Case Study # 3

Dysarthria in a man with Parkinson’s disease

By: Maddy H, Chanelle C, Nathan B,
Johnny A, Alana F
Professor: Leanne Carnaghan
Due: March 17, 2023
 Dysarthria in a man with Parkinson’s disease:
Joseph is 62 years old and has Parkinson’s disease
He has taken early retirement from his law practice. You see him as an outpatient
for his avocational needs and to provide education around safety in the home. He is married
and has three children and several grandchildren with whom he is quite close. He remains
active in his service club, regularly plays cards with friends and belongs to a book club. Joseph’s
speech is still intelligible, but the speech pathologist is helping him with his dysarthria, as it is
starting to cause him difficulty in social situations
Parkinson’s Disease
What is Parkinson’s? It is a neurodegenerative disease, movement is normally controlled by dopamine, a chemical that carries
signals between the nerves in the brain. When cells that normally produce dopamine die, the symptoms of Parkinson’s appear.

Causes:
● Genetics cause about 10 to 15% of all Parkinson's.
● Head Injury: Traumatic brain injury — an injury that results in an alteration in the level of consciousness — has been associated
with an increased risk of developing PD years after the injury; however, the mechanisms underlying this are unclear.
● Area of Residence: There are differences in the geographic distribution of PD. These could be due to differences in
environmental factors and genetic risk factors.
● Exposure to Metals: Occupational exposures to various metals have been suggested to be related to the development of PD. But
long-term exposure to metals is not easily measured and the results of studies measuring PD risk and specific metals have been
inconsistent.
● Solvents and Polychlorinated Biphenyls (PCBs): Trichloroethylene (TCE) is a solvent used in many industries and is the most
common organic contaminant in groundwater. Exposure to TCE was found to be associated with PD among workers whose
factory jobs resulted in long-term exposure. PCBs have been found in relatively high concentrations in the brains of people who
had PD. Occupational exposure to PCBs has been associated with greater risk of Parkinson's in women, but not in men.
(Cleveland,2020)
Who is most at risk for developing Parkinson’s Disease?
● Parkinson’s disease affects both men and women. Statistically, however, men have a slightly higher
chance of developing the disease. The risk of developing Parkinson’s disease also increases with age,
with the average age of onset being 65 years old. Five to ten percent of people develop the condition
before the age of 40 years old. When symptoms appear in people aged 21-40, this is known as
young-onset Parkinson’s disease. Juvenile Parkinson’s disease is the term used when symptoms
appear before the age of 18 years old, although this is extremely rare. (UBC, 2022)

People with a parent, sibling or child with Parkinson’s disease, are twice as likely to get it as people in
the general population. (UBC, 2022)
Communication Disorder & Symptoms
Dysarthria is a motor speech disorder that is caused by damage to the nervous system. It affects the muscles
used for speech which include the lips, tongue, vocal cords, and diaphragm. These muscles tend to become weak,
damaged, or even paralyzed. (Cleveland Clinic, 2020)

Symptoms
● Slurred speech
● Slow and soft speech
● Nasal, raspy or strained voice
● Uneven or abnormal speech rhythm
● Monotone speech
● Speaks in short bursts rather than full sentences
● Difficulty moving tongue or facial muscles

(NHS, 2023)
6 Communication Strategies
1. Avoid noisy environments
2. Speak slowly and loudly
3. Over-pronounce all sounds, especially the end sounds of words
4. Use shorter sentences or phrases if possible
5. Provide context before talking so people would expect specific phrases. Example: I like Subway.
6. Seat yourself so others can see your face

(Dugdale,2022)
2-3 Communication Challenges for Parkinson's
3 Communication Difficulties Joseph might have
● Difficulty starting speech:
Why: Due to his active life (family and social interactions) it would make it difficult to understand what he is trying
to say as it gets harder to speak. Eg, being asked a question and taking him a bit longer to organized thought and
be able to start the sentence he wants to say which is makes individual having to guess what is being stated.
● Slurred words/breathiness:
Why: It affects the communication by make his words not reconiziable to a family member or friends. It could also
affect how words and letters are being pronounced. For the breathiness, it would make require more effort and
energy to speak (layman's terms: Run out of gas as he speaks).
● Imprecise articulation (letters/ words, numbers):
Why: He is retired and belongs to a book club, service club, and plays cards with friends that as his condition
progresses it makes it hard for him to able to communicate eg, communication about what he read in a book for
his book club, or being able to hold a proper conversation during his card playing games he has his with is friends
or even with just talking to family (Grandchildren)
Herd, C. P., Tomlinson, C. L., Deane, K. H., Brady, M. C., Smith, C. H., Sackley, C. M., & Clarke, C. E. (2012)
Social Communication Challenges
Describe 4 ways the communication challenges might impact your

interactions with the person

Problems with the ability to process others emotions or thoughts

Struggles with facial masking (stiffness of facial muscles) causing difficulty to show expression or their mood (Moore,n.d.).

Issues with (adequate breath support, closure of vocal folds, movements of tongue and throat muscle articulation) causing their
speech to present in a very soft low tone which is difficult to hear ( Patterson,n.d).

Difficulty with speaking too slow or fast resulting in their speech pattern sounding like they have a terrible stutter (Patterson,
n.d).
References

Cleveland Clinic (November 16, 2020) Dysarthria- Symptoms & Causes. Retrieved March 10th 2023, form
https://my.clevelandclinic.org/health/diseases/17653-dysarthria

Dugdale, D. C. (2022, August 8). Communicating with someone with dysarthria: Medlineplus medical encyclopedia. MedlinePlus. Retrieved March 16, 2023,
from https://medlineplus.gov/ency/patientinstructions/000033.htm

Herd, C. P., Tomlinson, C. L., Deane, K. H., Brady, M. C., Smith, C. H., Sackley, C. M., & Clarke, C. E. (2012). Comparison of speech and language therapy
techniques for speech problems in Parkinson's disease. The Cochrane database of systematic reviews, 2012(8), CD002814.
https://doi.org/10.1002/14651858.CD002814.pub2

Mayo Clinic (n.d.) Dysarthria- Symptoms and causes. Retrieved March 10th 2023, from
https://www.mayoclinic.org/diseases-conditions/dysarthria/symptoms-causes/syc-20371994

Moore, D. K. P. (n.d.). Facial masking. Parkinson's Foundation. Retrieved March 10, 2023, from
https://www.parkinson.org/understanding-parkinsons/movement-symptoms/facial-masking

Patterson, D. A. (n.d.). Speech & Swallowing issues. Parkinson's Foundation. Retrieved March 10, 2023, from
https://www.parkinson.org/understanding-parkinsons/non-movement-symptoms/speech-swallowing

Herd, C. P., Tomlinson, C. L., Deane, K. H., Brady, M. C., Smith, C. H., Sackley, C. M., & Clarke, C. E. (2012). Comparison of speech and language therapy
techniques for speech problems in Parkinson's disease. The Cochrane database of systematic reviews, 2012(8), CD002814.
https://doi.org/10.1002/14651858.CD002814.pub2

UBC. (2022). Parkinson's disease. UCB. Retrieved March 15, 2023, from
https://www.ucb-canada.ca/en/Patients/Conditions/Parkinson-s-Disease#:~:text=Parkinson%E2%80%99s%20disease%20affects%201%20in%20every%20
500%20people,incidence%20of%2020%20new%20cases%20per%20100%2C000%20people%29.