Darley's contributions to the understanding, differential diagnosis, and scientific study of the dysarthrias

Abstract

The work of Frederic L. Darley and his colleagues has done much to shape approaches to the clinical diagnosis and understanding of the dysarthrias and the scientific study of speech production. From the perspective of the speech pathologist and the perspective of the speech scientist, this paper examines Darley's contributions to the clinical diagnosis and management of the dysarthrias, to the localisation and diagnosis of neurologic disease, to descriptions of the perceptual representations of disordered speech, and to efforts to integrate information about disordered neural control of speech with information about the normal neural control of speech. Gaps in knowledge and directions for future work in each of these areas are also discussed.

Re-Thinking Diagnostic Classification of the Dysarthrias: A Developmental Perspective

“…The authors concur with others who have written on the seminal contribution of the DAB model [1,4,19] . It is important to mention that it was not DAB, but rather paediatric clinicians and researchers over time who have applied the Mayo system to children.…”

“…Hence, this section does not aim to criticize the DAB model, but with a view to improving clinical practice in paediatrics, we critically question whether the application of this model to children is valid and empirically justified. Further, it is beyond the scope of this paper to discuss broader issues of the Mayo system that have been considered in the adult literature, including clinical utility and validity [1,[4][5][6]19] , stimuli or task selection [20] , intra-and inter-rater reliability [5] , and effects of listener background and experience on rating [5] . Such issues would pose equal challenges in the paediatric field, but they have not been systematically examined in relation to children, and hence will not be further expanded upon here.…”

Behavioural intervention effects in dysarthria following stroke: communication effectiveness, intelligibility and dysarthria impact

“…Frenchay Dysarthria Assessment; Enderby 1983), are not necessarily measures of communication change. Furthermore they include many non-speech tasks, such as tongue protrusion, which while providing a view of the integrity of the motor system, may be poorly correlated with communication (Duffy and Kent 2001). Also without videorecords, or having several judges present at the data collection point, inter-rater agreement on such tasks cannot be demonstrated.…”

“…Discrete lesions which might be associated with one diagnostic category are not typical of the dysarthric stroke population. Also within a given dysarthria category much individual variation of symptoms is noted and there is now wide recognition that subtypes exist within the established dysarthria categories, such as ataxic and flaccid (Duffy and Kent 2001). The features of dysarthria categories overlap to the extent that even experienced clinicians are minimally successful in diagnosis (Zyski and Weisiger 1987).…”

Acoustic Investigation of Vocal Quality following Treatment for Childhood Cerebellar Tumour

“…The benefits of supplementing perceptual judgements with acoustic and/or physiological assessment tools have been widely documented [11][12][13][14]. Specifically, in relation to vocal function, the application of acoustic evaluation of voice has been suggested as an integral part of a multidimensional approach to clarifying the nature and degree of vocal dysfunction [15].…”