Dysarthria - difficulty articulating

With dysarthria, speaking is more difficult because the muscles required for speech are not properly activated or controlled. A person knows what they want to say, but they do not always succeed in pronouncing the words clearly.
Speech can sound unclear, slow, monotonous, soft, or nasal. Sometimes it sounds as if someone is drunk, even though they are not. The speaking tempo and intelligibility may also vary.

Dysarthria is a neurological speech disorder. The cause lies in a disruption of the control of the muscles of the lips, tongue, jaw, palate, and vocal cords, among others.

In this case, muscle strength, muscle tone, coordination, and movement control may be affected.

Therefore, muscle paralysis is not necessarily present.

Dysarthria can develop suddenly, for example after a stroke or other brain injury.

Dysarthria can also occur in neurological conditions such as multiple sclerosis (MS), Parkinson's disease, and amyotrophic lateral sclerosis (ALS).

Everyday problems

You want to say something, but you are having great difficulty pronouncing the words correctly. Your speech is unclear, monotonous and nasal. The volume of your voice may also be too soft, or it may sound like you are speaking drunkenly.

With dysarthria, there is generally little control over speech due to a problem with the coordination (use) of the muscles of the lips, tongue, palate, and vocal cords. The problem with lip coordination can also be caused by muscle paralysis.

Characteristics of dysarthria

• Unclear to unintelligible speech
  

• Change in speaking tempo: patients start speaking faster and faster or, conversely, speak very slowly and drawlingly
  

• Monotonous speech: everything is said in a single tone and words in a sentence receive insufficient or no emphasis

   

• Too high or too low voice pitch
  

• The voice may sound hoarse or be very soft
  

• Shallow and weak breathing or, conversely, very audible inhaling and exhaling
  

• Involuntary repetition of syllables, word parts, or phrases (not to be confused with stuttering).
  

• Speech may sound hesitant due to syllables being pronounced separately, or the syllables may flow into each other too much.

Brain areas involved in dysarthria

In dysarthria, various brain regions and nerve pathways that control the speech muscles and regulate their movements may be involved.

Examples include the motor cortex, the basal ganglia, the cerebellum, and the brainstem. Damage to nerve pathways connecting these areas can also cause dysarthria. Which areas are affected partly determines how the speech disorder manifests.

Possible areas involved include, for example, the motor cortex, the basal ganglia, and the cerebellum. Damage to the nerve pathways and nerves that control the speech muscles can also cause dysarthria.

Tips for people with dysarthria

• Take your time to speak. Try not to speak too fast.
• Take breaks. Fatigue can reduce intelligibility.
• For important conversations, preferably choose a time when you have sufficient energy.
• If necessary, use assistive communication, such as writing, typing, or a text-to-speech app.
• A speech therapist can help find suitable ways to improve intelligibility and communication.

Tips for conversation partners

• Give people time to speak and do not simply finish sentences for them.
  
• Ensure a quiet environment with as little background noise as possible.
  
• Did you not understand something? Then ask for it to be repeated or check what you think you heard.
• Continue to address the person directly, even when they are using a communication aid.
• If necessary, ask targeted questions that can be answered with yes or no.
  
• Do not confuse difficulty speaking with difficulty thinking or understanding.

Dysarthria, speech apraxia, and aphasia may occur simultaneously after acquired brain injury.

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