Dysarthria: Respiration; Pittsburgh International Airport

Dysarthria is a collective name for speech disorders that arise from damage to the nervous system; it manifests as disturbances in muscular control of the speech mechanism, affecting respiration (breathing), phonation (vibration of vocal cords), articulation (modifying one's airstream to make speech sounds), resonance (hypernasality, hyponasality) and prosody (rhythm, stress and intonation of speech).  In the pediatric population, dysarthria is often caused by cerebral palsy, muscular dystrophy, Down's syndrome, traumatic brain injuries, etc. 

This post will focus on how to manage respiration in children with dysarthria.  The first step is to have proper positioning.  Sitting upright is optimal for many children as it allows for full lung expansion.  The next step is to make sure that your child is inhaling sufficiently.  The goal is to have sufficient breath support to complete a sentence, or to be able to say "ahhh" steadily for a minimum eight seconds.  If your child is having difficulty completing a sentence, it may be evident because she has to stop for a breath, she may become short of breath, or her voice may trail off toward the end of the sentence.  In this case, cue her to "Take a deep breath before each sentence."  You may be amazed at how well this cue works.  Once she has learned to take a deep breath before each sentence, she should have an idea of how long to make her sentences so that she can maintain adequate speech.  Once this is accomplished, you may then ask her to speak in longer sentences.  Through self-monitoring, she should be able to take deeper breaths and control her use of breath for longer sentences.  For older children having difficulty with breath support, instruct them to pause at appropriate times in sentences in order to take another breath.

A good way for your child to practice is to start by imitating short sentences, then longer sentences; remember to cue her to "Take a deep breath before each sentence," and maintain upright positioning.  Finally, let her move onto making up her own sentences, then participating in conversation all while monitoring her own speech.

If you live near the Pittsburgh International Airport (or just pass by it), it may be fun to watch the planes.  Use them as stimulus material for speech.

Image retrieved from http://www.cleveland.com/business/index.ssf/2009/11/pittsburgh_international_airpo.html.

Short sentences for repetition may include:
"I see a plane,"
"It is sunny,"
"The plane is flying."

Long sentences for repetition may include:
"There is a big, blue plane flying in the sky,"
"The pilot is flying the airplane through fluffy clouds,"
"The plane is up so high that it looks like a little speck."

To stimulate your child to make up her own sentences, ask her questions.  Some may include:
"Where do you think the plane is going?"
"How high to do you think the plane is flying?"
"What will the pilot do if it starts to rain?

Some topics for conversation may include discussing fun places to travel on a plane, comparing planes and trains, and thinking of ways to pass the time on a long flight.