Cranial Nerves
Imprecise articulation of bilabial and labiodental sounds; flat face expression
Facial (CN VII)
Involves damage to more than one motor system
Mixed Dysarthria
Name one speech task commonly used in motor speech evaluation and explain why it is important
AMRs - assess the speed and regularity of repetitive articulatory movements
Sustained /ah/ or Max phonation time - This task assesses respiratory and phonatory control, providing information about voice quality, loudness, and breath support, which are often impaired in motor speech disorders.
Reading a standard passage- Reading aloud helps evaluate prosody, articulation, and overall speech intelligibility in a connected speech context.
Which dysarthria is most commonly associated with Parkinson’s disease?
Hypokinetic Dysarthria
Explain what the Final Common Pathway does
It is the last link in the movement system. It transmits neural impulses from the lower motor neurons to the muscles, resulting in actual speech movements, and is crucial for all motor execution in speech.
Tongue atrophy, fasciculations, imprecise lingual consonants
Hypoglossal (CN XII)
Caused by cerebellar damage; speech sounds "drunken" with irregular articulatory breakdowns and excess and equal stress
Ataxic Dysarthria
What is the purpose of SMRs (Sequential Motion Rate): “puh-tuh-kuh” repeatedly and quickly
Reveals breakdowns in coordination and sequencing
-differentials apraxia from dysarthria (more impaired in apraxia)
Mixed dysarthrias occur most frequently in which condition?
ALS
How might an impairment with respiration show in speech?
speaking in short phrases, audible inspiration, forced inspiration/expiration
Jaw weakness; difficulty with bilabial and lingual-alveolar sounds
Trigeminal (CN V)
Caused by lower motor neuron damage; breathy voice, hypernasality, and muscle atrophy
What might you suspect if you notice tongue fasciculation during oral motor exam?
Lower motor neuron damage
For which disorder is exercise is contraindicated and the patient actually requires frequent rest?
Myasthenia Gravis
How might an articulation impairment show up in MSD?
imprecise consonants, distorted vowels, increased errors with increased rate
Breathy voice, hoarseness, hyper nasality, reduced pitch variation
Vagus (CN X)
Involuntary movements like chorea, tics, or dystonia affect speech; often has variable prosody and articulation
Hyperkinetic Dysarthria
Why is it important to assess speech across multiple tasks?
different tasks assess different components. This helps to differentiate between types of motor speech disorders and reveals deficits that may only appear under specific conditions (ex: spontaneous speech vs. repetition).
What two dysarthrias does someone with ALS usually demonstrate?
Flaccid and Spastic
How might an error with phonation show up in MSD?
Pitch breaks, monopitch, voice tremor
Glossopharyngeal (CN IX)
Caused by bilateral upper motor neuron damage; strained-strangled voice and slow rate
Spastic Dysarthria
What is the purpose of instrumental methods in Evaluation?
To supplement perceptual judgments
Which type of dysarthria or usually more mild and often temporary; may include imprecise articulation and a harsh voice after a unilateral stroke
UMN Dysarthria
How might an impairment with resonance show up in MSD?
hypernasality, hyponasality, weak pressure consonants