Hypo kinetic Dysarthria

Definition of hypokinetic dysarthria

Motor speech disorder caused by damage to the basal ganglia, resulting in reduced production of dopamine

Etiologies of hypokinetic dysarthria

• idiopathic Parkinson’s disease

• Neuroleptic-Induced Parkinsonism

• Postencephalitic Parkinsonism

• Traumatic Head injury (which damages the substantia nigra or basal ganglia)

• Toxic Metal poisoning (long-term exposure to manganese)

• Stroke (which damages basal ganglia)

Site of lesion

basal ganglia

Motor characteristics of Hypokinetic Dysarthria

• Akinesia

• disturbance of postural reflexes

• resting tremors

• limited range of motion of laryngeal muscles (incomplete vocal fold closure)

• decreased rate of movement

• reduced range of movement of articulators

• paradoxical movements

• reduced range of respiratory muscles

Speech characteristics (top 3)

• Monopitch

• Reduced stress

• monoloudness

Speech characteristics: Prosody

• monopitch

• reduce

• monoloudness

• inappropriate intervals of silence

• increased rate of speech*

speech characteristics: Articulation

• Imprecise consonants

Speech characteristics: Phonation

• harsh or breathy vocal quality

• low pitch

speech characteristics: respiration

• faster than typical breathing rates

• paradoxical breathing

• shallow breathing

• poorly controlled exhalation

• rapid, short breathing cycles

Speech characteristics: resonance

• possibly mild hypernasality (is not typical though)

Evaluation tasks

• conversational speech and reading

  • prosody

• AMRs

  • articulation

• Vowel prolongations

  • vocal quality

• conversational speech

treatment of hypokinetic dysarthria: rate reduction

• pacing boards

• hand/finger tapping

• alphabet board

• delayed auditory feedback

• reciting syllables to a metronome

Treatment: stretching tasks

• tongue-stretching

• lip stretching

• jaw stretching

Treatment: traditional articulation treament

• intelligibility drills

• phonetic placement

• exaggerating consonants

• minimal contrast drills

treatment: Phonation

• pushing and pulling

• hard glottal attack

• voice amplifiers

• instrumental biofeedback

• Lee-Silverman Voice Treatment-LOUD

• SPEAK OUT!

Treatment: respiration

• speaking immediately on exhalation

• cueing for complete inhalation

• slow and controlled exhalation

• stop phonation early

• optimal breath group

treatment: Prosody

• intonation profiles

• contrastive stress drills

• chunking utterances into syntactic units