Is 20 years too long?: improving intelligibility in long-standing dysarthria--a single case treatment study.

Resource management decisions by most speech and language therapists would suggest that treatment for a dysarthric client of 20 years' duration should be a low priority. This study describes the therapy of a dystonic client who had been virtually speechless for 20 years because of his severe dysarthria. Assessment of his speech revealed that lip rounding was particularly difficult for him. He was offered eight sessions of general dysarthria therapy and eight sessions of therapy specifically designed to reduce lip tension. The hypotheses driving this therapy plan were that it would be possible to effect changes in his longstanding speech patterns and that therapy focused on reducing lip tension would be more effective than non-specific dysarthria therapy. An intelligibility test was designed to monitor any changes in his speech production. Therapy improved the client's intelligibility and increased his confidence and consequent functional use of speech.