Evaluation of Speech
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The presentation of voice and laryngeal functions provides important clues for the diagnosis of a wide variety of speech disorders, but voice is just one component of the speech production system. When a person talks, the overall message is formulated and conveyed by complex integration of movements by the respiratory, phonatory, resonatory, and articulatory subsystems, as well as its prosodic components. This chapter focuses on the evaluation of speech for adults with dysarthria. The speech-language pathologist conducts a thorough, systematic examination of the speech production mechanism including observations at rest and during functional and maximal performance tasks. Auditory perceptual evaluation of speech is rated according to multiple parameters loosely arranged by subsystem. Clusters of speech characteristics, corroborated by results from the physical/functional examination, lead to the differential diagnosis among seven categories of dysarthria. Careful differential diagnosis can support the neurological workup of the patient and can lead to appropriate management plans. In addition to overall severity of the speech impairment, intelligibility is often considered a global rating of speech effectiveness. However, intelligibility is usually better than the overall impression of speech impairment and can grossly underestimate the patient’s disability and difficulties with participation in life’s activities. This chapter provides a glimpse into the complexity and depth of the motor speech evaluation and its implications for functional communication in adults with dysarthria. Each section discusses the rationale and interpretation of assessment procedures, current controversies, and recent innovations.
KeywordsDysarthria Auditory perceptual assessment Speech production subsystems Respiration Phonation Articulation Resonance Prosody
The views expressed in this chapter are those of the author and do not reflect the official policy of the Department of Army/Navy/Air Force, Department of Defense, or US Government.
- 1.American Speech-Language-Hearing Association. Dysarthria in Adults n.d. https://www.asha.org/Practice-Portal/Clinical-Topics/Dysarthria-in-Adults/. Accessed 24 June 2019.
- 10.Baken RJ, Orlikoff RF. Clinical measurement of speech and voice. 2nd ed. San Diego: Singular; 2000.Google Scholar
- 11.Lombard L, Solomon NP. Laryngeal diadochokinesis across the adult lifespan. J Voice. 2019; https://doi.org/10.1016/j.jvoice.2019.04.004.
- 17.Enderby P, Palmer R. Frenchay dysarthria assessment. 2nd ed. Austin: Pro-Ed.; 2008.Google Scholar
- 19.Drummond SS. Dysarthria examination battery. Communication Skill Builders: Tucson; 1993.Google Scholar
- 20.Tanner D, Culberson W. Quick assessment for dysarthria. Academic Communication Associates: Oceanside; 1999.Google Scholar
- 21.Duffy JR. Motor speech disorders: substrates, differential diagnosis, and management. 3rd ed. St Louis: Mosby; 2013.Google Scholar
- 23.American Speech-Language-Hearing Association. Motor Speech Disorders Evaluation (template) n.d. https://www.asha.org/uploadedFiles/slp/healthcare/AATMotorSpeech.pdf. Accessed 24 June 2019.
- 27.Hixon TJ, Hoit JD. Evaluation and management of speech breathing disorders: principles and methods. Redington Brown: Tucson; 2005.Google Scholar
- 30.Patel RR, Awan SN, Barkmeier-Kraemer J, Courey M, Deliyski D, Eadie T, et al. Recommended protocols for instrumental assessment of voice: American speech-language-hearing association expert panel to develop a protocol for instrumental assessment of vocal function. Am J Speech Lang Pathol. 2018;27(3):887–905.PubMedCrossRefGoogle Scholar
- 47.Patel R. Assessment of prosody. In: Lowit A, Kent RD, editors. Assessment of motor speech disorders. San Diego: Plural; 2011. p. 75–95.Google Scholar
- 50.Shriberg LD, Kwiatkowski J, Rasmussen C. The prosody-voice screening profile. Communication Skill Builders: Tucson; 1990.Google Scholar
- 51.Kuschmann A, Miller N, Lowit A, Mennen I. Assessment of intonation. In: Lowit A, Kent RD, editors. Assessment of intonation. San Diego: Plural; 2011.Google Scholar
- 52.White L, Liss JM, Dellwo V. Assessment of rhythm. In: Lowit A, Kent RD, editors. Assessment of motor speech disorders. San Diego: Plural; 2011. p. 231–51.Google Scholar
- 57.Yorkston KM, Beukelman DR, Hakel M. Speech intelligibility test for windows. Communication Disorders Software: Lincoln; 1996.Google Scholar