16 Diagnosing Dysarthria in Adults comprehend (Gatkowska 2002). They affect the sounds of speech, the quality of voice (which becomes fading, quiet, dull, hoarse, nasal or otherwise distorted), and the duration of breath, impacting on phonation time (the breath is typically shortened, while distorted air management causes short phonation). Other difficulties result from irregular interruptions in vocal emission and distortions in speech rate and rhythm. Still, the speech planning capacity, i.e. the word selection and sentence/utterance formulation, remains intact— all the pathological changes are confined to the realm of speech execution. Various types of dysarthria are often accompanied by d y s p h a g i a , due to which the patient experiences difficulties in swallowing saliva during speaking, sometimes even leading to s i a l o r r h e a , when thick saliva accumulates in the mouth and hinders speaking. Some patients complain about dryness in the throat or mouth, which additionally aggravates their discomfort. All these factors exacerbate the reception and comprehension of speech produced by a person affected by dysarthria. 2.1. PHONETIC DISTORTIONS Impairments in speech production appear both in aphasia and in dysarthria, with the latter as the main subject of our considerations.9 The two conditions are underpinned by different pathomechanisms, as is reflected in distinct phonetic impairments occurring in each case. Let us first consider the phonetic disorders accompanying aphasia. Aphasia is well known to affect the executive aspects of speech, but it does so in a different way than dysarthria, cf.: In comparative testing for aphasia, we examine the articulatory–acoustic performance of specific speech sounds functioning in the linguistic system as structural equivalents of phonemes, i.e. cortical patterns. The sounds produced by a patient are therefore analyzed with respect to their aphasia-conditioned phonetic and phonemic characteristics. (Mierzejewska 1993:152) According to Mierzejewska (1993), impairments due to Broca aphasia and Wernicke aphasia manifest themselves in all speech sounds with respect to all their articulatory–acoustic features. Any quantitative differences within articulatory groups are due to compensatory capacities depending on the severity of the basic condition. 9 The differences between dysarthria and aphasia are discussed in detail in section 3.1.
RkJQdWJsaXNoZXIy MTE5NDY5MQ==