Dysarthria and Cerebral Palsy

Dysarthria is a motor speech disorder that is specifically caused by neurological injury. Individuals with dysarthria have difficulty speaking or speak unclearly, although their actual speech patterns are normal. These speech issues can manifest in words being unintelligible, too quiet, stilted or inefficiently expressed. When this disorder is extreme (resulting in a complete loss of speech), it is called anarthria.

The causes of dysarthria vary widely, but include strokes, brain tumors and cerebral palsy. Dysarthria often comes in tandem with difficulty swallowing (dysphagia) because speaking and swallowing use the same muscular structures.

Dysarthria specifically relates to the inability to properly control the muscles that allow an individual to form speech, such as the lips, tongue, vocal cords or diaphragm. These muscles may be weak, paralyzed, or not work together well.

Cerebral palsy is a neurological injury that can be caused by a number of factors, many of which include birth injuries. Cerebral palsy often causes speech difficulties due to lesions in the parts of the brain used in planning, executing or regulating the motor functions of skeletal muscles used in speech. There are variable degrees of impairment, ranging from mild weakness or paralysis to a complete lack of coordination of the motor-speech system.

Because speaking and swallowing use the same muscles, issues with speech can be identified far before a child even begins to speak. If a child chokes or coughs a lot during feeding, cannot handle secretions, regurgitates nasally, or has chronic colds, pneumonia or congestion, the parent may take the child to a doctor, who will diagnose the child with dysphagia. Because dysarthria and dysphagia occur together, patients can be diagnosed with both at once. Additional signs of dysarthria can include the following:

• Slurred or mumbled speech
• Speech that is difficult to understand
• Slow speech
• Very fast speech that sounds like mumbling
• Limited movement in the jaw, lips and tongue
• Nonstandard pitch and rhythm
• Voice quality changes (sounding hoarse, breathy, nasal, or stuffy)
• Trouble swallowing or chewing
• Drooling

A trained speech-language pathologist (SLP) can identify the nature and severity of this disorder and create a treatment plan to enhance speech production. These plans include exercises that can modify breathing patterns and movement of the lips, tongue and face in order to improve comprehensibility and volume. The SLP also can teach caregivers, family, and teaching staff strategies to better understand and communicate with individuals with dysarthria. In some cases, where the dysarthria is very severe, the SLP may recommend the use of alternative means of communication (AACs). A speech-language pathologist can also provide information on proper chewing and swallowing techniques, exercises to develop clearer vocalization patterns and management of frustrations related to communication.

Just because children cannot pronounce words clearly does not necessarily mean that they have an issue with understanding language. That said, the brain injury that causes cerebral palsy is known to also cause intellectual or cognitive impairments, so it is important to determine this on a case-by-case basis.