EBP Compendium: Summary of Clinical Practice Guideline

Royal College of Speech & Language Therapists; Department of Health (UK); National Institute for Clinical Excellence (NICE)
RCSLT Clinical Guidelines: 5.11 Dysarthria
Taylor-Goh, S., ed. (2005).
RCSLT Clinical Guidelines. Bicester, Speechmark Publishing Ltd.

AGREE Rating: Highly Recommended

Description:

This guideline provides recommendations for the assessment and management of dysarthria in children and adults. This guideline is intended for primary use by speech-language pathologists (SLPs). Each recommendation is graded A (requires at least one randomized controlled trial), B (requires at least one well-conducted clinical study), or C (requires evidence from expert committee reports).

Recommendations:

• Assessment/Diagnosis
  • Assessment Areas
    • Speech
      • A perceptual assessment is necessary to provide a description of the speech and musculature. The assessment should consider:
        • Orofacial musculature
        • Respiratory function (particularly control and coordination for speech)
        • Phonation
        • Resonance
        • Articulation
        • Prosody
        • Intelligibility
        • Rationale (Level B Evidence) (p. 93).
      • “A good quality audio recording is beneficial. Access to additional instrumentation for the measurement of respiratory and vocal parameters such as aerodynamics, pitch, intensity resonance, vibratory cycle and/or other aspects of vocal quality is recommended” (Level C Evidence) (p. 94).
      • A complete communication skills profile should be carried out including the communicative strengths and weaknesses of the individual, communication use across typical environment and environmental impacts, and skills of communication partners (Level C Evidence) (p. 94).
• Treatment
  • Speech
    • General Findings - The SLP should provide an “explanation of the normal anatomy and physiology of the orofacial tract and speech production” and explain possible causal and maintaining factors and factors to the client (Level C Evidence) (p. 95).
    • Oral-Motor Treatments - “Where the aim is to reduce the degree of impairment or increase the physiological support for speech, a physiological approach may be appropriate. This may occur separately or in combination with either or both a compensatory and/or augmentative approach” (Level A Evidence) (p. 96).
    • Compensatory Treatments - “Where the aim is to minimize the effect of the overall disability and promote intelligibility, various compensatory approaches should be used. These may occur separately or in combination with a compensatory and/or augmentative approach” (Level B Evidence) (p. 96).
    • AAC -"When speech alone is insufficient to meet the individual’s communication needs, a variety of augmentative strategies should be used” (Level B Evidence) (p. 96). 

Keywords: Dysarthria

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Added to Compendium: November 2010