Childhood Dysarthria

Childhood dysarthria is a motor speech disorder that generally happens due to the damage of the muscles that control speech. According to the American Speech-Language-Hearing Association (ASHA), people with dysarthia have weak  mouth and respiratory system muscles, which in turn affects their ability to talk. In fact, some people with dysarthia not be able to move their mouth muscles at all.  In cases of infant and childhood dysarthria, the baby may have developed the disorder due to a birth injury that resulted in brain trauma. In other instances, dysarthria existed at birth, due to congenital reasons. Although babies may have dysarthia, it’s usually unknown until they begin talking and exhibit the signs and symptoms of the disorder.

Symptoms of Childhood Dysarthria

The severity of the signs and symptoms childhood dysarthria depends on where the damage is in the nervous system. As a child grows and and begins to talk, dysthraria may become more noticeable via slurred speech and an abnormal speaking pattern. Their speech can range from talking too fast or talking extremely slow. According to the University of Rochester Medical Center, children with dysarthia are often difficult to understand when speaking.

Because of the damage to the mouth and facial muscles, children with dysarthia will have limited movement of the jaw, tongue, and lips. In addition, they may also have swallowing and feeding problems, as well as excessive drooling and saliva buildup.

Other symptoms of childhood dysarthria may include:

  • Making extremely loud sounds and/or extremely low sounds
  • Trouble with using the the correct annunciations
  • Hypernasal or hoarse voice, or a combination of both

Causes of Childhood  Dysarthria

Dysarthria is caused by a variety of disorders that can affect the nervous system, including:

  • Stroke
  • Tumors
  • Parkinson’s Disease
  • ALS (Lou Gherig’s Disease)
  • Huntington’s Disease
  • Multiple Sclerosis
  • Unknown nervous system damage

However, children who develop dysarthria typically do so if they’ve experienced a brain injury. In many cases they’ve also been diagnosed with cerebral palsy. Although not all children who have dysarthria also have cerebral palsy, since it is is marked by speech impairment that’s caused by lack of muscle control, many children diagnosed with dysarthia will also have cerebral palsy as well.

How is Childhood Dysarthria Diagnosed?

Physicians and Speech language pathologists (SLP) usually find diagnosing an infant or child with dysarthia extremely challenging. According to the National Institutes of Health (NIH), there is currently no child-based dysarthria diagnostic method. Therefore, SLPs have to depend on developmental speech models that aren’t made for dysarthria, or a neurobehavioural classification system, which have created to diagnose adults.

In general, however, physicians administer a physical examination to rule out any other medical conditions. The production of airflow is generally checked as well as the ability of the child to move his/her  tongue, mouth, and jaw. In addition, an MRI scan or CT scan may be utilized to take images of the brain, along with a feeding and drinking evaluation.

A respiratory function examination may also be carried out. In general, children are asked to perform a static blowing task, such as blowing bubbles into a cup of water, so that physicians can determine the strength of their subglottal pressure. If strong enough to blow bubbles, then children normally have enough subglottal pressure for speech.

A procedure named laryngoscopy may also be done, if the physician feels that it is needed. A viewing tube known as a laryngoscope is placed in the mouth during the procedure, which goes through the throat to view the voice box. A laryngoscopy helps by:

  • Detecting the cause of voice problems
  • Detecting, if applicable, the causes of ear and throat pain
  • Evaluates difficulty in feeding and swallowing

What is the Treatment for Childhood Dysarthia?

Depending on the severity of the disorder, childhood dysarthia treatment can include a wide range of oral motor strengthening exercises. In some cases, assistance with cognitive restructuring  of oral movement is done via  neuro-musculature electrical stimulation, typically to the lips and face. Other treatment options can include:

  • Strategies to improve articulation skills, which in turn will help speech sound more clear
  • Activities to reduce speech rate and help prevent utterances

In recent years, techniques such as LSVT speech and motor learning have become a popular treatment method for improving speech functions.  LSVT, also know as the Lee Silverman voice treatment, is widely practiced as a therapy for those with Parkinson’s Disease that develop dysarthia, but many of its techniques have been applied to a wide variety of dystharia patients, regardless of the cause.

Augmentive and Alternative Communication (AAC) devices that make coping with a dysarthria easier.. These allow people who are unintelligible, or may be in the later stages of a progressive illness, to continue to be able to communicate without the need for fully intelligible speech.

Toddlers and older children can use several different devices or techniques to help with speech, such as:

  • Computers for typing words and sentences
  • Flip cards that have words or symbols
  • Special computer programs that allow you to create spoken words by typing words or clicking on symbols
  • Electronic touch tablets, such as in iPad, to help communicate as well as learn new methods to help with speech

In extreme cases, surgery may be an option for treatment. This generally happens if hypernasality is a serious and untreatable problem.

What is The Long-Term Outlook of Childhood Dysarthria?

Depending on the cause of dysarthria, symptoms can greatly improve, stay the same, or sometimes worsen. For example, for children who experienced brain damage, the prognosis tends to be favorable as the brain injury typically will not worsen, which typically means that dysarthia will not worsen, and with appropriate treatment, may improve over time. In cases in which a patient has Parkinson’s disease or Lou Gehrig disease, they eventually go on to lose their speaking abilities, despite vast amounts of  treatment. This of course, has more to do with the physical aspects of the aforementioned diseases, which cannot be treated once patients are in the diseases’ advanced stages.

It’s important to note, however, that children developing Parkinson’s Disease or Lou Gherig’s disease is rare. In fact, the majority of people who develop these diseases are over the age of 40.