quality of speech

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Assessing Speech

Causes of abnormal speech.

• Psychiatric disorder - mood disorder, anxiety, schizophrenia
• Confusion - delirium, dementia, intellectual disability
• Dysphasia / aphasia
• Dysarthria - stroke, brain injury, Parkinson's, MS
• Dysphonia - laryngitis, neuropathology, trauma, mass, atrophy, systemic disease
• Hearing impairment
• English as a non-native language
• Intoxication

Rate of Speech

Interpretation.

• Slow speech (bradylalia) Depression, Parkinson's disease, cognitive impairment
• Normal speech rate
• Rapid speech (tachylalia) - fast speech but able to be redirected Normal, mania, anxiety, stimulants
• Pressured speech - fast and without taking breaks, talking over other people and unable to be redirected Mania, anxiety

Volume of Speech

• Loud (hyperphonia) Personality trait, hearing impairment, mania
• Normal speech volume
• Weak (hypophonia) - low or soft speech Shyness, anxiety, depression, Parkinson's disease

Quantity of Speech

• Excessive talking (logorrhoea) - speaking at length and apparently without end Mania, ADHD, anxiety
• Talkative - actively takes part in conversation. Normal
• Poverty of speech - very little speech, even with persuasion. Shyness, depression, schizophrenia, cognitive impairment

Examples of Dysfluency

• Stuttering - repetition, prolongation, or pauses in speech May be developmental, neurogenic, or psychogenic
• Cluttering - rapid, disorganized speech with excessive word and phrase repetitions Often related to language or learning disabilities

Causes of Impaired Speech Fluency

• Foreign language
• Expressive - varied pitch and intonation Normal tonality
• Monotone - the patient uses a single tone for vocal expression. Boredom, depression, schizophrenia, autism spectrum disorder
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