Emily Cavanaugh

Motor Speech Disorders Assessment Report

Kent State Speech and Hearing Clinic

Overall Findings:

Based on the initial findings of the assessment conducted, the patient presents with flaccid
dysarthria characterized by right unilateral damage to cranial nerves five (trigeminal nerve) and
seven (facial nerve). The characteristics of flaccid dysarthria can differ from case to case
depending which cranial nerves are damaged. The trigeminal nerve is responsible for the motor
function and sensation in the face and mouth, while the facial nerve is responsible for controlling
muscles involved in facial expression (Duffy, 36). Taking this information into account, you can
see how the difficulties had with facial sagging, lip closure, sustained facial postures, and
voluntary movements such as smiling and lip pursing relate to the effected cranial nerves.
Additionally, due to the unilateral, or one sided, damage to the nerves, only the right side of the
face and mouth demonstrate the flaccidity. This is what is responsible for reduced articulator
accuracy, making sounds less intelligible, as well as facial sagging and asymmetry during facial
expressions.
During the assessment other subsystems used for speech were also observed. This includes the
respiratory-phonatory system, which looks at breath support. Results showed that these
subsystems are still functioning normally, which is good news for the probability of
improvements. Additionally, due to the onset of the difficulties stemming from surgery, we can
conclude that the dysarthria is not caused by a degenerative disease, meaning that we don’t
expect the dysarthria or the affected speech to become any worse over time.
Due to the findings of the assessment and the history of the patient it is recommended that
treatment target the strengthening of the articulators and increased accuracy of consonants, as
well as compensatory strategies for intelligibility and prosody. The patient is a good candidate
for treatment due to adequate breath support, competency, velopharyngeal closure, and high
levels of motivation.
 Emily Cavanaugh

Short Term Goals:

STG 1: The client will perform strengthening exercises targeting bilabial speech sounds (e.g. /p/,
/m/, /b/) while producing the target sounds accurately in isolation within drill activities with 80%
accuracy.

STG 2: The client will use accurate stress patterns by increasing intensity and duration of
targeted words in multiword utterances within a structured activity in order to increase
comprehensibility with 90% accuracy.

Approach Explanations:

STG 1:
Given the client’s high levels of motivation, the adequate functioning of other speech
subsystems, and the specific deficits in strength related to bilabial closure, he is a strong
candidate for speech sound oral motor exercises within a drill approach. He is likely to practice
at home, and increased strength relating to bilabial closure could greatly increase intelligibility,
as it was noted during the initial assessment that intelligibility decreased with more bilabial
sounds in speech. Exercises would begin to target the sound in isolation, moving to syllable,
word, and phrase level as strength increased. Given the patients diagnosis this treatment would
aim to normalize the function of the articulators and regain strength. His impairment is not
degenerative or progressive, making strengthening exercises appropriate for his case (Yorkston,
276).

STG 2:
The increased use of stress patterning to increase comprehensibility can be helpful to speakers
and listeners by establishing word boundaries within utterances. (Yorkston 287). While the
client’s rate is reported to be within average range, an increase in intonation and stress patterns
 Emily Cavanaugh

can have a large effect on comprehensibility. This could also decrease the client’s frustration
when participating in daily events and interacting with others. Considering the client already
possesses an average rate and has the cognitive functioning to understand the task, he is a strong
candidate for intervention targeting prosody.

Back-Up Plan:

In the case the approaches aiming at the normalization of function are not effective, the treatment
approach would then change to focus on compensatory strategies for the impairment. This
approach is reliant on feedback provided to the speaker about the sounds that are unintelligible,
prompting them to make the necessary changes based on the knowledge of the result of their
speech output (Yorkston 281). Compensatory strategies used could include contrastive
productions using minimal pairs of disordered sounds, as well as intelligibility drills, which
allows the speaker to compensate with motor movements in a way that is specific to their
impairment (Yorkston 283).
 Emily Cavanaugh

References

Duffy, R. Joseph. Motor Speech Disorders, Substrates, Differential Diagnosis, and

Management. 1995.

Yorkston, K., Beukelman, D., Strand, E., Hakel, M., Management of Motor Speech
Disorders in Children and Adults. ProEd, 2010.