W3b: Lecture 7 - Dysarthria in children Assessment

Question 1

What is childhood dysarthria?

Answer 1

Childhood dysarthria is a neurological speech disorder that affects neuromuscular execution and results in difficulties with articulation.

Question 2

What does “dysarthria” mean?

Answer 2

Dysarthria comes from “dys-“ meaning difficult or bad, and “arthron,” meaning articulation.

Question 3

What speech-related abnormalities are associated with childhood dysarthria?

Answer 3

Dysarthria affects the strength, speed, range, and accuracy of movement required for breathing, phonation, velo-pharyngeal function, and articulation.

Question 4

What are the effects of dysarthria on articulation?

Answer 4

It causes imprecise articulation.

Question 5

How does dysarthria impact breathing during speech?

Answer 5

Children with dysarthria may have shallow, irregular breathing and speak using small residual pockets of air.

Question 6

What resonance issues are common in childhood dysarthria?

Answer 6

Hypernasal speech and the audible escape of air through the nose during speech are common resonance problems.

Question 7

What voice issues can occur in children with dysarthria?

Answer 7

Children may have:
- an atypical voice quality
- a monotonous voice
- low-pitched voice,
- or their voice may be too loud or too quiet.

Question 8

How does dysarthria affect speech intelligibility and naturalness?

Answer 8

Dysarthria negatively affects both the intelligibility and naturalness of speech.

Question 9

What are some common causes of dysarthria in children?

Answer 9

• Stroke
• traumatic brain injury
• genetic syndromes (e.g., Down syndrome)
• cerebral palsy are common causes of dysarthria.

Question 9

What is cerebral palsy, and how is it related to childhood dysarthria?

Answer 9

Cerebral palsy is a group of developmental motor disorders affecting movement, balance, and posture, and it is one of the most common causes of childhood dysarthria.

Question 10

Why is cerebral palsy significant in paediatric rehabilitation?

Answer 10

Cerebral palsy is the largest diagnostic group in paediatric rehabilitation and the most common motor disability in childhood.

Question 11

What is the main aim of assessing dysarthria in children?

Answer 11

The aim is to:
- describe perceptual characteristics of speech
- identify affected speech subsystems
- assess the impact of dysarthria on speech intelligibility, naturalness, communicative effectiveness, and participation.

Question 12

Which speech subsystems are evaluated in a dysarthria assessment?

Answer 12

The subsystems evaluated are:
- articulation
- phonation
- respiration
- resonance.

Question 13

What other areas may be affected by dysarthria, apart from speech?

Answer 13

Dysarthria may also affect swallowing, language, and cognition.

Question 14

What do the NICE guidelines (2017) suggest about assessing children with cerebral palsy (CP)?

Answer 14

The guidelines recommend assessing concerns about speech, language, and communication, including speech intelligibility.

Question 15

What is one major issue highlighted in the assessment of paediatric dysarthria according to the NICE guidelines?

Answer 15

There is no standardised or agreed-upon paediatric dysarthria assessment tool.

Question 16

What are the key steps in diagnosing dysarthria in children?

Answer 16

Key steps include:
- reviewing medical information and developmental history
- assessing oromotor function
- assessing perceptual speech characteristics
- assessing the function of each speech subsystem
- assessing intelligibility.

Question 17

What early signs might indicate dysarthria in children according to Hodge (2004)?

Answer 17

Early signs include the persistence of infant reflexes, feeding difficulties, and dysfunction in non-speech activities.

Question 18

What can the assessment of oromotor function determine in dysarthria?

Answer 18

It can determine the presence and type of dysarthria.

Question 19

What aspects are observed during the assessment of oromotor function?

Answer 19

Observations include facial and neck muscle tone, movement of body parts used in speech (e.g., mandible, lips, tongue), and the range and consistency of movements

Question 20

What tool can be used to assess oromotor function?

Answer 20

Informal protocols or standardized tools like VMPAC or the Robbins & Klee Test can be used

Question 21

Is there a direct relation between the ability to produce oral movements in isolation and intelligible speech?

Answer 21

No, there is no direct relation between isolated oral movements and speech intelligibility.

Question 22

What does the Mayo Clinic Dysarthria Study-based rating system assess?

Answer 22

It assesses the severity of impairment in respiration, pitch, loudness, voice quality, resonance, prosody, and articulation on a five-point scale.

Question 23

What tasks are used to assess articulatory function in dysarthria?

Answer 23

Tasks include DDK tasks (diadochokinetic rate) and published assessments

Question 24

What speech subsystem functions are assessed by having the child perform tasks such as sustained vowels or changing pitch?

Answer 24

Respiratory and phonatory functions are assessed.

Question 25

How is the impact of speech system stress (e.g., speaking longer) evaluated?

Answer 25

It is evaluated by observing changes in rate, phonation, and articulation when the child speaks for longer periods or runs out of breath.

Question 26

How is intelligibility typically reported in assessments?

Answer 26

Intelligibility is reported as a percentage of words correctly identified by a listener or subjectively rated (e.g., mild, moderate, severe).