Hypokinetic Dysarthria Case Study

The Sounds in Words subtest of the Goldman Fristoe Test of Articulation – Third Edition (GFTA-3) was administered to assess L.R.’s speech sound inventory. The Sounds-in-Words subtest was used to elicit L.R.’s spontaneous speech production of single words using pictures and/or verbal cues. The subtest also assesses articulation of speech sounds in all word positions at the single word

On the articulation subtest of the DEAP X produced errors /ϴ/→ /f/, /ð/ → /d/ in all positions, as well as /k/→ /t/ and /g/→ /d/ in initial position. She also produced /ts/ → /tʃ/ in the final position of a word. X produced lateralizations of /ʃ/ and /s/ in all positions. The phonology subtest assess phonological processes in both single words and connected speech. On the phonology subtest she demonstrated fronting of /k/→ /t/ in initial position and blends. The single word-connected speech subtest indicated inconsistent errors when fronting /t/→ /k/. The scores based on the three subtests indicate the client produces distortions of /s/ and /sh/, as well as typical simplifications for /k/, /g/, /ϴ/, and /ð/

For some people the level of dysarthria is so high that understandable speech may not be an option. In this case, they learn other methods of communicating. Some people may use alphabet

Kee was diagnosed with a minor articulation disorder during kindergarten after being referred to a speech-language pathologist by school officials. Although Kee was born in the United States and spoke solely English his entire life, his family was relatively new to the country and had to adjust to both the culture and the language. While there are no known causes for articulation disorders, Kee’s difficulties with language during the early stages of his life may have resulted from his interactions at home, a diminished discrimination ability, or that articulation disorders are most prominent in males.

Once it was determined that the participants met the inclusion criteria, all patients began to undergo testing to evaluate the fatigue during conversation and the impact of “warm ups” on speech production. The testing required all individuals to complete 3 consecutive trials of continuous speech for a minimum of 10 minutes each, so that researchers could compare each participants initial and final trials to determine the amount of change in speech productions related to the amount of time the individual has spoken for (de Swart, 2004). Within the 10-minute time span that participants were given to speak, they were required to first complete AMRs (e.g. papapa, tatata, kakaka) to determine maximum repetition rate (MRR), then read aloud, and then finally produce AMRs again. In addition, maximum sounds prolongation (MSP) was measured via sustained vowel production of /a/ and voiceless consonant productions of /s/ and /f/. Finally, participants were asked to rapidly say the months of the year. Once all of the speech samples were collected, researchers compared the trials to determine if the negative effects of myotonia decreased with increased length of speech

How can our daily lives be if we only whispered? What about having a breathy or strained voice? For many, these questions do not come across when communicating. Yet, several do not realize the different types of voice problems that individuals have. Day by day numerous people are being diagnosed with Spasmodic Dysphonia. The majority do not understand what it is or how it can be treated. Researchers have begun conducting studies to identify brainstem functions with patients with Spasmodic Dysphonia, determine the risks, and develop the best recovery treatment for this disorder.

Even though PD is predominantly a motor system disorder, mental health problems such as depression and dementia, and disturbed sleep are frequently encountered non-motor impairments. Several studies indicate that depression, above any other factors, is the major determinant of decreased quality of life, affecting not only the patients themselves yet their family and carers. Meanwhile, it is likely that the patient age poses a high risk of developing dementia. Another problem need to be taken into account is orthostatic hypotension which may further contribute to the occurrence of falls in the late stages of PD. In addition, autonomic disturbances consisting of urinary incontinence, erectile dysfunction, constipation, drooling of saliva, dysphagia probably ensue.

Parkinson’s Disease (PD) is a progressive neurodegenerative movement disease affecting approximately 1% of people at age 60. It is the most second most commonly occurring neurodegenerative disease in the elderly (after Alzheimer’s Disease). In PD patients, loss of dopamine-producing neurons results in a range of motor and non-motor symptoms. The prevalence of PD increases with age, and currently there is no cure, no means of slowing the disease progression, and no means of prevention.

In order to understand the possible etiology and the signs and symptoms, it is important to first recognize the science of PD and what happens neurologically. Nolden, Tartavoulle, and Porche (2014) explain that the brain structures affected by the disease are known as the substantia nigra and the basal ganglia. The role of the basal ganglia is to provide control of fine motor movements. What happens with PD, is there is a loss of dopamine-producing neurons from the substantia nigra which causes a deficiency in dopamine levels. Without a sufficient amount of dopamine, there are not enough chemical messages being transmitted to initiate, control, and balance movement of the target muscles. It is worth noting though, that dopamine levels decrease naturally as one ages, so symptoms could become more aggressive and prevalent the older an individual gets. Fallon et al. (2015) explains that the dying cells contain Lewy bodies, defined as protein aggregates, which allow the disease to be identified. However, it is still undetermined what all factors cause the degeneration of those brain cells and PD as a whole.

It has been found that there is no definitive factor causing PD and around 85-90% of cases occur at random.1 PD cases appear to have a connection to the patient’s genetic factors if they develop the disease younger than the age of 50. There have been multiple gene mutations recognized as possible risk factors for PD. The genome-wide association studies have specifically acknowledged alpha synuclein, tau, and HLA as potential risk factors. In addition to genetic factors, environmental factors have been identified as a prospective cause of PD cases in patients over the age of 50. Studies have postulated an increased risk of developing PD if exposed to factors such as pesticides and well water.

Suzie’s ability to accurately produce /d/, /t/, /k/, and /g/ in all positions during unstructured conversation independently was excellent during the session. Her ability to correctly produce /ð/ in all word positions at the word level was also extremely strong given a delayed model and visual cue. At times she produced a /d/ sound instead of

(CITATION) According to Duffy (2005) range of movement, tongue strength, speech rate and voice onset time for stops are reduced. There is an increase in phoneme to phoneme transitions, in syllable and word

Parkinson’s disease (PD) is a progressive and chronic neurodegenerative disorder. It affects about 1.8% of people over the age of 65 years, and has a higher prevalence in males. In general however, those who are of young onset PD tend to have a smoother course of the disease. Most doctors claim that Parkinson’s disease itself is not fatal. However, as symptoms worsen they can cause incidents that result in death (Michael J. Fox Foundation, 2012).

Flaccid dysarthria results from damage to the lower motor neurons (LMN) or the peripheral nervous system (Hageman, 1997). The characteristics of flaccid dysarthria generally reflect damage to cranial nerves with motor speech functions (e.g., cranial nerves IX, X, XI and XII) (Seikel, King & Drumright, 2010). Lower motor neurons connect the central nervous system to the muscle fibers; from the brainstem to the cranial nerves with motor function, or from the anterior horns of grey matter to the spinal nerves (Murdoch, 1998). If there are lesions to spinal nerves and the cranial nerves with motor speech functions, it is indicative of a lower motor neuron lesion and flaccid dysarthria. Damage to lower motor neurons that supply the speech

Wise et al. (1999) used positron emission tomography (PET) with 12 normal patients who completed three speech-related tasks. Results showed the left anterior insula was activated during repetition of words. Studies also show that anterior insula activity is correlated with increased complexity of consonant cluster production (e.g., /s/ is less complex then /st/). An fMRI study by Bohland & Guenther (2006) best demonstrated this. They used tri-syllabic words with varying cluster sequence complexity as stimuli. Activation was seen in the left insula, and this activity enhanced as complexity of clusters increased. It has also been suggested that the insula plays a role in production of sound sequences that are novel to the speech system, such as pseudowords and non-native syllables. Shuster (2009) found the anterior insula activation during repetition of pseudowords compared to repetition of real words. During Moser et al.'s (2009) study, normal speakers produced three-syllable words that contained either non-native or native syllables. Greater activation in the left anterior insula was found during non-native syllable repetition. Further, activation was greatest during the first 10 minutes of the experiment, and decreased slightly during the second 10 minutes, suggesting again, that novel articulatory patterns enhance anterior insula activation. The evidence proposed by Shuster and Moser emphasize that the insula plays a role in novel articulatory patterns, which is different from well-practiced