Childhood Dysarthria: Auditory-Perceptual Profiles Against the Background of Typical Speech Motor Development

Purpose: The purpose of this study was to describe childhood dysarthria by means of auditory-perceptual analyses covering all speech subsystems. We aimed to identify the most seriously affected auditory-perceptual dimensions in the observed dysarthria profiles and to detect specific markers of childhood dysarthria against the backdrop of typical speech development. Moreover, the relationship between the speech disorder and other relevant aspects of multiple disability was investigated. Method: Thirty-one children with neurologic conditions were assessed with Bogenhausen Dysarthria Scales for Childhood Dysarthria, a German tool for the auditory-perceptual analysis of dysarthria in children. Nine relevant speech dimensions (scales, e.g., voice quality [VOQ]) and 29 individual symptoms (features, e.g., breathy) were evaluated. Moreover, we documented motor, communicative, and cognitive-linguistic measures (i.e., Gross Motor Function Classification System [GMFCS], Communication Function Classification System [CFCS], Test for Reception of Grammar [TROG-D], and memory span). Recently published data from typically developing children were used for the purpose of age normalization. Results: Dysarthria severity was moderately correlated with GMFCS and CFCS but not with TROG-D and memory span. At the group level, respiration, articulation, and prosodic modulation were most severely affected, whereas voice function was only mildly affected or even spared in the majority of children. Four features were identified as most relevant markers of childhood dysarthria: conspicuous rhythm/stress pattern, hypernasality, strained-strangled voice, and reduced articulatory precision. Conclusions: Childhood dysarthria is part of a complex multiple disability, but speech motor skills may still dissociate from gross-motor and cognitive- linguistic functions. Auditory-perceptual analyses incorporating age norms allow for a comprehensive description and identification of childhood dysarthria.