Distinguishing Perceptual Characteristics and Physiologic Findings by Dysarthria Type

Table adapted with permission from Duffy, J. R. (2013). Motor speech disorders: Substrates, differential diagnosis, and management. St. Louis, MO: Elsevier.

Dysarthria Type Distinguishing Perceptual Speech Characteristics Distinguishing Physical Characteristics
Flaccid
  • continuous breathiness
  • diplophonia
  • audible inspiration or stridor
  • nasal emission
  • short phrases
  • hypernasality
  • rapid deterioration and recovery with rest
  • imprecise alternating motion rates (AMRs)
  • weakness
  • flaccidity
  • atrophy
  • fasciculations
  • hypoactive gag reflex
  • facial myokymia
  • rapid deterioration and recovery with rest
  • synkesis
  • nasal backflow while swallowing
Spastic
  • slow rate
  • strained or harsh voice quality
  • pitch breaks
  • slow and regular AMRs
  • pathologic oral reflexes (sucking reflex; snout reflex; jaw jerk reflex)
  • lability of affect
  • hypertonia
  • hyperactive gag reflex
Ataxic
  • irregular articulatory breakdowns
  • excess and equal stress
  • distorted vowels
  • excessive loudness variation
  • irregular AMRs
  • dysmetric jaw, face, and tongue AMRs
  • head tremor
Hypokinetic
  • monopitch
  • monoloudness
  • reduced loudness and stress
  • tendency for rapid or accelerated rate
  • inappropriate silences
  • rapidly repeated phonemes
  • palilalia
  • rapid, "blurred" AMRs
  • masked facial expression
  • tremulous jaw, lips, tongue
  • reduced range of motion on AMR tasks
  • resting tremor
  • rigidity
Hyperkinetic
  • prolonged intervals
  • sudden forced inspiration/expiration
  • transient breathiness
  • transient vocal strain or harshness
  • voice stoppages/arrests
  • voice tremor
  • myoclonic vowel prolongation
  • intermittent hypernasality
  • marked deterioration with increased rate
  • inappropriate vocal noises
  • intermittent breathy/aphonic segments
  • distorted vowels
  • excessive loudness variation
  • slow and irregular AMRs
  • involuntary head, jaw, face, tongue, velar, laryngeal, and respiratory movements
  • relatively sustained deviation of head position
  • multiple motor tics
  • myoclonus of palate, pharynx, larynx, lips, nares, tongue, or respiratory muscles
  • jaw, lip, tongue, pharyngeal, or palatal tremor
  • facial grimacing during speech
Unilateral Upper Motor Neuron
  • slow rate
  • imprecise articulation
  • irregular articulatory breakdowns
  • strained voice quality
  • reduced loudness
  • unilateral lower face weakness
  • unilateral lingual weakness without atrophy/fasciculations
  • nonverbal oral apraxia

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