Download PDF
Semin Speech Lang 2014; 35(03): 221-233
DOI: 10.1055/s-0034-1384684
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Clinical Assessment of Motor Speech Disorders in Adults with Concussion

Michael P. Cannito
1   School of Communication Sciences & Disorders, University of Memphis, Memphis, Tennessee
› Author Affiliations
Further Information

Publication History

Publication Date:
12 August 2014 (online)

Also available at
    Permissions and Reprints

Abstract

This article reviews the occurrence of motor speech disorders of dysarthria and apraxia of speech following closed head injury and other traumatic brain injuries in adults as they apply to sport concussion and related trauma. Athletic sideline and speech-language pathology screenings are considered. Procedures for clinical assessment and diagnosis of motor speech disorder, most particularly dysarthria, are discussed with special reference to closed head injury. Included are the evaluation components of cranial nerve and speech mechanism examination, nonspeech musculature examination, perceptual and instrumental assessment procedures, quasi-standardized testing for dysarthria, and the determination of restrictions of participation in everyday life activities. The resultant output of such an evaluation is described in depth. Future directions for clinical research on motor speech disorders following sports concussion are also briefly considered.

Keywords

Motor speech disorders - concussion - traumatic brain injury - assessment and diagnosis
 

  • References

  • 1 Pellman EJ, Powell JW, Viano DC , et al. Concussion in professional football: epidemiological features of game injuries and review of the literature—part 3. Neurosurgery 2004; 54 (1) 81-94 , discussion 94–96
    CrossrefPubMedSearch in Google Scholar
  • 2 Enderby P, Crow E. Long-term recovery patterns of severe dysarthria following head injury. Br J Disord Commun 1990; 25 (3) 341-354
    CrossrefPubMedSearch in Google Scholar
  • 3 Stiller-Ostrowski JL. Fourth cranial nerve palsy in a collegiate lacrosse player: a case report. J Athl Train 2010; 45 (4) 407-410
    CrossrefPubMedSearch in Google Scholar
  • 4 Schafer RC. Cranial/Facial Trauma (ICPA Monograph #12). Philadephia, PA: ACA Press; 1997
    Search in Google Scholar
  • 5 Yorkston KM, Beukelman DR, Strand EA, Hakel M. Management of Motor Speech Disorders in Children and Adults. 3rd ed. Austin, TX: Pro-Ed; 2010
    Search in Google Scholar
  • 6 Duffy JR. Motor Speech Disorders: Substrates, Differential Diagnosis, and Management. 2nd ed. St. Louis, MO: Elsevier Mosby; 2005
    Search in Google Scholar
  • 7 Levin HS, Madison CF, Bailey CB, Meyers CA, Eisenberg HM, Guinto FC. Mutism after closed head injury. Arch Neurol 1983; 40 (10) 601-606
    CrossrefPubMedSearch in Google Scholar
  • 8 Marquardt TP, Cannito MP. In: Wallace GL, , ed. Adult Aphasia Rehabilitation. Boston, MA: Butterworth-Heinemann; 1996: 205-228
  • 9 Pierce RS, Phonological encoding and speech programming: the disorders of paraphasia and apraxia of speech. In: Vogel D, Cannito MP. , eds. Treating Disorderd Speech Motor Control. 2nd ed. Austin, TX: Pro-Ed; 2001: 195-238
    Search in Google Scholar
  • 10 Yorkston KM, Honsinger MJ, Mitsuda PM, Hammen VL. The relationship between speech and swallowing disorders in head-injury patients. J Head Trauma Rehabil 1989; 4: 1-16
    PubMedSearch in Google Scholar
  • 11 Beukelman DR, Nordness A, Yorkston KM. Dysarthria associated with traumatic brain injury. In: Hux K, , ed. Assisting Survivors of Traumatic Brain Injury: The Role of Speech-Language Pathologists. 2nd ed. Austin, TX: Pro-Ed; 2011: 185-226
    Search in Google Scholar
  • 12 Darley FL, Aronson AE, Brown JR. Speech Disorders; Nervous System; Motor Neurons; Diseases; Physiopathology. Philadelphia, PA: Saunders; 1975
    Search in Google Scholar
  • 13 Theodoros DG, Murdoch BE, Goozée JV. Dysarthria following traumatic brain injury: incidence, recovery, and perceptual features. In: Murdoch BE, Theodoros DG, , eds. Traumatic Brain Injury: Associated Speech, Language, and Swallowing Disorders. San Diego, CA: Singular; 2001: 27-52
    Search in Google Scholar
  • 14 Broglio SP, Guskiewicz KM. Concussion in sports: the sideline assessment. Sports Health 2009; 1 (5) 361-369
    CrossrefPubMedSearch in Google Scholar
  • 15 Cantu RC. Head injuries in sport. Br J Sports Med 1996; 30 (4) 289-296
    CrossrefPubMedSearch in Google Scholar
  • 16 Cantu RC. Second-impact syndrome. Clin Sports Med 1998; 17 (1) 37-44
    CrossrefPubMedSearch in Google Scholar
  • 17 Gavett BE, Cantu RC, Shenton M , et al. Clinical appraisal of chronic traumatic encephalopathy: current perspectives and future directions. Curr Opin Neurol 2011; 24 (6) 525-531
    CrossrefPubMedSearch in Google Scholar
  • 18 Hagen C. Language disorders in head trauma. In: Holland A, , ed. Language Disorders in Adults: Recent Advances. Austin, TX: Pro-ED; 1984: 245-282
    Search in Google Scholar
  • 19 Hula WD. Attention. In: Kimbarow ML, , ed. Cognitive Communication Disorders. San Diego, CA: Plural Publishing, Inc.; 2011: 1-44
    Search in Google Scholar
  • 20 Constantinidou F. Principles of human memory: an integrative clinical experience. In: Kimbarow ML, , ed. Cognitive Communication Disorders. San Diego, CA: Plural Publishing, Inc.; 2011: 45-76
    Search in Google Scholar
  • 21 Purdy M. Executive functions: theory, assessment, and treatment. In: Kimbarow ML, , ed. Cognitive Communication Disorders. San Diego, CA: Plural Publishing, Inc.; 2011: 77-118
    Search in Google Scholar
  • 22 Theodoros DG, Murdoch BE, Chenery HJ. Perceptual speech characteristics of dysarthric speakers following severe closed head injury. Brain Inj 1994; 8 (2) 101-124
    CrossrefPubMedSearch in Google Scholar
  • 23 Finitzo T, Pool KD, Freeman FJ , et al. Spasmodic dysphonia subsequent to head trauma. Arch Otolaryngol Head Neck Surg 1987; 113 (10) 1107-1110
    CrossrefPubMedSearch in Google Scholar
  • 24 Cannito MP. Neurological aspects of spasmodic dysphonia. In: Vogel D, Cannito MP, , eds. Treating Disordered Speech Motor Control. 2nd ed. Austin, TX: Pro-Ed; 2001
    Search in Google Scholar
  • 25 Goozée JV, Murdoch BE, Theodoros DG, Stokes PD. Kinematic analysis of tongue movements in dysarthria following traumatic brain injury using electromagnetic articulography. Brain Inj 2000; 14 (2) 153-174
    CrossrefPubMedSearch in Google Scholar
  • 26 Jaeger M, Hertrich I, Stattrop U, Schönle PW, Ackermann H. Speech disorders following severe traumatic brain injury: kinematic analysis of syllable repetitions using electromagnetic articulography. Folia Phoniatr Logop 2000; 52 (4) 187-196
    CrossrefPubMedSearch in Google Scholar
  • 27 Wang YT, Kent RD, Duffy JR, Thomas JE, Weismer G. Alternating motion rate as an index of speech motor disorder in traumatic brain injury. Clin Linguist Phon 2004; 18 (1) 57-84
    CrossrefPubMedSearch in Google Scholar
  • 28 Wang YT, Kent RD, Duffy JR, Thomas JE. Dysarthria associated with traumatic brain injury: speaking rate and emphatic stress. J Commun Disord 2005; 38 (3) 231-260
    CrossrefPubMedSearch in Google Scholar
  • 29 Wang YT, Kent RD, Duffy JR, Thomas JE. Dysarthria in traumatic brain injury: a breath group and intonational analysis. Folia Phoniatr Logop 2005; 57 (2) 59-89
    CrossrefPubMedSearch in Google Scholar
  • 30 Hammen VL, Yorkston KM. Respiratory patterning and variability in dysarthric speech. J Med Speech-Lang Pathol 1994; 2: 253-262
    PubMedSearch in Google Scholar
  • 31 Cahill LM, Murdoch BE, Theodoros DG. Perceptual analysis of speech following traumatic brain injury in childhood. Brain Inj 2002; 16 (5) 415-446
    CrossrefPubMedSearch in Google Scholar
  • 32 Yorkston KM, Beukelman DR. Assessment of Intelligibility of Dysarthric Speech. Austin, TX: Pro-Ed; 1981
    Search in Google Scholar
  • 33 Enderby P, Palmer R. FDA-2: Frenchay Dysarthria Assessment. 2nd ed. Austin, TX: Pro-Ed; 2008
    Search in Google Scholar
  • 34 KayPENTAX. Motor Speech Profile (MSP) Model 5141 [computer program]. Montvale, NJ: KayPENTAX; 2005
    Search in Google Scholar
  • 35 Zajac DJ, Warren DW, Hinton VA. Aerodynamic assessment of motor speech disorders. In: McNeil MR, , ed. Clinical Management of Sensorimotor Speech Disorders. New York, NY: Thieme; 2009: 64-79
    Search in Google Scholar
  • 36 Luschei ES, Finnegan EM. Electromyographic techniques for the assessment of motor speech disorders. In: McNeil MR, , ed. Clinical Management of Sensorimotor Speech Disorders. New York, NY: Thieme; 2009: 100-115
    Search in Google Scholar
  • 37 Barlow SM, Finan DS, Andreatta RD, Boliek C. Kinematic measurement of speech and early orofacial movements. In: McNeil MR, , ed. Clinical Management of Sensorimotor Speech Disorders. New York, NY: Thieme; 2009: 80-99
    Search in Google Scholar
  • 38 Theodoros DG, Murdoch BE. Laryngeal dysfunction in dysarthric speakers following severe closed-head injury. Brain Inj 1994; 8 (8) 667-684
    CrossrefPubMedSearch in Google Scholar
  • 39 Theodoros D, Murdoch BE, Stokes PD, Chenery HJ. Hypernasality in dysarthric speakers following severe closed head injury: a perceptual and instrumental analysis. Brain Inj 1993; 7 (1) 59-69
    CrossrefPubMedSearch in Google Scholar
  • 40 Brookshire RH. Introduction to Neurogenic Communication Disorders. 6th ed. St. Louis, MO: Mosby; 2003
    Search in Google Scholar
  • 41 Dongilli P, Hakel M, Beukelman DR. Recovery of functional speech following traumatic brain injury. J Head Trauma Rehabil 1992; 7: 91-101
    CrossrefPubMedSearch in Google Scholar
  • 42 Keatley A, Wirz S. Is 20 years too long? Improving intelligibility in long-standing dysarthria—a single case treatment study. Eur J Disord Commun 1994; 29 (2) 183-201
    CrossrefPubMedSearch in Google Scholar
  • 43 Wenke RJ, Theodoros D, Cornwell P. The short- and long-term effectiveness of the LSVT for dysarthria following TBI and stroke. Brain Inj 2008; 22 (4) 339-352
    CrossrefPubMedSearch in Google Scholar
  • 44 Netsell R, Daniel B. Dysarthria in adults: physiologic approach to rehabilitation. Arch Phys Med Rehabil 1979; 60 (11) 502-508
    PubMedSearch in Google Scholar
  • 45 Yorkston KM, Honsinger MJ, Beukelman DR, Taylor TD. The effects of palatal lift fitting on the perceived articulatory adequacy of dysarthric speakers. In: Yorkston KM, Beukelman DR, , eds. Recent Advances in Clinical Dysarthria. Boston, MA: College-Hill Press; 1989: 85-98
    Search in Google Scholar
  • 46 Fager S, Karantounis R. AAC assessment and intervention in TBI. In: Hux K, , ed. Assisting Survivors of Traumatic Brain Injury: The Role of Speech Language Pathologists. 2nd ed. Austin, TX: Pro-Ed; 2011
    CrossrefSearch in Google Scholar