Diagnosing Dysarthria in Adults. A New Speech Assessment Method for Polish, English, and Spanish

INTRODUCTION D y s a r t h r i a is the name of a class of organic speech sound disorders which impair the executive aspects of human speech, i.e. the function of the articulatory organs, the movements of the tongue, lips, and soft palate. The impairment of specific elements of the speech apparatus gives rise to qualitative changes in the speech sounds, possibly in tandem with shortened phonation duration and prosodic disorders, mainly affecting intonation and word stress. The speaker’s voice quality and pace of speech are also altered. This set of dysarthric symptoms in speech may appear secondary to a neurological disease, irrespective of the specific language spoken by the patient. Changes in the clinical picture of speech may sometimes become evident before the full manifestation of the neurological condition, therefore contributing to an earlier diagnosis. When speech changes are audible, professional speech analysis yielding a good and accurate diagnosis of dysarthria may be indicative of a particular neurological disease and thus confirm a neurological diagnosis, or – in the case of an unclear presentation – it may help resolve medical doubts. From the physiological perspective, human speech organs do not differ substantially, irrespective of a language spoken. Hence, when a dysarthria-causing disease impairs the function of the articulatory organs (mainly the tongue but also the lips and soft palate) and causes the phonation duration to be shortened, the pace of speech to be altered, and qualitative changes to arise in the patient’s voice, all these changes occur independently of the patient’s native language. We should interpret impaired prosodic elements similarly (mainly utterance intonation and word stress), as these changes are also independent of the language. Since the human speech apparatus is physiologically roughly the same in speakers of all languages, we may assume that its defects caused by dysarthria will manifest in speech in the same way. Granted, the phonetic systems (systems of speech sounds) of the Indo-European languages differ in terms of their inventory of sounds, sound length, prosody, accentual system, etc. However, speech apparatus defects will most likely manifest in the same speech sound groups produced by identical or similar articulatory processes across languages. The problem that the diagnostician faces, therefore, involves identifying those sounds in various languages and linking them to a specific disorder.

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