Question
What can you tell me about behavioral management techniques for rate, prosody, and naturalness in patients with dysarthria? What are some of the therapy techniques, and are they usually successful?
Answer
Management techniques for rate, prosody, and "naturalness" in patients with dysarthria vary depending on the type of dysarthria a person has. For example, if a person has a hypokinetic dysarthria then treatment strategies might include increasing volume or slowing the rate of speech. Whereas, for a person with spastic dysarthria, treatment strategies might include easy onset to decrease the hyperadduction of the vocal cords and/or increasing rate of speech. The same would hold true for prosody. Prosody is usually a major factor for individuals with ataxic, flaccid and/or hyperkinetic dysarthria, and less of a factor for individuals with spastic or possibly unilateral upper motor neuron dysarthria. As with any dysarthria type the goal of treatment should be to treat the aspect (i.e., rate, prosody, strength, speed, steadiness) of speech that produces the greatest functional benefit.
For treatment techniques that have "proven" to be successful (particularly with individuals with hypokinetic dysarthria) you might want to check out the Lee Silverman Voice Treatment (LSVT) web site. They have useful suggestions and a proven "track record" for research on hypokinetic dysarthria. Other good resources include:
Duffy, J.R. (2005). Motor Speech Disorders: Substates, Differential Diagnosis, and Management, 2nd edition. Elsevier-Mosby: St. Louis, MO.
Freed, D. (2000). Motor Speech Disorders: Diagnosis and Treatment. Singular: San Diego: CA.
Yorkston, K.M., Beukelman, D.R., Strand, E.A., and Bell, K.R. (1999). Management of motor speech disorders in Childrn and Adults, 2nd edition. Pro-Ed: Austin, TX.
Sandra L. Schneider, Ph.D. CCC-SLP, BC-NCD has been a practicing speech-language pathologist for over 20 years. She is currently an assistant professor at the Ohio State University, Columbus OH. She can be reached at schneider.291@osu.edu.
