CSDS 213: Traditional Articulation Treatments for Dysarthria

Intelligibility Drills

Patient is given a list of words, phrases or sentences to read

SLP turns away so they will only understand patient if stimuli are articulated clearly. Can also include spouse, family members, etc. in this activity.

If the listener does not understand the target word/phrase/sentence, the pt needs to determine why it was unclear and try again

If the second attempt is still unclear, the SLP provides specific feedback regarding why it was not understood (i.e., I didn’t know it was sleep because I couldn’t hear the “l”. Please try again with a stronger “l”.)

Phonetic Placement

SLP instructs the patient on the correct positioning of the articulators for target

phoneme(s) before they attempt to produce the target phoneme(s)

This educates patients regarding how speech sounds are produced

Can be combined with some “shaping”, if appropriate

SLP can also provide manner and voicing information, as appropriate (e.g., a “p” sounds like a “b” or a “z” sounds like a “d”)

Exaggerating Consonants (aka: overarticulation, complete word production)

Pts are taught to fully and intentionally articulate each phoneme with exaggerated movements

Increase emphasis on medial and final consonant sounds which are often imprecise or absent in conversational speech

Can also incorporate reduced rate and increased loudness, if appropriate

This can improve intelligibility dramatically

Minimal Contrast Drills

Have the pt produce pairs of words that differ by only one phoneme

Can the SLP identify which word is being produced?

The phoneme may vary due to manner (pine-mine), place (sea-she), or voicing (pay-bay)

Can also be used for vowels (men-man), although consonants do more to improve intelligibility

Can be done at word level, or in phrases and sentences

Can also incorporate spouses and others – can they hear the difference?