Update Dysarthria: Current evidence-based recommendations for speech therapy in dysarthria

Abstract

Background: Speaking is an essential part of communication and therefore highly relevant for participation and quality of life. Dysarthrias are the most common form of neurologically induced speech disorders which means that those affected either cannot be understood at all or only with difficulty. High-quality dysarthria diagnosis and therapy therefore have a high priority in speech therapy. Methods: A systematic literature search for RCTs and guidelines was conducted with the aims of identifying evidence-based and current recommendations for dysarthria diagnosis and therapy. Thus, the search included only evidence that was not older than five years. The quality of the RCTs found was assessed using the CASP checklist. Results: Three RCTs and eight guidelines were included in the analysis. In general, speech therapy treatment is recommended for dysarthria. Therapeutic adaptation to the individual needs of the affected person is necessary. The use of non-linguistic oral-motor movements is not recommended. On the other hand, communication aids such as technology-assisted communication should be considered when intelligibility is low. Discussion: Although dysarthria often occurs as a result of stroke and neurodegenerative diseases, there is little evidence of efficacy of adequate quality for the treatment of dysarthria. As a result, guidelines only contain generalized recommendations that are unlikely to provide concrete guidance for practice. In the guidelines’ recommendations, the disorders dysarthria and aphasia are not consistently and clearly separated from each other. Conclusion: Further research is needed to make evidence-based recommendations for dysarthria diagnosis and treatment. Also, more diversity in the study of treatment methods would be desirable.