2 Diagnosing Dysarthria in Adults The point of departure for the current study is an analysis of the speech impairments observed in adult neurological patients speaking Polish. First, I analyzed the acoustic (phonetic) defects in order to identify the articulatory processes impaired by a neurological disorder. In the next step, I identified the group of speech sounds that are produced by these same articulatory processes in English and Spanish. This shall allow the diagnostician to focus observation on these specific groups of sounds, since their distortion may indicate impairment of the articulatory apparatus. This original, linguistically-grounded method of diagnosing dysarthric speech disorders, developed and tested in a neurological clinic for Polish-speaking patients, was adapted for the diagnostic needs of English- and Spanish-speaking patients (Gatkowska 2012). The new s p e e c h a s s e s s m e n t m e t h o d (SAM) tests the efficacy of the tongue, lips, and soft palate in speech production by incorporating selected sounds present in the phonetic system of a given language. Other diagnostic tasks to test articulatory organ function can be used irrespective of the patient’s language. Diagnostic tests to evaluate the intelligibility of speech, prosodic elements, phonation, and writing ability (distinctively misshapen letters are an indication for neurological diagnosis) have been adapted for individual languages, i.e. Polish, English, and Spanish. In developing the new SAM, I followed what may be described as a certain “happy medium” methodology, striving to strike an ideal balance between minimizing the number of diagnostic tasks required of the patient and maximizing the informational value of the tasks, in order to facilitate an accurate diagnosis of dysarthria. The discussion of SAM is illustrated with examples of its practical application. The attachment contains 19 recordings that illustrate diagnostic testing of various forms of dysarthria carried out at the Neurology Clinical Department, Collegium Medicum, Jagiellonian University in Kraków, Poland, between 2010 and 2011. The patients are speaking Polish, and so their recordings are subtitled in English. Various forms of dysarthria recorded in the films are described and interpreted in Chapter Five. A full list of diagnostic tasks and instructions given by the diagnostician is provided in the Appendix. Izabela Gatkowska Kraków, May 2019
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