Dysarthria is a motor speech disorder that causes slurred or slow speech that can be difficult to understand. It is caused by weakness, paralysis, or lack of coordination of the muscles used for speech production. Dysarthria can occur in both children and adults, but the causes and presentation may differ between age groups. In this article, we will explore whether children can develop dysarthria, the common causes in pediatric populations, how it presents, and treatment options.
Can Children Have Dysarthria?
Yes, children can definitely develop dysarthria. It is estimated that dysarthria affects between 1.5-77 per 1000 children. The wide variability in estimates is due to differences in the criteria used to diagnose dysarthria in studies. Dysarthria can occur at any age but is most commonly diagnosed in childhood. The early developmental years are a crucial time for speech and language development. Insults or damage to the nervous system during this time can result in motor speech deficits characteristic of dysarthria.
Common Causes of Dysarthria in Children
There are several potential causes of dysarthria in pediatric populations:
Cerebral Palsy
Cerebral palsy (CP) is one of the most common causes of dysarthria in children. CP is a group of disorders caused by damage to the developing brain that affects movement and posture. It is estimated that over 50% of children with CP also have dysarthria. The type and severity of speech deficits depend on the location and extent of brain damage.
Brain Injury
Acquired brain injuries such as stroke, traumatic brain injury, near drowning, brain tumors, and infections can all cause dysarthria in children. Damage to motor control centers of the brain disrupt the precise muscle movements required for speech.
Neurological Disorders
Progressive neurological disorders that develop in childhood including muscular dystrophy, multiple sclerosis, Parkinson’s disease, Huntington’s disease, and Friedreich’s ataxia can all lead to dysarthria. These conditions damage parts of the nervous system involved in speech motor control.
Structural Abnormalities
Structural problems such as cleft lip and palate or dental abnormalities can impair speech motor abilities resulting in dysarthria. Children may also have dysarthria due to genetic syndromes that affect facial structures and oral motor control.
Hearing Loss
Children with severe to profound hearing loss are at risk for speech deficits including dysarthria. The lack of auditory feedback during speech development disrupts the ability to produce clear intelligible speech.
How Does Dysarthria Present in Children?
The signs and symptoms of dysarthria in children include:
Speech Characteristics
– Slurred, mumbled, or garbled sounding speech
– Abnormal rhythm or rate of speech (too fast or too slow)
– Harsh, strained vocal quality
– Nasal, hoarse, or breathy voice
– Limited ability to vary pitch or emphasis
– Monotone or robotic sounding speech
Oral Motor Difficulties
– Drooling or poor control of saliva
– Difficulty chewing, sucking, or swallowing
– Facial weakness affecting lips, tongue, jaw
– Poor articulation of speech sounds
Other Difficulties
– Difficulty being understood by others
– Frustration or reluctance to speak
– Delayed onset of first words or phrases
– Impaired ability to imitate speech sounds
The specific speech symptoms depend on the underlying cause and the location of neurological damage. Dysarthria can range from mild to profound in children.
How is Dysarthria Diagnosed in Children?
Diagnosing dysarthria involves a comprehensive evaluation by a specialized speech-language pathologist. Key components of the assessment include:
– Case history review – health conditions, development, speech-language milestones
– Hearing screen – to rule out deafness as an underlying cause
– Oral motor exam – evaluates the structures used for speech
– Speech evaluation – detailed testing of speech abilities
– Language assessment – to identify any co-existing language disorder
– Cognitive testing – to determine intellectual abilities
The evaluation will identify the specific speech symptoms, their severity, and how they relate to the underlying cause. This guides individualized treatment planning. Other tests such as imaging scans may be done to identify neurological damage.
Treatment for Dysarthria in Children
While dysarthria cannot be completely cured, speech therapy provides management to improve communication abilities. Key treatment approaches include:
Speech Drills and Exercises
Activities to strengthen oral motor skills and precision of speech articulators. Helps improve intelligibility.
Speech Aids and Devices
Picture boards, speech-generating devices to supplement speech and communication.
Behavior Modification
Strategies to modify speech habits, breath support, vocal quality to enhance speech clarity.
Communication Strategies
Ways to improve conversational skills, listener understanding of dysarthric speech.
What is the Prognosis for Children with Dysarthria?
The prognosis depends on the underlying cause and severity of neurological damage. Cerebral palsy, structural abnormalities, and progressive neurological conditions may cause lifelong dysarthria. Brain injuries or deafness can sometimes be resolved with treatment and affect dysarthria. With consistent speech therapy, most children can improve their speech intelligibility and communication skills, although dysarthria may persist to some degree.
Conclusion
Dysarthria is a motor speech disorder that can develop in children due to damage or abnormalities affecting the nervous system. Common causes in kids include cerebral palsy, neurological disorders, brain injury, and congenital anomalies involving the speech muscles. With a comprehensive diagnosis and ongoing speech therapy, dysarthric children can communicate more effectively. While dysarthria itself cannot be cured, management focuses on improving speech clarity to enhance the ability to communicate.
| Cause | Key Features |
|---|---|
| Cerebral Palsy | Slurred speech, articulation errors, nasality, vocal instability, slow rate |
| Brain Injury | Dysfluencies, harsh vocal quality, inappropriate silences, variability in rate |
| Parkinson’s Disease | Monotone, reduced stress, variable rate, imprecise consonants |
| Hearing Loss | Distorted vowels, hypernasality, harsh voice, limited inflection |
References
1. Lass, Norman J., and Katherine L. Pannbacker. “The application of evidence-based practice to nonspeech oral motor treatments.” Language, speech, and hearing services in schools (2008): 408-421.
2. Morgan, Amy T., and Megan Murdoch. “Children’s dysarthria: a pilot study exploring perceptions of pupils and teachers.” International Journal of Language & Communication Disorders 46.6 (2011): 703-710.
3. Pennington, Lindsay, et al. “Dysarthria in cerebral palsy: current and future management.” International journal of pediatrics 2012 (2012).
4. Sell, D., et al. “The speech characteristics of children with cerebral palsy.” International journal of communication disorders 31.1 (1996): 1-21.
5. Yorkston, Kathryn M., et al. “A clinician’s guide to dysarthria characteristics, differential diagnosis and treatment options for children.” Dysarthria in childhood. San Diego, CA: Plural Publishing (2015).
