muscles of the face, tongue, lips, palate and cheeks. They are carried out through the realization of different types of movements with both the tongue, lips, cheeks and jaw.
Through this type of work, it is pursued improve the articulatory quality of the patient. It is carried out through the repetition of different phonemes in an isolated way to, later, combine them with vowels to form words and syllables. It also includes repetition and reading of tongue twisters, words, phrases, sayings and dialogue texts.
It is chased get a correct breathing technique. It is taught to catch air through the nose, take it to the diaphragm and expel it through the mouth. This exercise includes different positions that range from standing, sitting or lying down.
These types of exercises are performed with the objective of get the best intonation and rhythm of speech possible. Within the possibilities of each patient the best result will be sought. To do this you can use the repetition and reading of interrogative phrases, dialogues, songs and poetry.
Carrión, J., Viñals, F., Vega, O. and Domíngez-Morales, R. (2001). Spastic dysarthria: rehabilitation of the phonation of a patient with craniocerebral trauma. Spanish Journal of Neurospicology, 3(4), 34-45.
Gallardo, R. and Gallego, O. (1995). School speech therapy manual. Malaga: cistern.