Motor Speech Disorders

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Motor Speech Disorders

Dysarthria is a group of motor speech disorders resulting from brain damage. We use a lot of muscles to speak; in our face, lips, tongue, and throat, plus the muscles we use to breathe. With dysarthria, damage to the brain or nerves can cause weakness, paralysis, or incoordination in those muscles. This can make it very difficult for a person to speak, and listeners might have trouble understanding them.

Apraxia of speech (AOS) is another type of motor speech disorder. To speak—to make and form the sounds of a spoken language—we use a lot of brainpower. Our brains have to plan and program how and when our muscles need to move for speech. With apraxia of speech, damage to the brain blocks the channels that carry those messages, making it very hard, sometimes impossible, for a person to speak.

Signs & Symptoms

Though dysarthria and apraxia of speech are separate, distinct conditions, they can—and often do—occur at the same time, alongside problems with language (a.k.a. aphasia).

Individuals with dysarthria might demonstrate:

"Slurred" or "mumbled" speech that is difficult to understand
Speaking too fast or too slow
Speaking too softly
Facial paralysis or numbness
Involuntary movements of the head, face, or mouth
Pausing for breaths frequently and/or irregularly while speaking, maybe even in the middle of words
Speech that sounds robotic or choppy
Difficulty moving their jaw, lips, and tongue
Changes in their voice- they might sound breathy or hoarse

Individuals with AOS might demonstrate:

Difficulty saying sounds correctly
Trouble imitating sounds or saying sounds on their own; they might leave out, change, or add sounds.
Groping movements—trying to move their jaw, lips, and tongue into the right place while talking
Inconsistent errors; they might say a word correctly one time and incorrectly the next.
Automatic speech— being able to say everyday words and phrases, like "hello" or "thank you," without much trouble.
In the most severe cases, individuals are unable to say any sounds at all.

Causes

Dysarthria and apraxia of speech are both caused by brain damage. While apraxia of speech results from damage to a specific area, the part of the brain that controls muscle movements, dysarthria can result from anything that damages the brain. Listed below are examples of conditions associated with each motor speech disorder; keep in mind, the lists are not exhaustive.

Dysarthria

Stroke
Traumatic brain injury (TBI)
Tumors
Degenerative and/or progressive diseases– ALS, Parkinson's disease, etc.
Demyelinating and/or inflammatory diseases– MS, meningitis, etc.
Infectious diseases- AIDS, shingles, etc.
Vascular diseases
Toxic/metabolic diseases- hypothyroidism, heavy metal poisoning, etc.

Apraxia of Speech

Stroke
Traumatic brain injury (TBI)
Tumors
Surgical trauma- tumor resection, post-surgical inflammation, etc.
Degenerative and/or progressive diseases- dementia, ALS, etc.
- Sometimes, AOS is the first or most noticeable symptom of these conditions; in such cases, the term primary progressive AOS is used

Diagnosis

Only a qualified speech-language pathologist (SLP) can diagnose motor speech disorders, but a medical doctor must determine the underlying cause. Talk to your doctor if you, or a loved one, have trouble speaking. If you are unsure, you do not need a referral from a doctor to request an appointment with us. Our licensed SLP can conduct a free screening to check your speech production skills, then help you make an appointment with a doctor if needed. A screening will also help the SLP decide if she needs to complete a full diagnostic examination of your speech or language skills.

To diagnose motor speech disorders, our SLP will use a variety of tests and materials to take a look at how well you:

Move your lips, jaw, lips, and tongue

Breathe (for speaking)

Say sounds, syllables, phrases, words, and sentences.

Speak during conversation

Understand words, questions, directions, and stories.

She will also ask you questions about the problems you encounter, the areas you feel you need to work on, the goals you would like to accomplish in therapy, and more. She will combine all that information and use it to help determine a diagnosis, as well as recommendations for treatment and care.

Treatment

There are a variety of techniques and approaches for the treatment of motor speech disorders. At Connections: Speech and Language Therapy, our SLP will customize your treatment according to your preferences, goals, and areas of concern. After completing a comprehensive evaluation, she will create and provide you with a personalized treatment plan to best address your speech production needs. During therapy, our SLP will guide you through tasks, activities, and exercises carefully designed to target, and help you overcome, the challenges of your motor speech disorder.

Dysarthria

The type and severity of your dysarthria will determine the strategies you learn and use in therapy. They might include:

Learning to monitor your speech rate- and to slow down or speed up, as necessary
Breath support exercises- tasks to help you speak louder or increase the number of words you can say with one breath.
Imitating or repeating speech production of sounds, syllables, words, phrases, and sentences.
Re-learning to add inflection and emphasis to words by changing your pitch and tone while speaking

Apraxia of Speech

Treatment for AOS involves re-training your speech muscles so that they move and produce sounds correctly again. It can be difficult and, at times, very frustrating to struggle with things that you never had to think about before, but our SLP is here to help. The techniques and exercises you learn and use in therapy will depend on the severity of your AOS, though they might include:

Repeating sounds or syllables over and over to practice the correct mouth movements
Imitating the mouth positions and movements for speech sounds
Speaking in time with a beat, melody, or rhythm.

In the most severe cases, a person with a motor speech disorder might need extra help to communicate in a way others can understand. Often, this help comes in the form of augmentative and alternative communication (AAC). Click the link below to learn more about AAC and how it can help:

Learn more

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