Difficulty speaking (dysarthria)

Dysarthria is difficulty speaking caused by problems controlling the muscles used in speech.

A child or adult with dysarthria may have:

slurred, nasal-sounding or breathy speech
a strained and hoarse voice
excessively loud or quiet speech
problems speaking in a regular rhythm, with frequent hesitations
"gurgly"-sounding or monotone speech
difficulty with tongue and lip movements
difficulty swallowing (dysphagia), which may lead to constant drooling

As a result of these problems, a person with dysarthria may be difficult to understand. In some cases, they may only be able to produce short phrases, single words, or no useful speech at all.

Dysarthria does not affect intelligence or understanding, but a person with the condition may also have problems in these areas. Speech problems can also affect social interaction, employment and education.

If you or your child has dysarthria, you may find it helpful to see a speech and language therapist. Ask your GP to refer you, or contact your nearest speech and language therapy clinic.

What causes dysarthria?

The muscles used for speech are controlled by the brain and nervous system. Dysarthria can develop if either of these is damaged in some way.

Dysarthria can either be:

developmental – when it occurs as a result of brain changes before or during birth, such as cerebral palsy
acquired – when it occurs as the result of brain changes later in life, such as damage caused by a stroke, a head injury, a brain tumour, or a progressive condition such as Parkinson's disease or motor neurone disease

Dysarthria in children is usually developmental while dysarthria in adults is often acquired, although both types can affect people of any age.

Whether dysarthria will improve with speech and language therapy depends on what has caused the condition and the extent of the brain damage or dysfunction. Some cases may remain stable while others may worsen over time.

How can a speech and language therapist help?

Speech and language therapists (SLTs) play an important role in identifying and assessing children and adults with dysarthria.

However, there's no guarantee that speech and language therapy can improve the speech of everyone with dysarthria.

Treatment success depends on the extent and location of the brain damage or brain dysfunction, or the stage of the progressive condition that's causing it.

Diagnosing dysarthria

To assess the extent of the speech problem, an SLT may ask you or your child to try any of the following tasks:

make different sounds
talk about a familiar topic
count numbers or recite days of the week
read a passage aloud

The therapist may also want to examine the movement of the muscles in the mouth and voice box (larynx), and may wish to make a recording.

Treating dysarthria

An SLT will try to improve and maximise your ability to talk, help you find different ways of communicating, and help you and your family adapt to your new situation.

They will work as part of a team of health professionals that includes people from the health, social and voluntary sector.

It's difficult to generalise about what will be effective, as successful treatment is determined by an individual's underlying condition and personal circumstances.

An SLT may recommend:

strategies to improve speech, such as slowing speech down
a programme of exercises to improve the volume or clarity of speech
assistive devices, such as a simple alphabet board, an amplifier, or a computerised voice output system

Some SLTs may be able to offer a short loan of a communication aid.

Communication tips

Tips for people with dysarthria

If you have dysarthria, you may find it helpful to:

take a good breath before you start speaking
put extra effort into stressing key words
speak slowly, saying one word at a time if necessary
leave a clear space between each word
make sure you are in the same room when talking and face your listener
attract the listener's attention (for example, by touch or calling their name) before you begin talking to them
keep sentences short and avoid long conversations if you are feeling tired
reduce background noise – for example, switch off the TV or radio
repeat yourself if needed

Tips for family, friends and carers

If you are speaking to a person with dysarthria, you may find the following advice helpful:

reduce distractions and background noise when you have a conversation
look at the person as they talk
after speaking, allow them plenty of time to respond – if they feel rushed or pressured to speak, they may become anxious, which can affect their ability to communicate
avoid finishing their sentences or correcting any errors in their language as this may cause resentment and frustration – ask what the person prefers
if you do not understand what they are trying to communicate, do not pretend you understand as they may find this patronising and upsetting – it's always best to be honest about your lack of understanding
if necessary, you could ask for clarification by asking yes/no questions or paraphrasing – for example, say: "Did you ask me if I'd done the shopping?"