Medicines for Dysarthria

What it is

Dysarthria is a condition in which a person has difficulty speaking clearly because the muscles used for speech are weak, or are difficult to control or coordinate. Unlike aphasia (which is a difficulty with language itself), dysarthria is a problem with the physical production of speech — the person knows what they want to say, but the muscles that produce speech (in the mouth, tongue, lips, throat, and for breathing) do not work properly, so speech comes out slurred, slow, quiet, strained, or otherwise unclear. Dysarthria is caused by conditions that affect the brain, nerves, or muscles involved in speech, and there are many possible causes — including stroke (a common cause), head injury, brain tumours, and progressive neurological conditions (such as Parkinson’s disease, multiple sclerosis, motor neurone disease, and others), as well as conditions affecting the nerves or muscles, and cerebral palsy (present from childhood). The features of dysarthria can include: slurred, unclear, or mumbled speech; slow or effortful speech, or speech that is too fast; quiet or weak speech, or, in some, strained or harsh speech; changes in the rhythm, pitch, or tone of speech; and difficulty controlling the volume. The person’s ability to understand language, and their intelligence, are not affected by dysarthria itself (though the underlying condition may have other effects). Dysarthria can range from mild (speech slightly less clear) to severe (speech very difficult to understand), and can significantly affect communication and quality of life. The main support for dysarthria is speech and language therapy, which helps people improve the clarity of their speech and use strategies to communicate more effectively, and, where needed, alternative or supportive communication methods. Treating or managing the underlying cause is also important. The key messages are that dysarthria is difficulty speaking clearly due to weak or poorly controlled speech muscles (usually from a brain or nerve condition), that it affects speech production rather than language or intelligence, and that speech and language therapy and communication strategies help.

How it is treated

Dysarthria is managed with speech and language therapy to improve speech clarity and communication, alongside treating or managing the underlying cause and supporting the person; the approach depends on the cause and severity. First, the underlying cause is identified and managed — for example, treating a stroke (a common cause; sudden slurred speech can be a sign of a stroke and is a medical emergency), or managing a progressive neurological condition — and the dysarthria is assessed by a speech and language therapist to understand its nature and severity. The cornerstone of support is speech and language therapy: a speech and language therapist works with the person to improve the clarity and effectiveness of their speech and communication, which may include exercises to strengthen and improve control of the speech muscles, techniques to speak more clearly (such as slowing down, over-articulating, pacing, and managing breathing and volume), and strategies to make communication easier; the approach is tailored to the individual and the cause and severity. Where speech is very difficult to understand, or as needed, alternative and augmentative communication methods (such as communication aids, apps, writing, or other tools) can help the person communicate. For progressive conditions, therapy and support are provided as the condition changes, helping the person maintain communication for as long as possible and adapt. Supporting communication in everyday life is important: those around the person can help by giving time and attention, being patient, reducing background noise, and using strategies to aid understanding, and the person can use techniques and aids to communicate more effectively. Support for the emotional and social impact of dysarthria (which can be frustrating and affect confidence and relationships) is also important. Because dysarthria is a symptom of an underlying condition, managing that condition, and multidisciplinary care where relevant, are part of the overall approach. The reassuring messages are that dysarthria is a difficulty with the physical production of speech (not with language or intelligence), that speech and language therapy helps people improve the clarity of their speech and communicate more effectively (with communication aids where needed), and that treating the underlying cause and support for communication and the emotional impact all help; so accessing speech and language therapy and support, and patience and strategies from those around the person, are the keys to living with dysarthria. Sudden slurred speech should be treated as a possible stroke and needs urgent help.