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Ms. Lassiter, a 35-year-old woman presented with a 2-year history of gradual mental deterioration, reduced ability to concentrate, and hand-writing difficulty. She complained of speech difficulty. Neurologic evaluation identified involuntary movements and balance difficulty, generalized motor impersistence, and mild cogwheel rigidity. Neuropsychological assessment confirmed the presence of significant cognitive limitations. MRI showed an abnormality in the right putamen that could represent iron deposition and mild generalized atrophy. During the speech examination rapid, unsustained, choreiform movements of the lower face, jaw, and tongue were present at rest. Involuntary tongue clicking was noted. She had difficulty maintaining a protruded tongue, open mouth, and lip retraction due to both motor impersistence and involuntary movements. Speech was characterized by an accelerated rate, imprecise articulation with irregular articulatory breakdowns, dysprosody, and variable rate. Vowel prolongation was characterized by low-amplitude tremor. Speech AMRs were irregular. Pitch and loudness variability was reduced, but pitch and loudness occasionally varied inappropriately. What type of dysarthria do you suspect?

A nurse wants to enhance their professional identity and decides to:

The movement disorders underlying hyperkinetic dysarthrias are categorized by: (Select all that apply)

Hypokinetic-hyperkinetic mixed dysarthria is commonly associated with ______________________________________.

Speaker strategies could include (Select all that apply)

Ms. Monroe, a 27-year-old woman, presented with a progressive history of gait imbalance, hand incoordination, and “slurred speech.” Her symptoms worsened around her menstrual periods and when she was nervous or fatigued; they had worsened slightly during a pregnancy. During the speech examination, she admitted to an approximately 10-year history of “slurred speech” that did not seem to be worsening. Conversational speech was characterized by occasional irregular articulatory breakdowns. Infrequently, rate was mildly slowed and multisyllabic words were produced with excess and equal stress. Prolonged “ah” was unsteady. Speech AMRs were slow but not noticeably irregular. What do you suspect the prognosis is for her condition?

Hallmark speech characteristics of hypokinetic dysarthria include: (Select all that apply)

What articulatory abnormalities are heard in this speech sample? (Select all that apply)

What is the priority nursing action when a new graduate nurse is observed not following the standards of professional practice?

What should the clinician consider when assessing and making judgements regarding a patient’s speech intelligibility?