Difficulty speaking (dysarthria)

Dysarthria is difficulty speaking that is caused by problems with the muscles used in speech. It can affect adults and children and can be a result of conditions such as stroke, brain tumour, Parkinson's disease and cerebral palsy.

Information written and reviewed by Certified Doctors.

Contents

Key Information

What should I do?

If you think you have this condition, you should call an ambulance or go to the hospital immediately.

How is it diagnosed?

If an emergency condition is not diagnosed immediately, dysarthria might be diagnosed after a communication assessment by a speech and language therapist. During this assessment, you might be asked to make specific sounds or talk about a familiar topic.

What is the treatment?

Speech and language therapy might improve your ability to talk by providing exercises and advice on overcoming difficulties.

Introduction

Dysarthria is difficulty speaking caused by problems with the muscles used in speech.

When it occurs in children it's usually the result of brain changes before or during birth and is known as developmental dysarthria.

Dysarthria can also develop later in life as a result of a head injury or a medical condition such as stroke or Parkinson's disease. This is known as acquired dysarthria.

A child or adult with dysarthria may be difficult to understand. Their speech may be slurred, imprecise or quiet. In some cases the individual will only be able to produce short phrases, single words or no useful speech at all.

If you or your child have dysarthria, you may find it helpful to see a speech and language therapist. Ask your doctor to refer you. Whether the condition improves or not with speech and language therapy depends on what has caused the dysarthria and the extent of the brain damage or dysfunction.

This page:

  • covers the causes and symptoms of developmental and acquired dysarthria
  • explains briefly how a speech and language therapist may be able to help
  • offers some communication tips

Different types of dysarthria

The causes of dysarthria in adults and in children are different. The symptoms depend on the underlying cause.

Acquired dysarthria (adults)

Dysarthria that occurs later in life usually results from a condition such as:

Speech can be affected in a number of ways by the above conditions. For example:

  • speech can become quieter or slurred
  • the voice can become hoarse or strained
  • patients may have altered speech rhythm or have hesitations in their speech

Dysarthria can affect the person's ability to engage in everyday activities and work. They may also drool and have swallowing problems.

Developmental dysarthria (children)

Developmental dysarthria is most commonly seen in children with cerebral palsy. This results from brain damage that occurred before or during birth.

Children with dysarthria often have shallow, irregular breathing and their voice and speech may be affected in any of the following ways:

  • the voice may be strained, hoarse or nasal, and they may drool, have difficulty articulating and have problems swallowing
  • the voice may be excessively loud and low pitched, and they may struggle to make tongue movements
  • the voice may be breathy and monotone, with fast, imprecise articulation of words
  • the voice may sound 'wet and they may struggle to make tongue movements and control lips

These problems can make communication very difficult and may affect the child's social interaction, employment and education.

How can a speech and language therapist help?

Speech and language therapists play an important role in identifying and assessing children and adults with dysarthria.

However, there's no guarantee that speech and language therapy can improve the speech of all patients with dysarthria. Treatment success depends on the timing, and the extent and location of the brain damage or brain dysfunction or the stage of the progressive condition that's causing it.

Diagnosing dysarthria

To assess the extent of the speech problem, a speech therapist may ask you or your child to try any of the following tasks:

  • make different sounds
  • talk spontaneously on a familiar topic
  • count numbers or recite days of the week
  • read a passage aloud

The speech therapist will also want to examine the movement of the muscles in your mouth and larynx (voice box), and may wish to make a recording.

Treating dysarthria

A speech therapist will try to improve and maximise your ability to talk, help you find different ways of communicating, and help you and your family adapt to the new situation.

They will work as part of a team of health professionals that includes people from the health, social and voluntary sector.

It's difficult to generalise about what will be effective, as successful treatment is determined by the patient's underlying condition and personal circumstances.

The speech therapist may recommend:

  • strategies to improve speech, such as slowing speech down
  • a programme of exercises to improve the volume and/or clarity of speech
  • assistive devices such as a simple alphabet board, an amplifier or a computerised voice output system

Some speech therapists may be able to offer a short loan of a communication aid.

Communication tips for carers

If you live with or care for a person with dysarthria, you may find the following advice helpful:

  • Reduce distractions and background noise when you have a conversation.
  • Watch the person as they talk.
  • After speaking, allow them plenty of time to respond. If they feel rushed or pressured to speak, they may become anxious, which can affect their ability to communicate.
  • Avoid finishing their sentences or correcting any errors in their language as this may cause resentment and frustration. Ask what the person prefers.
  • If you do not understand what they are trying to communicate, do not pretend you understand. They may find this patronising and upsetting. It's always best to be honest about your lack of understanding. You could ask for clarification by asking yes/no questions or paraphrasing - for example, say: "Did you ask me if I'd done the shopping?"
Content supplied by NHS Choices