Slurred speech is poorly intelligible speech products due to fuzzy articulation. It can occur with alcohol intoxication, cerebral tumors, neurodegenerative processes, dysarthria, rhinolalia, hearing loss, use of inappropriate dentures, jaw dislocation. To diagnose the etiofactors of slurred speech, a neurological, speech therapy, otolaryngological, dental examination is performed. In order to restore speech function, etiotropic and pathogenetic treatment of the leading pathology is carried out, corrective speech therapy classes are carried out.
The term "dysarthria" itself is translated as "disorder of articulate pronunciation." Slurred speech is noted in most types of dysarthria disorders: pseudobulbar, bulbar, extrapyramidal, cerebellar dysarthria. The cause of the disorder of speech motor skills is the defeat of the cranial nerves that innervate the articulatory apparatus. Dysarthria can develop with the following nosologies:
Due to inaccurate articulation, incomprehensibility for others, the oral speech of dysarthria is characterized by the metaphor "porridge in the mouth." The pronunciation of almost all groups of sounds is significantly distorted: both vowels and consonants. Due to hypersalivation, characteristic squelching overtones appear, reducing the intelligibility of pronunciation.
Along with phonetics, speech prosody suffers. The voice is weak, fading, intermittent, hoarse with a nasal tint. The speech is monotonous, slow, there is no intonational expressiveness and emotional coloring of the statement. Breathing is superficial, arrhythmic, speech exhalation is weakened. All this makes the speech statement poorly understood.
The quality of speech production deteriorates in proportion to the severity and prevalence of paresis and paralysis of the oral, vocal, and respiratory muscles. Taking into account the degree of innervation insufficiency, slurring of speech can vary from mild "blurring" with erased dysarthria to slurred speech and even its complete absence - anarthria - in severe forms.
With open rhinolalia, oral speech is extremely slurred. This is due to the total distortion of the sound image of the word. The lips practically do not participate in articulation, the tongue is pulled deep into the oral cavity, the tip of the tongue cannot fully engage with the incisors and alveoli. Snoring, clicking, hissing, whistling noises are mixed with speech sounds.
At the time of phonation, excessive tension of the facial muscles is noted. The voice is choked, unmodulated. Due to air leakage through the nose, a hypernasal shade occurs. The pronunciation becomes indistinct, illegible.
With an anterior dislocation of the TMJ, the patient's mouth is slightly open, the chin is pushed forward. Attempts to close the jaws are sharply painful. Salivation is noted. The patient's speech is difficult or impossible, which is why he tries to explain himself with gestures.
With a posterior dislocation of the lower jaw, on the contrary, the opening of the mouth is limited. The chin moves backwards, the tongue protrudes deep into the mouth, there is no contact between the antagonist teeth. Due to the impossibility of movement of the jaws, slurred speech is noted.
The cause of articulation disorders may be the absence of several or all teeth. First of all, the clarity of pronunciation of front-lingual sounds is disturbed. With adentia, speech becomes lisping, slurred. The most severe diction suffers in the absence of teeth on both jaws.
Adentia
Defectiveness, blurred speech can be observed in dental patients at the stage of adaptation to dentures: bridge-like, removable, based on implants. Normally, this time interval takes from 1 to 3 days, its individual duration correlates with the physiological and psychological characteristics of the patient, the quality of the manufactured orthopedic structures.
The stage of adaptation is characterized by a sensation of the prosthesis as a foreign body, increased salivation, reduced chewing efficiency, vomiting, tension of the articulatory muscles. There are violations of diction, additional overtones (smacking, whistling), general indistinctness and illegibility of speech.
Severe speech disorders affect deaf from birth and early deaf patients. With hearing loss, both the understanding of speech and its pronunciation are impaired. The structure of the word is distorted due to the loss of sounds and whole syllables, the approximation of articulation, the impossibility of exercising auditory control. Indistinctness of speech is expressed in its monotony, deafness, omission of words, a large number of agrammatisms.
Patients with phlegmonous tonsillitis in the abscessing stage complain of fever, excruciating pain when swallowing saliva, drinking water and food, difficulty opening the mouth, salivation. The inflammatory tumor spreads to the soft palate, palatine arches and uvula, as a result of which the mobility of the articulatory organs is disturbed. Due to severe swelling in the oral cavity and trismus of the jaws, speech becomes slurred, and the voice is nasal. All symptoms gradually regress after opening the abscess.
Inarticulateness, slurred speech is characteristic of persons who are in a state of intoxication. With a mild degree of intoxication, the semantic side of the statement is more violated - speech becomes meaningless, primitive, inconsistent.
With severe alcohol intoxication, the articulation of labial and anterior lingual sounds becomes difficult. A person distorts words, puts stresses incorrectly, “swallows” sounds and syllables. The pace of speech slows down, hesitations appear, repetitions of words. Slurred speech disappears as sobering up.
The tactics of diagnostic examination depends on the alleged causes of slurred speech. The algorithm consists of medical and pedagogical aspects: the first allows for nosological diagnostics, the second - to establish the leading mechanism and degree of speech function disorder:
The content of medical care depends on the underlying pathology that led to slurred speech. Both therapeutic and surgical approaches, rehabilitation and recovery measures are used:
The content of speech therapy classes and the methods used differ depending on the structure of the speech defect. However, in all cases, in order to overcome slurred speech, it is necessary to develop articulatory motor skills and improve pronunciation skills. For this purpose, the following methods are used in speech therapy practice:
As part of speech rehabilitation after hearing aids, classes with a deaf teacher are shown. Persons with dentures during the adaptation period are advised to talk more, read slowly and count aloud, work out the pronunciation of "difficult" sounds and sound combinations. With systematic studies, the indistinctness of speech gradually decreases, in many cases a clear, legible pronunciation is achieved.