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Intensive dysarthria therapy for younger children with cerebral palsy
Lindsay Pennington1, Ella Roelant, Vicki Thompson
1Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK. lindsay.pennington@ncl.ac.uk
Insights
This study found that brief, intensive speech therapy improved speech intelligibility and communication for some children with dysarthria and cerebral palsy. Therapy focused on breath support, phonation, and speech rate led to positive outcomes.
Area of Science:
- Neurology
- Speech-Language Pathology
- Pediatrics
Background:
- Children with dysarthria and cerebral palsy (CP) often experience challenges with speech intelligibility and social participation.
- Targeted interventions are needed to improve communication abilities in this population.
Purpose of the Study:
- To evaluate the impact of a 6-week intensive therapy program on speech intelligibility and communication participation in young children with dysarthria and CP.
- The intervention specifically targeted breath support, phonation, and speech rate.
Main Methods:
- Fifteen children (ages 5-11) with dysarthria and CP received 3 weekly therapy sessions for 6 weeks.
- Speech intelligibility was assessed pre-therapy and at 1, 6, and 12 weeks post-therapy by familiar and unfamiliar listeners.
- Communicative participation was measured using the Focus on the Outcomes of Communication Under Six (FOCUS) tool.
Main Results:
- Significant improvements in speech intelligibility were observed for both single words and connected speech.
- Communication participation scores (FOCUS) increased for parents and teachers post-therapy.
- Individual responses to therapy varied, and intelligibility gains did not correlate with participation improvements.
Conclusions:
- A brief, intensive therapy approach can enhance speech intelligibility and communicative interactions in some children with dysarthria.
- Further research is needed to understand individual variability in treatment response.
Aim:
The aim of this study was to investigate if intervention targeting breath support, phonation, and speech rate increases speech intelligibility and participation in the conversational interactions of younger children with dysarthria and cerebral palsy (CP).
Method:
Fifteen children with dysarthria and CP (nine males, six females; age range 5-11 y, mean age 8 y, SD 2 y; CP type: eight spastic, four dyskinetic, one ataxia, two Worster Drought syndrome; Gross Motor Function Classification System levels II-IV, median level II) participated in this study. Children received three sessions of individual therapy per week for 6 weeks. Intelligibility of single words and connected speech was compared across five points: 1 and 6 weeks before therapy and 1, 6, and 12 weeks after therapy. Three familiar listeners and three unfamiliar listeners scored each recording. Participation in communicative interactions was measured using the Focus on the Outcomes of Communication Under Six (FOCUS) tool. Analyses of variance and paired t-tests were used to investigate change.
Results:
Mean speech intelligibility increased after therapy to familiar listeners (single words 10.8%, 95% confidence interval [CI] 7.2-14.4; connected speech 9.4%, 95% CI 4.8-14.1) and unfamiliar listeners (single words 9.3%, 95% CI 6.8-11.8; connected speech 10.5%, 95% CI 7.3-13.8). FOCUS scores increased following therapy for parents (mean increase 30.3, 95% CI 10.2-50.4) and for teachers (28.25, 95% CI 14.4-42.1), but changes did not correlate with intelligibility. A wide variation was seen in individual responses to therapy.
Interpretation:
Brief intensive therapy is associated with gains in intelligibility and communicative interactions for some younger children with dysarthria.
