Dysarthria in Friedreich’s Ataxia

Dysarthria is a collective name that refers to a group of movement disorders that affect the muscular control of speech, resulting in altered voice quality, speech clarity, and intelligibility. It can be caused by genetic ataxia, such as Friedreich’s ataxia (FA).

Dysarthria in Friedreich’s ataxia reduces the quality of life of people as it affects their ability to communicate and to participate in society.

How is speech generated?

Motor speech is controlled by the cerebellum, the part of the brain at the back of the skull, and a variety of structures in the upper half of the brain, including the “Broca’s area,” the sensorimotor cortex, and the basal ganglia. More than 100 muscles are required for clear speech. These control and generate a balanced respiration, phonation or the production of speech sounds, and articulation.

Research about dysarthria in Friedreich’s ataxia

Researchers have not yet found a direct relationship between speech motor impairment and FA. However, they discovered that the different dimensions of speech motor deficits are differentially associated with the quality and effectiveness of verbal communication, the scaling of speech motor deficits, and the duration and severity of ataxia. It is thought that the severity and progression of ataxia also may have an impact on the respiratory and vocal tract motor systems.

Is there a treatment for dysarthria?

Pharmaceutical studies have concluded there are no controlled behavioral treatments specific for dysarthria. However, there are treatment programs that can be applied to each individual after a comprehensive assessment by a specialist. These programs may include different speech parameters, such as respiratory support, speech rate, stress placement, and clarity of articulation.

Intensive courses such as the Lee Silverman Voice Treatment (LSVT), a speech therapy program for progressive neurological problems, have reported some improvements in phonatory and articulatory functions.

A speech therapist also may consider alternatives to LSVT to improve intelligibility and clear speech, such as producing shorter sentences, and taking more frequent breaths. People with FA may be taught to self-monitor their speech quality and identify speech strategies.

When speech intelligibility falls below 50 percent, or it has a significant impact on the quality of life of the person with FA, alternative and augmentative means of communication (AAC) may be considered. These include all forms of fundamental communication other than oral communication — pen and paper, an alphabet chart, and gestures and body language. High-technology aids with written and/or voice output also are available.

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