15 2. Dysarthria: Changes in the Clinical Picture of Speech hemisphere. Temporary dysprosodic disorders including rhythm, rate (tempo), and expression impairments are sometimes reported to accompany cerebellum-related dysarthria (Kent et al. 1992; Pruszewicz 1992; Yorkston, Strand, Miller 1993). A commonly accepted c l a s s i f i c a t i o n o f d y s a r t h r i a t y p e s that I use in my clinical practice was offered by Darley et al. (e.g. Darley, Aronson & Brown 1969, 1975; Darley, Spriestersbach & Anderson [1963] 1978). The key criterion in their classification is the d om i n a n t s ymp t om of the disorder. Dysarthria etiologies vary, including degenerative diseases, cardiovascular diseases, or toxic diseases and other conditions. Their severity, though, is contingent on the location and range of the speech motor area lesion. Darley et al. distinguish the following types of dysarthria: – flaccid, – spastic, – ataxic, – hypokinetic, – hyperkinetic, – mixed (1969). This classification is also adopted in this study, albeit with a slight modification introduced to reflect the speech condition precisely. By this token, all mixed types of dysarthria will be described by a compound name, with the first part corresponding to the dominant form of dysarthria and the other part(s) corresponding to the signs and symptoms of other form(s) of the disorder, if any. This proposal has practical ramifications, since the speech condition is dynamic, and various dysarthric symptoms reveal at various stages of its course. In this way, if a patient has been accurately diagnosed, it is possible to follow the dynamics and symptoms of the speech disorder’s development by studying the patient’s medical history.8 If left without any modification, the general name “mixed dysarthria” obscures any relevant symptoms and becomes an umbrella term that could be used to cover all less clearly diagnosed cases. The details of such dysarthria classification are discussed in Chapter Four on dysarthria diagnostics, and the new terminology for mixed cases is dealt with in Chapter Five on dysarthria in neurological diseases. Speech produced by a dysarthria-affected patient is characterized by a number of a r t i c u l a t o r y d i s t o r t i o n s which make it difficult to 8 This diagnostically relevant information is part of the Speech Assessment Method proposed in here, cf. below.
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