Assessment of dysarthric speech: a case for a combined perceptual and physiological approach

Abstract

Traditionally, the assessment of dysarthric speech has mainly involved the use of perceptual evaluation measures. The inherent inadequacies of this method of assessment have resulted in the development of a range of instrumental assessment techniques to provide more objective analyses of the underlying physiological impairments of the speech apparatus in individuals with a dysarthric speech disturbance. The aim of the current study was to highlight the importance of a combined approach to the assessment of dysarthria with reference to two case studies of individuals with dysarthric speech: a 32-year-old adult who suffered a severe closed head injury and a nine-year-old child who experienced a cerebrovascular accident involving the basilar artery. Each subject was assessed using a battery of perceptual and physiological techniques. The results for each case indicated that instrumental measures were effective in identifying the severity and nature of the underlying physiological impairments in the various subsystems of the speech mechanism, and highlighted the importance of verifying perceptual judgements with instrumental measures. The results are discussed in relation to the value of a combined perceptual and physiological approach in determining an accurate evaluation and diagnosis of the dysarthric speech impairment and in defining appropriate treatment goals.