Disorders in motor speech refer to difficulty planning, coordinating or controlling the muscles required to produce clear and natural sounding speech. These disorders are typically the result of damage to the brain or nervous system from events such as a stroke, or traumatic brain injury, or as a result of a progressive, neurological condition (e.g. Parkinson’s disease, ALS).
There are two main types of motor speech impairments including:
Dysarthria: Impairments in speech resulting from reduced strength and/or coordination of the muscles of the speech mechanism (lips and tongue). Characteristics include:
- Slurred or mumbled speech
- Speaking too slowly or too quickly
- Speaking too softly
- Sounding monotone
- Sounding too nasal
- Changes in how your voice sounds
Apraxia: Impairments in the planning and execution of the voluntary movements that control speech despite normal muscle strength and tone. Characteristics include:
- Difficulty initiating speech sounds
- Groping for sounds
- Inconsistent errors
- Slow rate of speech
- In severe cases, an inability to produce any sound
If you or a family member are experiencing difficulty with motor speech, our team of speech-language pathologists can complete a formalized motor speech evaluation to best determine the presence and type of impairment and develop an individualized treatment plan to target your specific speech needs.
Motor Speech Evaluation: What to Expect
During your initial evaluation, one of our specialized speech-language pathologists will have you perform a variety of tasks to best evaluate the structure and function of the speech muscles as well as a perceptual assessment of your overall speech intelligibility and how these impairments impact your communication in your day-to-day life.
During the assessment, your clinician will perform a thorough oral motor examination in which they will observe the movements of your oral musculature and complete a comprehensive assessment of the different mechanisms that contribute to functional speech across a variety of tasks including repetition of sounds, words or sentences, reading aloud, and informal conversation.
Motor Speech Treatment
Treatment of motor speech disorders is tailored specifically to the patient’s individual impairments and functional communication needs. It often includes a variety of approaches such as:
Restorative Treatments: This approach focus on structured exercises to improve the strength and coordination for the different muscles and/or subsystems contributing to speech. The effectiveness of these types of treatments depends largely on the specific type and severity of impairment.
Compensatory Treatments: This approach focuses on improving speech through compensatory behaviors and involves the training and rehearsal of specific speech strategies such as:
- Slowing your rate of speech
- Using more breath to speak louder
- Exaggerating oral movements for speech
- Modifying the pitch and/or stress patterns to increase the naturalness for speech
Communication Partner Training: This approach focuses on training frequent communication partners (friends and family) on strategies to optimize functional communication such as:
- Modifying the speaking environment (e.g. reduce external noise)
- Standing face-to-face when speaking
- Asking for verification
Augmentative and Alternative Communication: This approach focuses on establishing alternative means of communication and is typically used for more severe and/or progressive impairments. Augmentative supports can be low-tech or high-tech and may include:
- Training the use of gesture and/or pointing
- Paper-based picture and/or writing supports
- Computer-based speech-generating devices that can be accessed through a variety of methods (e.g. touch, eye-gaze)
Our clinical staff also includes certified providers in LSVT LOUD™, a standardized treatment protocol aimed at maximizing communication in patients with Parkinson’s disease by improving vocal loudness and overall speech intelligibility. Our clinicians will perform a specialized evaluation in conjunction with our Otolaryngologists as indicated to determine candidacy and develop an individualized treatment approach.
In addition to individual evaluations, our clinicians are also team members of 2 multidisciplinary clinics.
The Parkinson’s clinic is held once a month. Patients have speech and swallowing screenings during clinic and are scheduled for full evaluations as needed.
The ALS clinic is held 3 days per month and patients experiencing speech and swallowing difficulties are seen each time they attend clinic as needed.