Practice guidelines for dysarthria: Evidence for the behavioral

management of the respiratory/phonatory system

By K.M. Yorkston, K.A. Spencer, J.R. Duffy, L.A. Golper,

E.A. Strand, M. Sullivan, R.M.Miller, and D.R. Beukelman

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 and address the issue of management of respiratory/phonatory dysfunction in dysarthria. A literature search yielded 32 intervention studies related to behavioral treatment of respiratory/phonatory dysfunction. A summary of the type and quality of evidence from this research is provided. Additionally, a clinical decision-making flowchart is offered for the behavioral management of respiratory/phonatory dysfunction in dysarthria. Management strategies clustered under three general categories: (1) improving respiratory support, (2) increasing respiratory/phonatory coordination and control, and (3) improving phonatory function. Support for the use of specific respiratory/phonatory interventions varied considerably; techniques substantiated by converging evidence will be highlighted.