Middle Eastern Journal of Disability Studies

Background and Objective: Multiple sclerosis (MS) is a kind of inflammatory and degenerative demyelinating disease in central nervous system. According to severity of impairment and site of lesions, different symptoms in these patients can be seen. One of the most common communication symptom that has been seen in these patients is dysarthria. Dysarthria is a kind of motor speech disorders that can affect all component of speech production. Communicational disorders can create a lot of limitation in daily life such as decrease taking part in educational experience and job finding that can be lead social isolation and depression in the population. The aim of this study was to investigate the frequency of impaired speech characteristics in mono lingual multiple sclerosis patients of Ahvaz city and their usage of speech therapy services.
Methods: This cross sectional study was performed on 102 mono lingual multiple sclerosis patients in Ahvaz (Khuzestan province, southwest of Iran).Patients studied in this research were selected between MS society members of Ahvaz Jundishapur University of Medical Sciences. Diagnosis of dysarthria in patients was made by perceptual assessment through vowel prolongation, Dia Docko Kinetic (DDK), counting and contextual speech tasks. Speech and language pathologist was gathered information about the recourse of patients to the speech therapy clinics by asking from each patient. Data analysis in this cross sectional study was done using descriptive-analysis statistics such as paired-sample T-test, chi square test, mean schedule and standard deviation using SPSS program 22 series. In addition, validity estimation was done to check diagnosis accuracy of dysarthria in multiple sclerosis patients.
Results: Among 102 patients, 65.7% was woman and 34.3%man. 54.9% of them had dysarthria. The most impaired speech characteristics that was seen in these patients were included harsh quality of voice (94.6%), voice tremor (75%), strained–strangled voice (73.2%), slow and irregular alternative motion rate (69.9%), moo loudness (60.7%), imprecise consonant (51.8%), mono pitch (39.3%) and prolonged interval (37.5%) respectively. Among 102 patients, 3.9%used speech therapy services. Ten percent of recorded samples checked again to investigate diagnosis validity of dysarthria. Results show high validity with 84% correlation coefficient and p-value<0.001. 
Conclusion: According to results obtained in this study, most frequency occurrence in impaired speech characteristics were in the area of the phonatory, articulation, prosody and resonance aspects that due to malfunction of larynx, loss of fine movement of larynx, slow and imprecise movement of tongue, distortion in cerebellar function and deficit on respiration control. Therefore, it seems that all the component of speech production involved in these population. Therefore, it could be lead a lot of communicational limitation. Many of patients had not use speech therapy services experience and some of them when refer to speech therapy clinics that was too late when the disease progressed and create a lot of limitation for the patients and their family. It seems that there is not any proper referral system from physicians to speech therapy clinics. In addition, patients had not any insight about speech therapy services.