No place for motor speech acts in the assessment of dysphagia? Intelligibility and swallowing difficulties in stroke and Parkinson's disease patients.

Speech and language therapists are increasingly being asked to treat dysphagic patients. Concern has been expressed and surveys have confirmed that radiological assessment procedures are rarely available. Consequently, patients must often be assessed and their treatment planned on the basis of bedside examinations. Despite evidence that swallowing disorders need not be related to problems of articulation, recommendations on the procedure of such examinations frequently include an evaluation of speech and non-speech articulatory movements. A study is reported of patients who exhibit both dysphagia and dysarthria as a result of either stroke or Parkinson's disease. Assessments of the intelligibility of their speech and of their swallowing problems were found to be unrelated. The implications of this finding for the assessment of dysphagia are discussed.