Difficulty speaking (dysarthria)

Dysarthria is difficulty speaking caused by problems controlling the muscles used in speech.

A child or adult with dysarthria may have:

  • slurred, nasal-sounding or breathy speech
  • a strained and hoarse voice
  • excessively loud or quiet speech
  • problems speaking in a regular rhythm, with frequent hesitations
  • "gurgly"-sounding or monotone speech
  • difficulty with tongue and lip movements
  • difficulty swallowing (dysphagia), which may lead to constant drooling

As a result of these problems, a person with dysarthria may be difficult to understand. In some cases, they may only be able to produce short phrases, single words, or no useful speech at all.

Dysarthria does not affect intelligence or understanding, but a person with the condition may also have problems in these areas. Speech problems can also affect social interaction, employment and education.

If you or your child has dysarthria, you may find it helpful to see a speech and language therapist. Ask your GP to refer you, or contact your nearest speech and language therapy clinic.

What causes dysarthria?

The muscles used for speech are controlled by the brain and nervous system. Dysarthria can develop if either of these is damaged in some way.

Dysarthria can either be:

Dysarthria in children is usually developmental while dysarthria in adults is often acquired, although both types can affect people of any age.

Whether dysarthria will improve with speech and language therapy depends on what has caused the condition and the extent of the brain damage or dysfunction. Some cases may remain stable while others may worsen over time.

How can a speech and language therapist help?

Speech and language therapists (SLTs) play an important role in identifying and assessing children and adults with dysarthria.

However, there's no guarantee that speech and language therapy can improve the speech of everyone with dysarthria. 

Treatment success depends on the extent and location of the brain damage or brain dysfunction, or the stage of the progressive condition that's causing it.

Diagnosing dysarthria

To assess the extent of the speech problem, an SLT may ask you or your child to try any of the following tasks:

  • make different sounds
  • talk about a familiar topic
  • count numbers or recite days of the week
  • read a passage aloud

The therapist may also want to examine the movement of the muscles in the mouth and voice box (larynx), and may wish to make a recording.

Treating dysarthria

An SLT will try to improve and maximise your ability to talk, help you find different ways of communicating, and help you and your family adapt to your new situation.

They will work as part of a team of health professionals that includes people from the health, social and voluntary sector.

It's difficult to generalise about what will be effective, as successful treatment is determined by an individual's underlying condition and personal circumstances.

An SLT may recommend:

  • strategies to improve speech, such as slowing speech down
  • a programme of exercises to improve the volume or clarity of speech 
  • assistive devices, such as a simple alphabet board, an amplifier, or a computerised voice output system

Some SLTs may be able to offer a short loan of a communication aid.

Read more about sources of support for carers of people with communication problems.

Communication tips

Tips for people with dysarthria

If you have dysarthria, you may find it helpful to:

  • take a good breath before you start speaking
  • put extra effort into stressing key words
  • speak slowly, saying one word at a time if necessary
  • leave a clear space between each word
  • make sure you are in the same room when talking and face your listener
  • attract the listener's attention (for example, by touch or calling their name) before you begin talking to them
  • keep sentences short and avoid long conversations if you are feeling tired
  • reduce background noise – for example, switch off the TV or radio
  • repeat yourself if needed

Tips for family, friends and carers

If you are speaking to a person with dysarthria, you may find the following advice helpful:

  • reduce distractions and background noise when you have a conversation
  • look at the person as they talk
  • after speaking, allow them plenty of time to respond – if they feel rushed or pressured to speak, they may become anxious, which can affect their ability to communicate
  • avoid finishing their sentences or correcting any errors in their language as this may cause resentment and frustration – ask what the person prefers
  • if you do not understand what they are trying to communicate, do not pretend you understand as they may find this patronising and upsetting – it's always best to be honest about your lack of understanding
  • if necessary, you could ask for clarification by asking yes/no questions or paraphrasing – for example, say: "Did you ask me if I'd done the shopping?"

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