After this course, you will be able to list factors that may contribute to hypokinetic dysarthria and speakers with Parkinson's disease (PD). You will also be able to describe at least two challenges for the assessment of speech in individuals with Parkinson's disease and how these challenges can be addressed. You will be able to list at least two behavioral modifications that are evidence-based practice treatment options for hypokinetic dysarthria in speakers with Parkinson's disease without deep brain stimulation (DBS). Also after this course, you will be able to describe the impact of deep brain stimulation on speech in speakers with Parkinson's disease. Finally, you will be able to describe how behavior modification treatments can be modified for speakers with Parkinson's disease and deep brain stimulation.
I am going to start out with a general introduction about the speech characteristics of people with Parkinson's disease and hypokinetic dysarthria. Then we will go into the discussion about the first article, which deals with factors that may contribute to hypokinetic dysarthria. This will be a review article and it has a lot of great information. We will spend quite some time on the article before moving on to the second article, which looks at various treatment approaches for hypokinetic dysarthria and compares their effects on speech intelligibility. This is very interesting work. The third article addresses the need to treat people with Parkinson's disease who had surgical treatment; that is, deep brain stimulation. This article will look at Lee Silverman Voice Treatment (LSVT) and how that works for people with deep brain stimulation.
Hypokinetic Dysarthria
I assume that many of you are familiar with hypokinetic dysarthria. The prominent speech characteristics, as described Darley, Aronson, and Brown (1969) a long time ago, include reduced vocal loudness and vocal decay, meaning that over time there is a fading in loudness. This is commonly known as hypophonia for people with Parkinson's disease. There are also hoarseness, harshness, and breathiness in the voice; reduced pitch and loudness inflection; and imprecise consonants and distorted vowels that make their speech sound very mumbled and slurred. There are also short rushes of speech called festinations. There are inappropriate pauses and hesitation to begin speaking, some dysfluencies, and voice tremor, especially when asked to sustain phonation over some time.
When I ask my students to identify different types of dysarthria based on speech samples, I notice that they often catch on to hypokinetic dysarthria first. This may be because it is a pretty unique type of dysarthria. For example, the accelerated speaking rate is not very common in people with dysarthria. Most people with dysarthria have slowed speech. It is easily recognizable and therefore it might be much easier to identify compared to some other dysarthrias. Also, the festinations and dysfluencies are fairly unique to hypokinetic dysarthria.
