Dysarthria Treatment in Kyiv

The question "can dysarthria be treated" concerns all parents whose child has this condition. Dysarthria is not only a speech disorder that arises when the brain centers responsible for speech mechanisms are damaged. Besides speech, dysarthria affects several areas of a child's development: speech motor skills suffer, pronunciation is impaired, and speech becomes unclear and indistinct.

Timely treatment of dysarthria in children may help avoid serious consequences and make speech understandable to others.

Classification, Forms and Types of the Disorder

Depending on the location of the damage, the following types of dysarthria are distinguished:

• cerebellar or ataxic: the pathways from and to the cerebellum are affected;
• bulbar or paretic: paralysis of the articulatory nerves and muscles;
• spastic or pseudobulbar: spastic paralysis and muscle hypertonia;
• extrapyramidal or subcortical: disruption of the subcortical nuclei;
• cortical: damage to the areas of the cerebral cortex responsible for the articulatory apparatus.

There is also a cold-induced type of dysarthria.

In addition, several other forms of the disorder are distinguished: afferent and efferent forms of cortical dysarthria, hyperkinetic and hypokinetic forms of extrapyramidal dysarthria, and mixed dysarthria in the case of multifocal damage.

The condition has four degrees of severity:

• first, mild (mild or "erased" dysarthria), when the speech impairment is noticeable only to a speech therapist;
• second, mild to moderate, when speech is understandable but has some defects;
• third, moderate, when the child is understood only within the family circle;
• fourth (severe), when speech resembles a set of sounds or is absent altogether (anarthria).

The condition can be acquired as a result of injuries or diseases, but congenital dysarthria is most often diagnosed in children.

Space-occupying brain tumors and the consequences of an acute cerebrovascular event can also cause dysarthria. The problem may occur in combination with abnormalities in an individual's prenatal and perinatal development. Dysarthria is common in patients with cerebral palsy.

Onset of Dysarthria in Children, Prognosis, Complications

The condition arises from impaired function of the muscles of the articulatory apparatus or of the mechanism that transmits impulses from the central nervous system, distorted communication with peripheral organs and difficulty controlling them.

As a result, the muscles of the speech apparatus develop poorly, and muscle tone is impaired. This leads to rigidity, spasticity and paresis. In this case, the mobility of the soft palate, lips and other speech organs suffers. These impairments cause articulation disorders. The defect extends to the entire speech apparatus and prevents clear pronunciation of sounds.

In the first two stages, in children with normal psychophysical development, full correction may be possible. The third and fourth degrees of dysarthria are accompanied by complex damage to the speech-motor analyzer, so the prognosis is less optimistic.

Nevertheless, the doctors of our Center aim to help make the child's speech as understandable as possible.

Complications

If treatment of dysarthria in a child is ignored, serious complications may follow. Difficult pronunciation leads to impaired perception of sounds, causing other consequences of dysarthria in children:

• poor school performance (difficulty with writing, answering at the board and reading);
• problems communicating with peers (ridicule, an inferiority complex, neuroses);
• difficulties with socialization (insecurity, fear of asking questions, obstacles to development).

In schoolchildren, dysarthria has a negative effect on personal life and future professional activity.

Symptoms and Signs of Dysarthria

The main sign of dysarthria in a child is impaired pronunciation of all words, not just of individual sounds.

The mechanisms of the condition are multifaceted, so the symptoms of dysarthria also vary:

• Impaired sound pronunciation.
  Problems with diction and unclear speech. A child usually has difficulty with hissing and whistling sounds. This may be accompanied by distortion of "r" and "l" or by dropping them altogether. As a result, the child's speech is slurred and indistinct.
• Eating problems.
  Children with dysarthria may avoid foods that require thorough chewing: meat, bread crusts, carrots, apples and so on. They eat messily and poorly and have difficulty chewing because of weakly developed cheek, tongue and lip muscles.
• Insufficient vocal responses.
  A child may have a voice that is too quiet and weak or, on the contrary, harsh. Talking is hard because of an impaired breathing rhythm. The child starts a phrase on the inhalation and breaks off when there is not enough air. As a result, speech is rapid or slow and often lacks emotional coloring.
• Poorly developed gross and fine motor skills.
  Children with dysarthria do not like to draw, model clay or play with small toys. They cannot button buttons or tie shoelaces. They are slow and tire quickly when they need to make complex movements and keep their balance (for example, standing or hopping on one leg).
• Difficulty with spatial orientation.
  A sign of dysarthria may be that a child confuses right and left.
• Other speech impairments.
  Besides poor pronunciation of sounds, the child finds it hard to build connected speech. The problem may be aggravated by drooling and overstrain of the facial muscles.

Each form of dysarthria has specific speech and non-speech impairments. For example, the erased form of dysarthria in children is characterized by difficulty chewing solid food. Only a qualified speech therapist can make an accurate diagnosis of dysarthria.

Prevention of dysarthria consists of early diagnosis of speech disorders and their correction.

Diagnosis of Dysarthria

It is very important to correctly distinguish speech disorders from similar conditions. In dyslalia, sound pronunciation is also impaired, but the brain centers are not affected. Alalia is characterized by systemic underdevelopment of speech associated with insufficient development of the speech centers, whereas dysarthria syndrome is caused by organic insufficiency of the innervation of the speech muscles.

The causes of dysarthria must also be identified. The diagnosis of dysarthria lies within the scope of neurology and speech therapy. Speech therapy testing is aimed at assessing speech parameters (coordination of the speech organs, sound pronunciation, coherence and productivity of speech) and non-speech parameters (development of the facial muscles, correct breathing during communication, range of movement of the temporomandibular joint). In addition to oral speech, the speech-language pathologist also checks written speech.

The neurologist determines the severity of reflexes and, when indicated, orders additional diagnostic procedures:

• electroencephalography (EEG);
• MRI of the brain.

A consultation with an otolaryngologist is also recommended for children with dysarthria.

Treatment of Dysarthria

Dysarthria is usually accompanied by other pathological symptoms, and the first step is to see a neurologist to determine its cause. The speech therapist assesses the articulatory organs and determines the level of speech development, after which a system of sessions is selected individually to correct speech and related problems (motor problems, feeding problems caused by weak facial muscles, and so on).

After the existing symptoms of dysarthria are identified, their comprehensive treatment begins. At CSM, experienced specialists work with the patient in the following areas:

• medical: prescribed by a pediatric neurologist and includes medication, therapeutic exercise, massage, acupuncture and device-based methods;
• social and educational: speech therapist, special education teacher, psychologist;
• sensory integration: focused on developing sensory functions such as auditory and visual gnosis, as well as memory and graphomotor skills;
• speech therapy: treatment of dysarthria is carried out individually to develop speech motor skills;
• device-based methods: inTime, BAC, TCMP, Forbrain.

The program includes speech therapy massage and exercises to normalize the tone and motor function of the facial muscles. The speech therapist works with the child's voice (strength, modulation) and conducts sessions on speech breathing and prosody. Attention is given to fine motor skills of the hands and to auditory therapy (the innovative inTime method).

Treatment of dysarthria in children aims to develop correct pronunciation of all sounds. The child receives phonemic hearing training and pronunciation correction. The specialist tries to elicit a specific sound and automate it in the flow of speech, followed by differentiation.

While communication skills are developed, the child learns self-control and the independent use of prosodic means.

The further task is to prevent speech disorders from recurring or to overcome them.

Preparing children with dysarthria for school includes psychological preparation for learning, prevention of errors and the development of graphomotor skills.

CSM specialists have extensive experience with the diagnosis of dysarthria, and the key to a positive outcome is an individually designed correction and therapy program.

Tips and Recommendations

Even with a diagnosis of latent dysarthria, a child should attend sessions with qualified specialists. At the same time, parents also need to make an effort:

• speak clearly and correctly, and be a model in conversation;
• exercise the child's jaw muscles by adding solid food to the diet: meat, apples, bread with a crust;
• develop speech and the cheek muscles: puffing out the cheeks, rinsing the mouth;
• do articulation exercises regularly;
• watch the symmetry of the movements of the lips, tongue and jaw during sessions.

It is important to follow the speech therapy sessions, tell the speech therapist about successes and setbacks, and follow the specialist's recommendations.

Which Doctor Treats Dysarthria?

The specialists to see for dysarthria are a speech therapist and a neurologist. With comprehensive rehabilitation at CSM, patients may make considerable progress in developing speech. You can have dysarthria treatment with us at a convenient time. Our doctors aim to help the child develop clear pronunciation sufficient for comfortable communication and socialization. For details, please call the numbers listed on the Center's website.

Sources

• Wikipedia
• Journal "Acute and Emergency Conditions in a Physician's Practice"