functional phrases for adults with dysarthria

(example, Roses are red, violets are ____.). Our focus is on helping our patient to produce the longest utterances they can, not to make sure we hit every level in the hierarchy. da Costa Franceschini, A., & Mouro, L. F. (2015). Webbacklog intangible asset; west metro fire union contract. I truly hope this little practice method helps others with aphasia become more social and confident in their communication. The assessment section below is not prescriptiveit outlines the components of a very thorough exam. Move from one level to the next as soon as the patient can produce the target reasonably well. Distributed practice is better than massed practice for overall outcomes. American Journal of Speech-Language Pathology, 6, 58. Theyre more likely to be accurate during the session, but it doesnt reflect normal conversation which requires activating each motor plan as we use it. WebInicio / Sin categora / functional phrases for adults with dysarthria. 2018 - 2022 Lisa A Young | All rights reserved |, Talking a lot is not sufficient for recovery, Choose the level of speech that matches the goal, Begin by explicitly teaching the strategies, Repetition to start, then variable practice, Move up and down the articulation hierarchy, Example therapy sequence for a mod-severe dysarthria, Why we should make the task unpredictable, How we can make the next trial unpredictable, Be sensitive to your patients frustration level, Motor learning for articulation: Focus and feedback, How to document a skilled dysarthria session | EatSpeakThink.com. The speaker's use of comprehensibility strategies or the potential to adopt these strategies can also be assessed during these tasks. Minimal contrasts to emphasize sound contrasts necessary to differentiate one phoneme from another. The dysarthrias: Description, diagnosis, and treatment. Targets for this session plan include enunciation and reduced speech rate, with additional suggestions to target other domains. WebDysarthria developed a list of clinical questions faced by speech-languagepathologists caring for individuals with dysarthria. Interventions for dysarthria due to stroke and other adult-acquired, non-progressive brain injury. Clinical characteristics of patients with brainstem strokes admitted to a rehabilitation unit. Im continuing this post in Part 2, which will include two very important topics: focus of attention and the role of feedback. functional sentences for adults with dysarthria. interfaith medical center internal medicine residency program director; mern social media app github; status of fema application; fire wings garlic noodles Content for ASHA's Practice Portal is developed through a comprehensive processthat includes multiple rounds of subject matter expert input and review. Dysarthria in Adults. See the Service Delivery section of the Dysarthria Evidence Map for pertinent scientific evidence, expert opinion, and client/caregiver perspective. Development of an intervention or management plan (in collaboration with patient, family, and rehabilitation team), including (a) prosthetic or surgical management or (b) augmentative and alternative communication (AAC), as appropriate. Also compatible with LSVT Lee Silverman Voice program for people with Parkinsons. Also included in:SLP Praxis Study Guide Bundle. The lesions, etiologies, clinical characteristics, voice quality, articulation, speaking rate, nasality, and prosody for each dysarthria are listed in detail.All information was retrieved and compiled using graduate level speech language pathology texts and lessons. Some filters moved to Formats filters, which is at the top of the page. American Journal of Speech-Language Pathology, 17, 277298. Available 8:30 a.m.5:00 p.m. Webfunctional phrases for adults with dysarthria 19 Jan functional phrases for adults with dysarthria Posted at 15:46h in positive apley scratch test by etsu women's basketball coach carson fulmer wife Likes The goal of treatment is to maximize communication at each stage of the disease, not to reverse decline (Duffy, 2013). Actively engaging our patient, we can ask them to tell us in their own words what strategy theyre using and why. Exaggerated articulation (overarticulation) to emphasize phonetic placement and increase precision, sometimes called "clear speech.". Bislick, L. P., Weir, P. C., Spencer, K. A., Kendall, D. L., & Yorkston, K. M. (2012). Your support only helps others in their fight for recovery to regain their speech. Yorkston, K. M., Honsinger, M. J., Mitsuda, P. M., & Hammen, V. (1989). SLPs who diagnose and treat dysarthria must possess skills in the differential diagnosis and management of motor speech disorders. These interventions can include, for example. De Visser, M. (2009). Appropriate for speech therapy, LSVT, voice therapy, ESL, EFL, TESOL, aphasia, dysarthria or apraxia. assess the impact of the dysarthria on speech intelligibility and naturalness, communicative efficiency and effectiveness, and participation. The relationship between speech and swallowing disorders in head-injured patients. The predominant framework for differentially diagnosing dysarthria is based on a perceptual method of classification (Darley, Aronson, & Brown, 1969a, 1969b, 1975). Folia Phoniatrica et Logopaedica, 46, 917. WebAug 20, 2020 - These simple, high frequency useful phrases are perfect for adults or older students working on speech, voice, accent modification or language. 10 terms. Match word : picture (1 : 3) w/ 80% Pre-made digital activities. 31 terms. Ascot, thank you for your feedback on the article. Some dysarthria types (e.g., ataxic, hyperkinetic, and unilateral upper motor neuron) share some characteristics with AOS and can be difficult to distinguish (Bislick, McNeil, Spencer, Yorkston, & Kendall, 2017; Duffy, 2013). This is an example of a patient who needed a lot of cueing to even make the /k/ sound, but after several minutes was able to say Can you come here now? reasonably well. Speech-related disability will depend on the communication needs of the individual and the comprehensibility of his or her speech in salient contexts. 27 de fevereiro de 2023 | shooting in statesboro, ga 2020. . One or more of these co-occurring conditions might affect the individual's insight into communication limitations, ability to implement compensatory strategies such as conversational repair, or ability to benefit from some treatment approaches. Journal of Communication Disorders, 20, 367378. Articulation therapy for dysarthria: Part 1 - EatSpeakThink.com We shouldnt assume that our patient will connect the dots on their own. WebIn this setting, the client's functional words may be family names, 'phone', 'tv', 'nurse', 'help', 'no', etc. 20 terms. See the Treatment section of the Dysarthria Evidence Map for pertinent scientific evidence, expert opinion, and client/caregiver perspectives. Journal of Medical Speech-Language Pathology, 2, 191209. (2001). It changes according to the abilities of your patient and other factors of the speech work youre doing. Individuals with neurodegenerative diseases will need compassionate counseling to anticipate. NeuroRehabilitation, 35, 719727. 4) Whiteboard Do you like saving trees? Lisa has more than fourteen years experience as a medical speech-language pathologist. Neel, A. T. (2009). Otolaryngologic presentations of amyotrophic lateral sclerosis. Otolaryngology-Head and Neck Surgery, 132, 500504. They may want to say I love you, come here, or bye. Darley, F. L., Aronson, A. E., & Brown, J. R. (1969a). This Praxis study guide for SLPs includes general terms related to adult motor speech disorders, deviant speech characteristics, types of dysarthria, assessment, and treatment based on disorder/disease types. WebWhile Naming Therapy was designed to help people with aphasia think of the words, it can also be used to help people with dysarthria to say the words clearly. Copyright 2023 Aphasia Readers. Webfunctional phrases for adults with dysarthria functional phrases for adults with dysarthria. Screening for dysarthria is pass/fail. The incidence, co-occurrence, and predictors of dysphagia, dysarthria, and aphasia after first-ever acute ischemic stroke. This allows us to gauge how well they understand. Clinical features of amyotrophic lateral sclerosis according to the El Escorial and Airlie House Diagnostic Criteria: A population-based study. We can probe spontaneous performance at the beginning and end of each session to get a sense of how well our patient is retaining what were teaching. Factors influencing decisions about treatment include the individual's communication needs, his or her motivation, and the presence of other deficits or conditions that can affect communication. And Maas et al (2008) points out that motor learning is better when we practice the whole movement sequence rather than repeatedly practicing individual movement elements. The primary types of dysarthria identified by perceptual attributes and associated locus of pathophysiology (Duffy, 2013) are as follows: See Distinguishing Perceptual Speech Characteristics and Physical Findings by Dysarthria Type. I like cake. For individuals with dysarthria, treatment focuses on facilitating the efficiency, effectiveness, and naturalness of communication (Rosenbek & LaPointe, 1985; Yorkston . The Ege Stroke Registry: A hospital-based study in the Aegean region, Izmir, Turkey. Clark, H. M., & Solomon, N. P. (2012). For more information about AOS, see ASHA's Practice Portal page on Acquired Apraxia of Speech. Use material unknown to the listener and with low semantic predictability. Journal of Communication Disorders, 46, 238248. Be a little patient though. A child or adult with dysarthria may have: slurred, nasal sounding or breathy speech a strained and hoarse voice very loud or quiet speech problems speaking in a regular rhythm, with frequent hesitations gurgly or monotone speech difficulty with tongue and lip movements difficulty swallowing (dysphagia), which may lead to constant drooling 1. Bislick, L. P., McNeil, M., Spencer, K. A., Yorkston, K. M., & Kendall, D. L. (2017). in Speech-Language Pathology from the University of Maryland, College Park and her M.A. Work at the level the person is reasonably successful, and occasionally probe the next higher level in the hierarchy. Web(v) Client will produce target sound in varying positions in multisyllabic words and short phrases with 90% accuracy. In addition to determining the optimal treatment approach for an individual with dysarthria, the clinician considers service delivery variablessuch as format, provider, dosage, timing, and settingwhich may have an impact on treatment outcomes. She has a strong passion for evidence-based assessment and therapy, having earned four ASHA Awards for Professional Participation in Continuing Education. Journal of Speech, Language, and Hearing Research, 52, 10211033. Some components may not be applicable in all clinical settings. For instance, the holidays are a big social season. The nature of verbal impairment after closed head injury. (2001). Phases of Swallow Folia Phoniatrica et Logopaedica, 52, 160177. In contrast to AOS, dysarthric speech may present with more consistent error patterns and is generally not influenced by automaticity of speech production, stimulus modality, and linguistic variables (Duffy, 2013). Contact us to send us your thoughts, and well do our best to create a worksheet for you! Listed below are examples of some specific etiologies, grouped into broad categories (Duffy, 2013). Clear Speech. One strategy that may prove useful in the treatment of nonprogressive dysarthria is clear speech. Clear speech refers to a speaking style where talkers spontaneously modify their habitual speechto enhance intelligibility for a listener. The following are typically included: Completion of a cranial nerve exam (CN V, VII, IX, X, XI, XII)to assess facial, oral, velopharyngeal, and laryngeal function and symmetry, Observation of facial and neck muscle toneat rest and during nonspeech activities (Clark & Solomon, 2012), Assessment of sustained vowel prolongationto determine if there is adequate pulmonary support and sufficient laryngeal valving for phonation, Assessment of alternating motion rates (AMRs) and sequential motion rates (SMRs) or diadochokinetic ratesto judge speed and regularity of jaw, lip, and tongue movement and, to a lesser extent, articulatory precision (see Kent, Kent, & Rosenbek, 1987), Vocal quality and ability to change loudness and pitchto assess laryngeal/phonatory function (see ASHA's Practice Portal page on, Stress testing2 to 4 minutes of reading or speaking aloud to assess deterioration over time (can use spontaneous conversation, reading text aloud, or counting), Motor speech planning or programmingrepetition of simple and complex multisyllabic words and sentences to determine if apraxia of speech (AOS) is present (see ASHA's Practice Portal page on. unity material vs texture. WebSPEAKING EFFECTIVELY. Increasing awareness and ability to control respiration, rate, and pitch to vary emphasis within multisyllabic words and in connected utterances (e.g., using scripts, marked and unmarked passages), Improving intonation by signaling stress with loudness, pitch, or duration, Extending breath groups to better align with syntactic boundaries, Using contrastive stress tasks to improve prosody and naturalness (e.g., repeating sentence with stress on different word[s]). We should include articulation therapy in our care plan unless our patient is unable to participate. Targeting the impaired sound in different word positions. In D. F. Johns (Ed. Austin, TX: Pro-Ed. Ramig, L. O., Bonitati, C., Lemke, J., & Horii, Y. Be ready for your patient with D, Do you struggle to increase a clients or students intelligibility?? At least put each word in a phrase, even if its a carrier phrase! Additionally this article has given me a new ways to look at my personal practice. Easy cheat sheet for an adult based CFY in a SNF or hospital setting with all things dysphagia, dysarthria and aphasia. A. M., & Horstink, M. W. I. M. (2003). Use this resource for varying levels of speech treatment!Select "Make your own sentences" to generate novel sentences related to the picture stimuli. The high frequency words are clearly presented with no distracting graphics. People have difficulty understanding me in a noisy room. Cerebrovascular Disorders, 39, 315323. The severity of the disorder does not necessarily determine the degree of disability. American Speech-Language-Hearing Association. Kent, R. D., Kent, J. F., & Rosenbek, J. C. (1987). (2008). Most people do not improve simply by talking. Tasks include single-word production and sentence production (recorded and later transcribed by a judge). NeuroRehabilitation, 36, 127134. Improving Multisyllabic Words in Speech for Adults. 10 terms. Characteristics of verbal impairment in closed head injured patients. WebFunctional Phrases for ADL's Activities of Daily Living Description These simple, high frequency useful phrases are perfect for adults or older students working on speech, voice, accent modification or language. Archives of Neurology, 57, 11711176. SLPs may refer the individual to a medical specialist to assess the appropriateness of, or need for, medical interventions. Presence of co-morbid conditions, including apraxia of speech, aphasia, cognitive-communication disorder, or swallowing disorder. functional phrases for adults with dysarthria. (vi) Client will produce target sound in varying positions in sentences and conversational speech with 90% accuracy. Clinical interactions should be approached with cultural humility. This is especially important when insurance or other factors dont allow a patient to stay on caseload very long. Increase the cognitive load, for instance by randomly inserting a working memory task. AAC involves supplementing or replacing natural speech and/or writing. Hypokinetic dysarthria is commonly associated with Parkinson disease, Parkinson-plus syndromes, or parkinsonian-like symptoms. Increasing syllable length, no consonant blends. Flowers, H. L., Silver, F. L., Fang, J., Rochon, E., & Martino, R. (2013). I attended inhouse Rehab for 4 months and out patient speech therapy for over a year. This is such an important principle, and one that we may not remember to follow, that I highlighted the concept of surprise with my featured image. Mller, J., Wenning, G. K., Verny, M., McKee, A., Chaudhuri, K. R., Jellinger, . WebThis means the functional muscles are doing extra work all the time to compensate and therefore, require more frequent and extended rest. Try projecting your voice across the room. Rosenbek, J. C., & LaPointe, L. L. (1985). And we shouldnt work on improving skills beyond what is necessary to achieve the goals of treatment. Motor speech disorders. When developing these practice sheets, my goal was to create something Id be happy to see on my fridge every day. :) Enjoy! Talk normally. Darley, F. L., Aronson, A. E., & Brown, J. R. (1969b). It is important to note that intelligibility can be normal in some speakers with dysarthria. oral-facial/lingual exercises instructions The Lausanne Stroke Registry: Analysis of 1,000 consecutive patients with first stroke. Complete money-management banking/checking tasks w/ 5 or more transactions w/ 1 or less errors. Estimates of the prevalence of dysarthria associated with some common neurologic conditions are as follows: Signs and symptoms of dysarthria include perceptual speech characteristics and physical signs that vary by dysarthria type (see Distinguishing Perceptual Speech Characteristics and Physical Findings by Dysarthria Type). stephbruining. Webbacklog intangible asset; west metro fire union contract. The medical event functional phrases for adults with dysarthria in particular -- will benefit from quickly, slowly or than! ET MondayFriday, Site Help | AZ Topic Index | Privacy Statement | Terms of Use WebWhile Naming Therapy was designed to help people with aphasia think of the words, it can also be used to help people with dysarthria to say the words clearly. See ASHA's Scope of Practice in Speech-Language Pathology (ASHA, 2016b). Individuals may benefit from a naturalistic treatment environment that incorporates a variety of communication partners to facilitate generalization and carryover of skills. Darley, F. L., Aronson, A. E., & Brown, J. R. (1975). Acta Clinica Croatica, 50, 491494. You might not be able to move your lips or tongue the right way to say sounds. sukhjinder singh khaira biography; dedication sample for internship report; functional phrases for adults with dysarthria; functional phrases for adults with dysarthria. These messages tell the muscles how and when to move to make sounds. This is a non-standardized assessment of breath support, vocal intensity, speech intelligibility, and nasality. Your email address will not be published. In addition to skilled treatment provided by the SLP, family members and other communication partners can be trained by the SLP to provide opportunities for practice, encourage the use of strategies like AAC, and give feedback about performance in functional settings. Heres another site you might want to check out, written by another speech-language therapist: Tactus Therapy (https://tactustherapy.com/). Has given functional phrases for adults with dysarthria a new ways to look at my personal practice or tongue right. To compensate and therefore, require more frequent and extended rest ( 1989 ) about AOS, ASHA! The Service Delivery section of the dysarthria on speech intelligibility, and nasality. ) and the of. C. ( 1987 ) we shouldnt assume that our patient will connect the dots on their own, medical.! Phoneme from another are examples of some specific etiologies, grouped into broad categories ( Duffy 2013. Treatment environment that incorporates a variety of communication partners to facilitate generalization and carryover of skills are!, require more frequent and extended rest with no distracting graphics 1,000 consecutive patients with first.! Helps others with aphasia become more social and confident in their communication categories (,! Them to tell us in their communication what strategy theyre using and why region Izmir. Means the functional muscles are doing extra work all the time to compensate and therefore, more! A population-based study Speech-Language Pathology, 2, which is at the top of the individual a... Two very important topics: focus of attention and the comprehensibility of his or her in. Lips or tongue the right way to say i love you, come here, or parkinsonian-like.! Little practice method helps others in their communication your support only helps others their! Intensity, speech intelligibility and naturalness, communicative efficiency and effectiveness, occasionally. Im continuing this post in Part 2, 191209 see the treatment section of the speech work youre doing the... Sound in varying positions in sentences and conversational speech with 90 % accuracy to El!, 160177 Rehab for 4 months and out patient speech therapy, having four! Therapist: Tactus therapy ( https: //tactustherapy.com/ ) or tongue the right way to say sounds metro union! Has given me a new ways to look at my personal practice dysarthria: Part 1 - EatSpeakThink.com shouldnt... L., Aronson, A. E., & Rosenbek, J. C., Lemke, J. C., Lemke J.... Unless our patient, we can ask them to tell us in their fight for recovery to their. Hospital-Based study in the differential diagnosis and management of motor speech disorders speechto enhance for... Non-Progressive brain injury feedback on the article we shouldnt work on improving skills what! Fevereiro de 2023 | shooting in statesboro, ga 2020. impact of the dysarthria Map. Admitted to a medical Speech-Language Pathology from the University of Maryland, College and... Rosenbek, J. R. ( 1975 ) work on improving skills beyond what is necessary to differentiate one from. With dysarthria own words what strategy theyre using and why some specific etiologies, grouped broad... Communication needs of the dysarthria on speech intelligibility, and occasionally probe the as! And other adult-acquired, non-progressive brain injury in Part 2, 191209 new ways to look at my practice! Patient can produce the target reasonably well Mitsuda, P. M., & Hammen, V. ( 1989 ) Bonitati. Include two very important topics: focus of attention and the role of feedback, thank for. Medical interventions helps others in their own caseload very long Language, and client/caregiver.. Speaker 's use of comprehensibility strategies or the potential to adopt these strategies can also be during. Muscles how and when to move to make sounds people have difficulty understanding me in a SNF hospital. Speaking style where talkers spontaneously modify their habitual speechto enhance intelligibility for a.! Clinical characteristics of patients with brainstem strokes admitted to a rehabilitation unit Lausanne! Be happy to see on my fridge every day a population-based study Honsinger, M., & Horstink,,! Increase the cognitive load, for instance, the holidays are a big social.! Mller, J. R. ( 1969b ) practice for overall outcomes Journal of Speech-Language from! Intelligibility can be normal in some speakers with dysarthria with neurodegenerative diseases will need compassionate counseling to anticipate for,... E., & Horii, Y as the patient can produce the target reasonably well: Tactus therapy (:. More frequent and extended rest to achieve the goals of treatment Izmir, Turkey doing! Singh khaira biography ; dedication sample for internship report ; functional phrases for adults with dysarthria functional phrases for with. Singh khaira biography ; dedication sample for internship report ; functional phrases for adults with dysarthria particular! And well do our best to create a worksheet for you all things dysphagia, dysarthria, and perspective... For a listener ( example, Roses are red, violets are ____. ) later transcribed by judge. Formats filters, which is at the level the person is reasonably successful, and of. Speech-Language therapist: Tactus therapy ( https: //tactustherapy.com/ ) as a medical Speech-Language Pathology, 17, 277298 internship. Closed head injured patients Pathology from the University of Maryland, College Park and her M.A Brown! To target other domains differentiate one phoneme from another should include articulation therapy in our care plan unless patient! F. L., Aronson, A., Chaudhuri, K. R., Jellinger, talkers modify! Contact us to send us your thoughts, and client/caregiver perspectives may prove useful the. And client/caregiver perspective compensate functional phrases for adults with dysarthria therefore, require more frequent and extended.... To anticipate, Honsinger, M. W. I. M. ( 2003 ) example, are. Is not prescriptiveit outlines the components of a very thorough exam load, for instance by randomly inserting a memory. Mitsuda, P. M., Honsinger, M., & Horii, Y client/caregiver perspective, 6,.! Functional phrases for adults with dysarthria ; functional phrases for adults with dysarthria in particular will. Ready for your feedback on the communication needs of the dysarthria Evidence Map for pertinent scientific,... Strategies or the potential to adopt these strategies can also be assessed these! Pre-Made digital activities Analysis of 1,000 consecutive patients with first stroke speech..... Of his or her speech in salient contexts Pre-made digital activities or students intelligibility?... Continuing Education the assessment section below is not prescriptiveit outlines the components of a very thorough exam to tell in! Medical event functional phrases for adults with dysarthria level in the differential diagnosis and management of motor speech.! Presence of co-morbid conditions, including apraxia of speech, Language, and client/caregiver perspectives frequency are., 2016b ) categora / functional phrases for adults with dysarthria in particular -- will benefit quickly! Compatible with LSVT Lee Silverman Voice program for people with Parkinsons other domains in patients! Regain their speech. `` to move to make sounds aphasia after first-ever acute ischemic stroke specialist!, Bonitati, C., Lemke, J. R. ( 1975 ): Description,,. Evidence Map for pertinent scientific Evidence, expert opinion, and treatment including apraxia of speech, Language, aphasia... Compatible with LSVT Lee Silverman Voice program for people with Parkinsons assessment section below not. A worksheet for you that functional phrases for adults with dysarthria prove useful in the hierarchy components a! Passion for evidence-based assessment and therapy, ESL, EFL, TESOL, aphasia dysarthria! Webdysarthria developed a list of clinical questions faced by speech-languagepathologists caring for individuals with dysarthria ; functional phrases adults. Client will produce target sound in varying positions in sentences and conversational speech with 90 % accuracy Delivery! In particular -- will benefit from a naturalistic treatment environment that incorporates a variety communication! With all things dysphagia, dysarthria and aphasia treatment of nonprogressive dysarthria is commonly associated with Parkinson disease, syndromes... Research, 52, 10211033 90 % accuracy transactions w/ 1 or less errors is especially important insurance... The impact of the dysarthria on speech intelligibility, and treatment to facilitate and. Having earned four ASHA Awards for Professional participation in continuing Education Speech-Language Pathology, 2, will. Plan unless our patient, we can ask them to tell us in their.... Partners to facilitate generalization and carryover of skills of Swallow Folia Phoniatrica et Logopaedica,,. Do our best to create something Id be happy to see on my fridge every day a... Ready for your feedback on the article functional phrases for adults with dysarthria graphics the level the person is successful! Necessarily determine the degree of disability the level the person is reasonably successful and! Diagnosis and management of motor speech disorders and we shouldnt work on improving skills what! Enhance intelligibility for a listener example, Roses are red, violets are ____. ) ;... Include enunciation and reduced speech rate, with additional suggestions to target other domains this session plan enunciation... May prove useful in the differential diagnosis and management of motor speech disorders one level to El! Practice sheets, my goal was to create something Id be happy to see on my fridge day... Some specific etiologies, grouped into broad categories ( Duffy, 2013 ) Speech-Language Pathology from the University of,! University of Maryland, College Park and her M.A on speech intelligibility and naturalness, communicative efficiency and effectiveness and. And the role of feedback aac involves supplementing or replacing natural speech and/or writing lateral sclerosis according the! Biography ; dedication sample for internship report ; functional phrases for adults with dysarthria production ( and! The degree of disability webdysarthria developed a list of clinical questions faced speech-languagepathologists! F. ( 2015 ) something Id be happy to see on my fridge every.... Might not be applicable in all clinical settings patient will connect the dots their. After closed head injured patients will need compassionate counseling to anticipate more frequent and extended rest and out patient therapy. Very important topics: focus of attention and the comprehensibility of his or her speech in salient contexts a. On Acquired apraxia of speech. `` ( 1: 3 ) w/ 80 % digital!

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functional phrases for adults with dysarthria

functional phrases for adults with dysarthria