Suman KUMAR, İndranil CHATTERJEE, Navnit KUMAR, Ankita KUMARİ

Management of flaccid dysarthria in a case of attempted suicide by hanging

Abstract. Present study highlights a case of 26 year old male patient who was diagnosed as flaccid dysarthria due to delayed anoxic encephalopathy by attempting suicide through hanging. Assessment and management based on speech therapy has been emancipated. This case study concluded the importance of counseling and family centered approach regarding speech therapy outcome and alternative and augmentative communication (AAC). However, patient preferred verbal mode of communication and his lack of motivation failed the use of AAC with him. A composite therapy approach including traditional approaches, prosody and naturalness, increasing respiratory support along with visual biofeedback were used, which did not turned out to be effective. This dilemma to either direct therapy for verbal mode of communication which is not effective for the case or to use AAC needs further thinking and studies with more participants to find an appropriate solution which could lead us out of this impasse to some direction. Thus the challenge for speech therapists exists. Key words: Encephalopathy, anoxic encephalopathy, dysarthria, hyperkinetic dysarthria, flaccid dysarthria, hanging, suicidal attempt

Keywords:

Encephalopathy, anoxic encephalopathy, dysarthria hyperkinetic dysarthria, flaccid dysarthria, hanging, suicidal attempt,

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Harrison. Principle of Internal Medicine. New York: McGraw-Hill International, 1975.
Darley FL, Aronson AE, Brown JR. Motor speech disorders. Philadelphia: W. B. Saunders, 1975.
Duffy JR. Motor speech disorders: Substrates, differential diagnosis, and management. St. Louis: Mosby, 1995.
Duffy JR. Motor speech disorder: substrates, differential diagnosis and management (2nd ed). St. Luis: Mosby, 2005.
Kearns KP, Simmons NN. Interobserver Reliability and Perceptual ratings: more than meets the ear. Journal of Speech and Hearing Research 1988; 31: 131-136.
Wilson DK. Voice problem of children (2nd ed). Baltimore: Willium & Wilkin, 1979.
Goodglass H, Kaplan E, Barresi B. The Assessment of Aphasia and Related Disorder. (3rd ed). Baltimore: Lippincott Williums & Wilkins, 2001.
Linebaugh CW. Treatment of flaccid dysarthria, in Current Therapy of Communication Disorder: Dysarthria & Apraxia (ed. W.H.Perkins), New York, Thieme 1983; 59-67.
Enderby P, John A, Petheram B. Therapy Outcomes Measures for Rehabilitation Professionals (2nd ed) West Sessex: John Wiley & Son Ltd. 2006.
Sellars C, Hughes T, Langhorne P, Speech and language therapy for dysarthria due to nonprogressive brain damage: a systematic Cochrane review. Clin Rehabil 2002; 16: 61-68.
Yorkston KM, Management of motor speech disorders in children and adults, Texas, Pro-ed, 1999.
Murdoch BE, Pitt G, Theodoros DG, Ward EC. Real time continuous visual feedback in the treatment of speech breathing disorders following childhood treatment brain injury: report on one case. Pediatric Rehabilitation 1999; 3: 5-20.
Rosenbek JC, LaPointe LL. The dysarthrias: Description, diagnosis, and treatment. In: Johns D(eds).Clinical Management of Neurogenic Communicative Disorders,(2nd ed). Boston :Little, Brown Co, 1985, pp97-152.
Yorkston KM, Beukelman DR, Strand EA, Bell KR. Management of motor speech disorders in children and adults. Austin,Pro-Ed.1988.
Tikofsky RS, Tikofsky RP. Intelligibility measure of dysarthria speech. J Speech Hearing Res 1964; 7: 325-333.
Hanson ML, Barrett RH. Fundamentals of orofacial myology. Springfield: Charles C. Thomas,1988.
Aronson AE. Clinical Voice Disorders: An interdeciplinary approach (3rd ed.) New York: Thieme, 1990.
Dattilo J, Camarata S. Facilitating conversation through self-initiated augmentative communication treatment. J Appl Behavioral Ana 1991; 24: 369- 378.
Yorkstone KM. Treatment Efficacy in Dysarthria. J Speech Hearing Res 1996; 39: s46-s47.
Hegde MN. Pocket Guide to Assessment in Speech Language Pathology. San Diego, CA, Singular Publishing Group, Inc, 1996.
Abkarian GG, Dworkin JP. Treating severe motor speech disorders: give speech a chance. J Med Speech-Lang Pathol 1993; 1: 285.
Hodge M, Wellman L. Management of children with dysarthria. In: Caruso AJ, Strand EA (eds). Clinical management of motor speech disorders in children. New York: Thieme, 1999, pp209-280.
Hodge MM. Nonspeech oral motor treatment approaches for dysarthria: Perspectives on a controversial clinical practice. Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders 2002; 12: 22-28.
Clark HM. Neuromuscular treatments for speech and swallowing: A tutorial. American Journal of Speech-Language Pathology 2003; 12: 400–415.
Weismer G. Philosophy of research in motor speech disorders. Clinical Linguistics and Phonetics 2006; 20: 315-349.
Ray J. Effects of orofacial myofunctional therapy on speech intelligibility in individuals with persistent articulatory impairments. Inte J Orofacial Myology 2003; 29: 5-14.
Dworkin JP, Hartman DE. Progressive speech deterioration and dysphagia in amyotrophic lateral sclerosis: Case report. Archives of Physical Medicine and Rehabilitation 1979; 60: 423–425.
McAuliffe MJ, Ward EC, Murdoch BE, Farrell AM. A nonspeech investigation of tongue function in Parkinson’s disease. J Gerontol A Biol Sci Med Sci 2005; 60: 667-674.
Solomon NP, Robin DA, Luschei ES. Strength, endurance, and stability of the tongue and hand in Parkinson disease. J Speech Language Hearing Res 2000; 43: 256-267.
Caruso AJ, Strand EA. Clinical management of motor speech disorders in children, New York, Theime.1999.
Fried-oken M. Voice recognition device as a computer interface for motor and speech impaired people. Arch Phys Med Rehabil 1985; 66: 678-681.