Dysarthria Assessment - Joe

Date of Observation: 12/7/2024

Setting: Speech Therapy Office

This blog is a reflection on an observed therapy session with a 53-year-old male, Joe, who was diagnosed with hypokinetic dysarthria as a result of Parkinson's disease. The speech-language pathologist, Dr. Racheal, conducted the session in a private, comfortable room with no distractions. Joe was open and eager to participate in the assessment process. Dr. Rachael had a good work focus on the assessment procedures crucial for his condition.

Materials Used:

Frenchay Dysarthria Assessment (FDA-2) Rating Form

Mirror

Scoring Graph

Tongue depressor

Glass of water.

Goals:

In this session, the primary objective was to perform a Frenchay Dysarthria Assessment on Joe to determine the nature of his speech potential through several tasks aimed at reflexes, respiration, articulation, and intelligibility. The evaluation was to identify his strong and weak areas to develop a proper therapeutic strategy for his case.

Impression: 

Dr. Rachael was professional and compassionate during the session. She described precisely how each subtest was administered and why this was important in evaluating Joe's speech problems. I loved how gentle Dr. Rachael was with Joe. She let him complete every activity in his own time without rushing him. Joe was relieved by his constructive comments during the assessment and his feedback during the process.

What I learned:

This session highlighted the systematic manner in which the Frenchay Dysarthria Assessment is conducted. In each task, Dr. Rachael assessed particular components of Joe's speech, providing insights into the characteristics of his dysarthria. Some examples of components she evaluated are respiration, reflex, and intelligibility.

Respiration

Dr. Rachael: Okay, Joe. Take a deep breath and say, 'The cat is on the mat.' How does that feel?

Reflex Assessment

To assess Joe's oral reflexes, Dr. Rachael used a tongue depressor and made sure to explain what she was doing to ease any anxiety.

Intelligibility

Dr. Rachael: Let's work on completeness. Can you repeat after me?: "She sells seashells by the seashore."

Dr. Rachael took notes on Joe's clarity and precision of speech and used a scoring graph to categorize his articulation.

Dr. Rachael also used a mirror during the session, which I found pretty interesting. At some points, she instructed Joe to use the mirror to observe how he moved his mouth.

Dr. Rachael responded positively, ensuring she recognized the client's efforts and improvements.

Question

I also observed that the clinician often stopped during the activities to let Joe think and respond. Is this a frequent approach clinicians use to assist their clients in regulating their pace? When do clinicians know when to use direct questioning and when to let clients come up with the answer themselves?

Allowing pauses is essential to conducting dysarthria assessments with clients such as Joe. Clinicians estimate when clients need help depending on their verbal and nonverbal signals. They intervene with soft cues if their clients need help or guidance, allowing them to respond independently and build confidence and accuracy. This balance between prompting and allowing space is essential in speech therapy, especially for those with communication problems.

Reference: https://pubmed.ncbi.nlm.nih.gov/27747392/

Link to final presentation: bit.ly/slpenthusiast