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Practice Guidelines for Dysarthria: Evidence for Effectiveness of Treatment of Rate, Loudness or Prosody
Kathryn M. Yorkston, Mark Hakel, David Beukelman, and Susan Fager

In 1997, the Academy of Neurologic Communication Disorders and Sciences (ANCDS) established a Writing Committee to develop evidence-based practice guidelines for speech-language pathologists who treat individuals with dysarthria. The current guidelines draw from both the research literature and expert opinion to summarize the effectiveness of treatment of rate, loudness and prosody in dysarthria. A search of electronic databases (PsychINFO, MEDLINE, and CINAHL) and hand searches of relevant edited books yielded 49 intervention studies in the categories of loudness (N=20), rate (n=19), prosody (N=9), and general instructions (N=6). Results of this review suggest that the strongest evidence regarding treatment efficacy is in the area of modification of loudness in individuals with PD who have hypokinetic dysarthria. In this area, treatment efficacy research has progressed from case reports to group studies comparing various treatment approaches or providing information on long-term follow-up. Researchers have also investigated some factors regarding modification of speaking rate that may have an active treatment effect. Other clinical investigators have reported cases illustrating the potential benefits of treatment techniques involving prosody and general instructions. Although many interventions were shown to be effective in particular speakers with dysarthria, a number of issues warrant further research.

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