Therapy for Dysarthria and Slurred Speech

Dysarthria affects both older and younger people

The other day I was giving a speech to the Houston Stroke Warriors and had a question from the audience about slurred speech.  Many do not know that dysarthria is the term for slurred speech and it often happens following a traumatic brain injury, stroke, aphasia, or neurological disease. Now how would the layperson know what a dysarthria is?

The way I explain it is simple.  It sounds as if a person just drank a considerable amount of alcohol.  Most of us have had the opportunity of being somewhere when a person we knew had way too much to drink.  Their speech was slurred, and indistinct.  That is what a cerebellar dysarthria might sound like.  When the cerebellar area of the brain is damaged the result will likely affect the accuracy of articulation and the prosody-melody of speech.  There are individuals who may have just a dysarthria which is classified as a motor speech disorder.  They may have intact language and can formulate what they want to say, but the motor of speech slurs the sounds and makes it, at times, difficult to understand, since the sounds are not produced accurately.  Following brain injury or insult the motor speech mechanism can be greatly and negatively affected.  There are also many cases where both the language center of the brain, can no longer process language in addition to the motor speaking difficulty. 

When i explained to the group that a cerebellar dysarthria sounded as if someone had too much to drink, many realized how common it was with people who had a stroke or aphasia.  With those who have the ability to express and formulate language, the approach to speaking improvement involves adjusting the speaking “motor.”  By that I mean that often the speech langauage pathologist must show the person with dysarthria a different way of speaking.  It will often be a way that is slower, with a greater length of pausing between each spoken word.  The speech language pathologist or caregiver must learn to model the new way of speaking.  To model a way of speaking the speech pathologist or caregiver must give the person with dysarthria a model of slower rate, with increased pausing or latency between each spoken word.  I have seen people with dysarthria who were barely intelligible or understood go to speech improve their speaking clarity almost immediately, once the caregiver or speech model constantly gives the person with the speaking difficulty a new way of speaking to duplicate.  It is often done initially with very short phrases, which gradually builds up to sentences, paragraphs and then conversation.  

I must emphasize here the role of an excellent speech model who can provide a different speed and way of speaking that could be easily imitated.  Often when I see a person with dysarthria for a speech evaluation, I show them a way of speaking towards the conclusion of the visit and ask them to “say it like I do.”  As if by a “magic” the person who had just been so difficult to understand, can now say a phrase or sentence quite clearly.

I can not tell you how often I have seen patients with dysarthria, who never knew of a way to improve the clarity of their speaking and realized that it could be dealt with successfully with an excellent speech model who was familiar with the Teaching of Talking Approach.  Contact me if you would like to find out more about The Teaching of Talking Approach to Dysarthria.  A basic understanding of the Teaching of Teaching Method should be learned first.  This is a method that teaches you how to ask questions that will immediately trigger one, two, three words or more in phrases or sentences as long as the person with the speaking difficulty is stimulable or able to imitate vowels, single syllables or whole words.  The speed and manner of the questions asked will also have a profound influence on the speed of the answer given by the person with the speaking difficulty.

The Teaching of Talking is available on our website at .  From the home page go to the content area and clik on order Teaching of Talking Book, or Teaching of Talking on    To find out more about our work with Amazon, please go to  The audio-book The Teaching of Talking, Learn to Do Expert Speech and Language Stimulation at Home With Children and Adults is also available on iTunes (audio-books).

When you read and learn the Teaching of Talking Method, you will be able to apply this technique to a number of speaking difficulties.  Do not hesitate to contact me of I can be of any service to you.

Best regards,



About Mark Ittleman

Mark Ittleman is a Senior Speech Language Pathologist and serves those with moderate to profound speaking difficulties. He consults with many of the best rehabilitation hospitals and now travels the country with his wife, and lectures at Universities, Hospitals, and Aphasia Organizations. He also consults with people all over the world with speaking difficulties and their families.
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