Gap Education
Disoriented by Dysarthrias?
Tim Stockdale, SLPD, CCC-SLP
Reference: Duffy, 2020 (Motor Speech Disorders, 4th Edition)
Understanding motor speech disorders like flaccid, spastic, ataxic, hypokinetic, hyperkinetic, and unilateral upper motor neuron (UUMN) dysarthrias can be tricky. Here's a quick guide to help you navigate:
✅ Examine Primary Features:
Look for key characteristics:
Spastic: Slow, strained-strangled.
Flaccid: Short phrases, breathy voice, hypernasality, imprecise consonants (but features are variable depending on the cranial or spinal nerves impacted).
Ataxic: Irregular rhythm, "drunken" quality.
Hypokinetic: Variable rate, monotone (think Parkinson’s).
Hyperkinetic: Involuntary movements disrupting speech (think of laryngeal dystonia/spasmodic dysphonia.
Unilateral Upper Motor Neuron: Often mild features, imprecise consonants production, slow DDK production.
✅ Consider the Etiology:
What caused the damage? Stroke, trauma, degenerative disease?
✅ Identify the Lesion Location:
Is it affecting upper motor neurons, lower motor neurons, the cerebellum, the basal ganglia, or somewhere else?
✅ Search for Confirmatory Signs:
Muscle tone (hypertonia or hypotonia), reflexes, gait abnormalities, or tremors can support the diagnosis.
💡 Tip: Diagnosis often relies on a combination of speech characteristics, confirmatory signs, and understanding of the neural pathways. Treatment may focus on improving communication efficiency and compensating for lost abilities, not just on "strengthening."
See Duffy, 2020 (Motor Speech Disorders, 4th Edition) for more info!