Neurogenic Orofacial Weakness and Speech in Adults With Dysarthria

Author:

Solomon Nancy Pearl1,Makashay Matthew J.1,Helou Leah B.12,Clark Heather M.34

Affiliation:

1. National Military Audiology & Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, MD

2. Systems Neuroscience Institute, University of Pittsburgh, PA

3. Department of Neurology, Speech Pathology, Mayo Clinic, Rochester, MN

4. Department of Communication Sciences and Disorders, Appalachian State University, Boone, NC

Abstract

Purpose This study compared orofacial strength between adults with dysarthria and neurologically normal (NN) matched controls. In addition, orofacial muscle weakness was examined for potential relationships to speech impairments in adults with dysarthria. Method Matched groups of 55 adults with dysarthria and 55 NN adults generated maximum pressure (P max ) against an air-filled bulb during lingual elevation, protrusion and lateralization, and buccodental and labial compressions. These orofacial strength measures were compared with speech intelligibility, perceptual ratings of speech, articulation rate, and fast syllable-repetition rate. Results The dysarthria group demonstrated significantly lower orofacial strength than the NN group on all tasks. Lingual strength correlated moderately and buccal strength correlated weakly with most ratings of speech deficits. Speech intelligibility was not sensitive to dysarthria severity. Individuals with severely reduced anterior lingual elevation P max (< 18 kPa) had normal to profoundly impaired sentence intelligibility (99%–6%) and moderately to severely impaired speech (26%–94% articulatory imprecision; 33%–94% overall severity). Conclusions Results support the presence of orofacial muscle weakness in adults with dysarthrias of varying etiologies but reinforce tenuous links between orofacial strength and speech production disorders. By examining individual data, preliminary evidence emerges to suggest that speech, but not necessarily intelligibility, is likely to be impaired when lingual weakness is severe.

Publisher

American Speech Language Hearing Association

Subject

Speech and Hearing,Linguistics and Language,Developmental and Educational Psychology,Otorhinolaryngology

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