Dysarthria is a motor speech disorder that can affect many aspects of speech. But what are the different types and how do you treat them?
In this post, you’ll learn:
- The 8 types of dysarthria
- Causes and symptoms of each
- Treatment ideas for each
Bookmark this page to open during evaluations and treatment. And visit our shop for print-and-go handouts and materials!
Should You Diagnose The Type of Dysarthria?
While some SLPs prefer to diagnose the type of dysarthria, others stick to a general “dysarthria” diagnosis plus severity level. Either way is fine!
If it’s hard to determine the exact type of dysarthria you’re seeing, no worries. Zoom out and remember that the goal of dysarthria treatment is to improve communication and quality of life.
To effectively treat dysarthria, you need to know the underlying cause of the dysarthria, severity level, and subsystem. This will help you write goals and measure progress.
For example:
The patient demonstrates moderate dysarthria (severity level) characterized by inadequate breath support, low vocal intensity, and rapid rate of speech (subsystems) due to Parkinson’s disease (cause).
Keep reading to learn more about the type of dysarthria and underlying subsystems.
More Dysarthria Resources
What Are The Types of Dysarthria?
Dysarthria can be categorized in different ways. For this article, we drew from Duffy’s research to identify 8 types (2020).
Below are the possible causes and symptoms of each. But keep in mind that these can vary from patient to patient.
1. Flaccid Dysarthria
Possible Causes
- Lower motor neuron damage
- Trauma
- Myasthenia gravis
- Gullain-Barré syndrome
Symptoms
- Weakness
- Breathiness, short phrases
- Hypernasality, nasal emissions
- Speaking on inhalation
2. Spastic Dysarthria
Possible Causes
- Bilateral upper motor neuron damage
- Amyotrophic lateral sclerosis (ALS)
- Traumatic brain injury (TBI)
- Multiple sclerosis (MS)
- Stroke
Symptoms
- Hypertonia
- Slow rate
- Strained vocal quality
- Pitch breaks
3. Hypokinetic Dysarthria
Possible Causes
- Parkinson’s disease
- Basal ganglia damage
- TBI
- Stroke
Symptoms
- Rigidity, reduced range of motion
- Rushed speech
- Monopitch, mono-loudness, flat affect
- Tremor-like oral-motor movements
4. Ataxic Dysarthria
Possible Causes
- Cerebellum damage
- TBI
- Stroke
- Degenerative diseases
- Infections
Symptoms
- Reduced muscle coordination
- Excess and equal stress
- Distorted vowels
- Lack of coordination in jaw, face, and tongue
5. Hyperkinetic Dysarthria
Possible Causes
- Basal ganglia damage
- Huntington’s disease
- Stroke
Symptoms
- Involuntary movements, motor tics, myoclonus
- Distorted vowels
- Intermittent vocal quality changes, hypernasality
- Excessive loudness variation
6. Mixed Dysarthria
Possible Causes
- Seen in Stroke or TBI with multiple areas of the brain affected
- ALS
- MS
Symptoms
- Various combinations of dysarthria types (e.g., spastic–ataxic, flaccid–spastic)
- Slow speech
- Prosody disrupted
- Hypernasality
- Strained voice
7. Unilateral Upper Motor Neuron Dysarthria
Possible Causes
- Stroke
- Tumors
- Focal trauma (surgical trauma, etc.)
Symptoms
- Irregular articulatory breakdowns
- Unilateral lower facial drooping
- Unilateral lingual weakness
- Hoarse vocal quality
8. Undetermined Dysarthria
Possible Causes
- CVA
- TBI
- Neurogenic disorders
Symptoms
- Perceptual features are consistent with dysarthria but don’t fit into any of the identified dysarthria types (ASHA, n.d.)
For a more complete list of symptoms, see ASHA’s Distinguishing Perceptual Characteristics and Physiologic Findings by Dysarthria Type.
Where To Start Dysarthria Treatment?
To start dysarthria treatment, focus on the speech subsystem (below) affecting your patient the most. You can pinpoint this by doing a motor speech assessment.
For example, your patient talks at the phrase level, has a quiet voice, and is about 70% intelligible. Your assessment shows that they talk at the phrase level because they run out of breath quickly. You start by treating respiration (breathing) because increased respiratory support will help your patient speak longer utterances and speak louder, thereby improving intelligibility and communication.
A different patient talks at the conversation level but is only about 30% intelligible because they talk so quickly and barely move their jaw and lips. You start by treating articulation because this will improve their ability to communicate and be understood by those around them the most.
Speech Subsystems
The 5 speech subsystems are:
- Respiration
- Phonation
- Prosody
- Articulation
- Resonance
How is each subsystem impacted by dysarthria? And how do you treat them? Keeping scrolling!
1. Respiration
Difficulties with respiration can look like difficulties with inhalation/exhalation, difficulties controlling breathing for speech, reduced breath groups when speaking, variable levels of loudness, or vocal fatigue.
Respiration Treatment Ideas
- Inspiratory checking
- Building up breath control
- Breath control exercises
- Diaphragmatic breathing
- Postural adjustments
- Respiratory muscle strength training
- Communication partner training
- Intelligibility tips
See the Motor Speech Pack for premade patient handouts and worksheets.
2. Phonation
Difficulties with phonation can look like variable pitch, pitch breaks, abnormal vocal quality (breathy, hoarse, harsh, rough, strangled), audible inhalation/stridor, vocal tremor, monopitch, or diplophonia.
Dysarthria Phonation Treatment Ideas
- Breath control exercises
- Treat vocal fold hypoadduction/hyperadduction
- LSVT LOUD, SPEAK OUT! or PLVT
- Communication partner training
- Intelligibility tips
See the Motor Speech Pack for premade patient handouts and worksheets.
3. Prosody
Difficulties with prosody can look like too fast/slow of rate when speaking, excessive stress or lack of stress, rushes of speech, or variable rate.
Dysarthria Prosody Treatment Ideas
- Practice sentence stress
- Practice heteronyms
- Communication partner training
- Intelligibility tips
4. Articulation
Difficulties with articulation can look like slurred speech, imprecise consonants, and dysfluencies.
Dysarthria Articulation Treatment Ideas
- Articulation cues
- Hierarchy of speech sounds
- Pacing board
- Communication partner training
- Intelligibility tips
See the Motor Speech Pack for premade patient handouts and worksheets.
5. Resonance
Difficulties with resonance can look like hypernasality, hyponasality, or nasal emissions/snorts.
Dysarthria Resonance Treatment Ideas
- Refer out velopharyngeal incompetence
- Learn more about how to treat resonance and hypernasality
(ASHA, n.d.)
Dysarthria Worksheets For Adults
Visit our shop for pre-made dysarthria treatment assessments, handouts, wordlists, and much more!
References
- American Speech-Language-Hearing Association. (n.d.). Distinguishing Perceptual Characteristics and Physiologic Findings by Dysarthria Type. Retrieved February 28, 2024, from https://www.asha.org/practice-portal/clinical-topics/dysarthria-in-adults/distinguishing-perceptual-characteristics/
- American Speech-Language-Hearing Association. (n.d.). Dysarthria in adults [Practice portal]. Retrieved Jan, 2024 from https://www.asha.org/Practice-Portal/Clinical-Topics/Dysarthria-in-Adults/
- Brewer, C. (2021). The Adult Speech Therapy Workbook. Harmony Road Design
- Duffy, J. R. (2020). Motor speech disorders: Substrates, differential diagnosis, and management (4th ed.). Elsevier.
- Jayaraman DK, M Das J. Dysarthria. [Updated 2023 Jun 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK592453/