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Levy ES, Moya-Galé G. Revisiting Dysarthria Treatment Across Languages: The Hybrid Approach. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:2893-2902. [PMID: 38056466 DOI: 10.1044/2023_jslhr-23-00629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
PURPOSE Ten years after Miller and Lowit's (2014) groundbreaking book providing a cross-linguistic perspective on motor speech disorders, we ask where we are regarding dysarthria treatment across languages in two specific populations: adults with Parkinson's disease (PD) and children with cerebral palsy (CP). METHOD In this commentary, we consider preliminary evidence for both language-independent and language-specific approaches to treatment and propose a hybrid approach to speech treatment across languages, centered on the individual with dysarthria who speaks any given language. CONCLUSIONS Treatment research on individuals with dysarthria secondary to PD and CP is advancing, but several areas remain to be explored. Next steps are suggested for addressing the paucity and complexity of cross-linguistic speech treatment research.
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Frankford SA, Estrada A, Stepp CE. Contributions of Speech Timing and Articulatory Precision to Listener Perceptions of Intelligibility and Naturalness in Parkinson's Disease. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:2951-2963. [PMID: 39116309 PMCID: PMC11427422 DOI: 10.1044/2024_jslhr-23-00802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 04/09/2024] [Accepted: 06/06/2024] [Indexed: 08/10/2024]
Abstract
PURPOSE Parkinson's disease (PD) results in hypokinetic dysarthria in as many as 90% of cases. Among the most distinctive features of hypokinetic dysarthria are atypical timing and articulatory imprecision in speech production. Here, we examined the contributions of perceived speech timing typicality and articulatory precision, both on their own and while controlling for the other, on intelligibility and naturalness in speakers with PD. METHOD Twenty speakers with PD and four healthy older adults read aloud the first paragraph of the Rainbow Passage. Twenty inexperienced listeners with typical hearing listened to these recordings and rated intelligibility, naturalness, timing typicality, and articulatory precision using separate visual analog scales. Ratings were averaged across listeners and entered into linear regression models with intelligibility and naturalness as dependent variables and timing typicality and articulatory precision as independent variables in each. RESULTS Articulatory precision, but not timing typicality, was positively correlated with intelligibility on its own, but neither was associated with intelligibility after accounting for the other. Both timing typicality and articulatory precision were positively correlated with naturalness on their own as well as after controlling for the other variable. CONCLUSION These results contribute to the overall understanding of speech factors associated with intelligibility and naturalness in speakers with PD and indicate that considering the unique contributions of related perceptual constructs may provide more information than bivariate relationships alone.
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Fumel J, Bahuaud D, Weed E, Fusaroli R, Basirat A. A Systematic Review and Bayesian Meta-Analysis of Acoustic Measures of Prosody in Parkinson's Disease. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:2548-2564. [PMID: 39018262 DOI: 10.1044/2024_jslhr-23-00588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/19/2024]
Abstract
PURPOSE Linguistic prosody is affected in Parkinson's disease (PD), which implicates the basal ganglia's role in the production of prosody. However, there is no recent systematic synthesis of the available acoustic evidence of prosodic impairment in PD. This study aimed to identify the acoustic features of linguistic prosody that are consistently affected in PD. METHOD The authors systematically reviewed articles that reported acoustic features of prosodic production in PD. Articles focused on fundamental frequency (F0) and its variability, intensity and its variability, speech and articulation rate, and pause duration and ratio. From a total of 648 records identified, 36 met criteria for inclusion and exclusion. For each acoustic measurement and task, data from people with PD (PwPD) were compared with those from controls to extract effect sizes. Pooled effect sizes were estimated using robust Bayesian hierarchical regression models. RESULTS PD was associated with decreased F0 variability and increased pause duration. There was limited evidence of reduced intensity variability and speech rate in PwPD. No evidence was found to suggest that PD affects articulation rate or pause ratio. CONCLUSIONS The primary acoustic parameters of prosody affected by PD are F0 variability and pause duration. The identification of these acoustic parameters has important clinical implications for the selection of PD management strategies. The association of F0 variability and pause duration with PD suggests that the neural circuits controlling these parameters are at least partly shared and might include the basal ganglia. While the current study focused on the phonetic realization of prosodic cues, future studies should examine whether and how PD affects prosody at higher levels of processing. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.25892923.
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Affiliation(s)
- Jules Fumel
- Univ. Lille, CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, F-59000 Lille, France
| | - Delphine Bahuaud
- Department of Speech and Language Therapy, Faculty of Medicine, UFR3S, Univ. Lille, F-59000 Lille, France
| | - Ethan Weed
- Department of Linguistics, Cognitive Science and Semiotics, School of Communication and Culture, Aarhus University, Denmark
- Interacting Minds Centre, School of Culture and Society, Aarhus University, Denmark
| | - Riccardo Fusaroli
- Department of Linguistics, Cognitive Science and Semiotics, School of Communication and Culture, Aarhus University, Denmark
- Interacting Minds Centre, School of Culture and Society, Aarhus University, Denmark
- Linguistic Data Consortium, University of Pennsylvania, Philadelphia
| | - Anahita Basirat
- Univ. Lille, CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, F-59000 Lille, France
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Sullivan L, Martin E, Allison KM. Effects of SPEAK OUT! & LOUD Crowd on Functional Speech Measures in Parkinson's Disease. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:1930-1951. [PMID: 38838243 DOI: 10.1044/2024_ajslp-23-00321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
PURPOSE This study investigated the effects of the SPEAK OUT! & LOUD Crowd therapy program on speaking rate, percent pause time, intelligibility, naturalness, and communicative participation in individuals with Parkinson's disease (PD). METHOD Six adults with PD completed 12 individual SPEAK OUT! sessions across four consecutive weeks followed by group-based LOUD Crowd sessions for five consecutive weeks. Most therapy sessions were conducted via telehealth, with two participants completing the SPEAK OUT! portion in person. Speech samples were recorded at six time points: three baseline time points prior to SPEAK OUT!, two post-SPEAK OUT! time points, and one post-LOUD Crowd time point. Acoustic measures of speaking rate and percent pause time and listener ratings of speech intelligibility and naturalness were obtained for each time point. Participant self-ratings of communicative participation were also collected at pre- and posttreatment time points. RESULTS Results showed significant improvement in communicative participation scores at a group level following completion of the SPEAK OUT! & LOUD Crowd treatment program. Two participants showed a significant decrease in speaking rate and increase in percent pause time following treatment. Changes in intelligibility and naturalness were not statistically significant. CONCLUSIONS These findings provide preliminary support for the effectiveness of the SPEAK OUT! & LOUD Crowd treatment program in improving communicative participation for people with mild-to-moderate hypokinetic dysarthria secondary to PD. This study is also the first to demonstrate positive effects of this treatment program for people receiving the therapy via telehealth.
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Affiliation(s)
- Lauren Sullivan
- Department of Communication Sciences and Disorders, Northeastern University, Boston, MA
| | - Elizabeth Martin
- Department of Communication Sciences and Disorders, Northeastern University, Boston, MA
| | - Kristen M Allison
- Department of Communication Sciences and Disorders, Northeastern University, Boston, MA
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Perry SE, Troche M, Huber JE, Curtis J, Kiefer B, Sevitz J, Dennard Q, Borders J, Browy JR, Dakin A, Gonzalez V, Chapman J, Wu T, Katz L, Britton D. Behavioral Management of Respiratory/Phonatory Dysfunction for Dysarthria Associated With Neurodegenerative Disease: A Systematic Review. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:1069-1097. [PMID: 38232176 DOI: 10.1044/2023_ajslp-23-00274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
PURPOSE This systematic review represents an update to previous reviews of the literature addressing behavioral management of respiratory/phonatory dysfunction in individuals with dysarthria due to neurodegenerative disease. METHOD Multiple electronic database searches and hand searches of prominent speech-language pathology journals were conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards. RESULTS The search yielded 1,525 articles, from which 88 met inclusion criteria and were reviewed by two blinded co-investigators. A large range of therapeutic approaches have been added to the evidence base since the last review, including expiratory muscle strength training, singing, and computer- and device-driven programs, as well as a variety of treatment modalities, including teletherapy. Evidence for treatment in several different population groups-including cerebellar ataxia, myotonic dystrophy, autosomal recessive spastic ataxia of Charlevoix-Saguenay, Huntington's disease, multiple system atrophy, and Lewy body dementia-were added to the current review. Synthesis of evidence quality provided strong evidence in support of only one behavioral intervention: Lee Silverman Voice Treatment Program (LSVT LOUD) in people with Parkinson's disease. No other treatment approach or population included in this review demonstrated more than limited evidence, reflecting that these approaches/populations require urgent further examination. CONCLUSION Suggestions about where future research efforts could be significantly strengthened and how clinicians can apply research findings to their practice are provided. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24964473.
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Affiliation(s)
- Sarah E Perry
- University of Canterbury/Otago, Christchurch, New Zealand
- New Zealand Brain Research Institute, Christchurch
| | - Michelle Troche
- Laboratory for the Study of Upper Airway Dysfunction, Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
| | - Jessica E Huber
- Department of Communicative Disorders and Sciences, University at Buffalo, NY
| | - James Curtis
- Department of Otolaryngology - Head & Neck Surgery, Weill Cornell Medical College, New York, NY
| | - Brianna Kiefer
- Department of Physical Medicine and Rehabilitation, University of California Davis Medical Center, Sacramento
| | - Jordanna Sevitz
- Laboratory for the Study of Upper Airway Dysfunction, Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
| | - Qiana Dennard
- Department of Speech & Hearing Sciences, Portland State University, OR
| | - James Borders
- Laboratory for the Study of Upper Airway Dysfunction, Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
| | | | - Avery Dakin
- Laboratory for the Study of Upper Airway Dysfunction, Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
| | | | | | - Tiffany Wu
- Laboratory for the Study of Upper Airway Dysfunction, Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
| | - Lily Katz
- Department of Otolaryngology, University of Wisconsin Health University Hospital, Madison
| | - Deanna Britton
- Department of Speech & Hearing Sciences, Portland State University, OR
- Northwest Clinic for Voice and Swallowing, Oregon Health & Science University, Portland
- Department of Rehabilitation Medicine, University of Washington, Seattle
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Van Der Bruggen S, De Letter M, Rietveld T. Effects of near-monotonous speech of persons with Parkinson's disease on listening effort and intelligibility. CLINICAL LINGUISTICS & PHONETICS 2023:1-14. [PMID: 37913529 DOI: 10.1080/02699206.2023.2272032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 10/12/2023] [Indexed: 11/03/2023]
Abstract
The majority of patients with Parkinson's disease (PD) develop hypokinetic dysarthria with a disturbance of prosody. The most important acoustic characteristic of prosodic impairment in PD is a lack of fundamental frequency (F0)-variability. It is well established that a lack of F0-variability can negatively influence the speech intelligibility of neurotypical speakers in background noise. The purpose of this study was to investigate which aspect of processing speech realised by speakers with PD is affected by lack of intonation: intelligibility as measured by a transcription task, scaled intelligibility and/or perceived listening effort when there is no background noise. F0-flattening of Semantically Unpredictable Sentences (SUS) was achieved, while the natural F0-declination was preserved. This kind of F0-flattening affected scaled intelligibility and perceived listening effort, while transcription performance remained unchanged.
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Affiliation(s)
| | - Miet De Letter
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Toni Rietveld
- Department of Language and Communication, Radboud University Nijmegen, Harlingen, The Netherlands
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Pernon M, Assal F, Kodrasi I, Laganaro M. Perceptual Classification of Motor Speech Disorders: The Role of Severity, Speech Task, and Listener's Expertise. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:2727-2747. [PMID: 35878401 DOI: 10.1044/2022_jslhr-21-00519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE The clinical diagnosis of motor speech disorders (MSDs) is mainly based on perceptual approaches. However, studies on perceptual classification of MSDs often indicate low classification accuracy. The aim of this study was to determine in a forced-choice dichotomous decision-making task (a) how accuracy of speech-language pathologists (SLPs) in perceptually classifying apraxia of speech (AoS) and dysarthria is impacted by speech task, severity of MSD, and listener's expertise and (b) which perceptual features they use to classify. METHOD Speech samples from 29 neurotypical speakers, 14 with hypokinetic dysarthria associated with Parkinson's disease (HD), 10 with poststroke AoS, and six with mixed dysarthria associated with amyotrophic lateral sclerosis (MD-FlSp [combining flaccid and spastic dysarthria]), were classified by 20 expert SLPs and 20 student SLPs. Speech samples were elicited in spontaneous speech, text reading, oral diadochokinetic (DDK) tasks, and a sample concatenating text reading and DDK. For each recorded speech sample, SLPs answered three dichotomic questions following a diagnostic approach, (a) neurotypical versus pathological speaker, (b) AoS versus dysarthria, and (c) MD-FlSp versus HD, and a multiple-choice question on the features their decision was based on. RESULTS Overall classification accuracy was 72% with good interrater reliability, varying with SLP expertise, speech task, and MSD severity. Correct classification of speech samples was higher for speakers with dysarthria than for AoS and higher for HD than for MD-FlSp. Samples elicited with continuous speech reached the best classification rates. An average number of three perceptual features were used for correct classifications, and their type and combination differed between the three MSDs. CONCLUSIONS The auditory-perceptual classification of MSDs in a diagnostic approach reaches substantial performance only in expert SLPs with continuous speech samples, albeit with lower accuracy for AoS. Specific training associated with objective classification tools seems necessary to improve recognition of neurotypical speech and distinction between AoS and dysarthria.
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Affiliation(s)
- Michaela Pernon
- Neurology Department, Geneva University Hospitals, Switzerland
- Faculty of Medicine, University of Geneva, Switzerland
- Laboratoire de Phonétique et Phonologie, UMR 7018, CNRS-Université Sorbonne Nouvelle, Paris, France
- CRMR Wilson & Parkinson Unit, Neurology Department, Hôpital Fondation Adolphe de Rothschild, Paris, France
| | - Frédéric Assal
- Neurology Department, Geneva University Hospitals, Switzerland
- Faculty of Medicine, University of Geneva, Switzerland
| | - Ina Kodrasi
- Signal Processing for Communication Group, Idiap Research Institute, Martigny, Switzerland
| | - Marina Laganaro
- Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland
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Heffner CC, Myers EB, Gracco VL. Impaired perceptual phonetic plasticity in Parkinson's disease. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2022; 152:511. [PMID: 35931533 PMCID: PMC9299957 DOI: 10.1121/10.0012884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 07/05/2022] [Accepted: 07/06/2022] [Indexed: 06/08/2023]
Abstract
Parkinson's disease (PD) is a neurodegenerative condition primarily associated with its motor consequences. Although much of the focus within the speech domain has focused on PD's consequences for production, people with PD have been shown to differ in the perception of emotional prosody, loudness, and speech rate from age-matched controls. The current study targeted the effect of PD on perceptual phonetic plasticity, defined as the ability to learn and adjust to novel phonetic input, both in second language and native language contexts. People with PD were compared to age-matched controls (and, for three of the studies, a younger control population) in tasks of explicit non-native speech learning and adaptation to variation in native speech (compressed rate, accent, and the use of timing information within a sentence to parse ambiguities). The participants with PD showed significantly worse performance on the task of compressed rate and used the duration of an ambiguous fricative to segment speech to a lesser degree than age-matched controls, indicating impaired speech perceptual abilities. Exploratory comparisons also showed people with PD who were on medication performed significantly worse than their peers off medication on those two tasks and the task of explicit non-native learning.
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Affiliation(s)
- Christopher C Heffner
- Department of Speech, Language, and Hearing Sciences, University of Connecticut, Storrs, Connecticut 06269, USA
| | - Emily B Myers
- Department of Speech, Language, and Hearing Sciences, University of Connecticut, Storrs, Connecticut 06269, USA
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Knowles T, Adams SG, Jog M. Variation in Speech Intelligibility Ratings as a Function of Speech Rate Modification in Parkinson's Disease. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:1773-1793. [PMID: 33950711 DOI: 10.1044/2021_jslhr-20-00593] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose The aim of this study was to quantify changes in speech intelligibility in two cohorts of people with Parkinson's disease (PD; those with and without deep brain stimulation [DBS]) across a broad range of self-selected speech rate alterations in (a) read sentences and (b) extemporaneous speech (monologues). Method Four speaker groups participated in this study: younger and older controls, people with PD undergoing standard pharmaceutical treatment, and people with PD and DBS. Naïve listeners rated the intelligibility of read sentences and extemporaneous monologues, spoken by participants at seven self-selected speech rates from very slow to very fast. Intelligibility was modeled as a function of group, speech rate condition, and speech task. Results Overall, compared to habitual speech rate, slower speech rate conditions were not associated with changes in speech intelligibility, whereas faster-than-habitual conditions were associated in declines in intelligibility. Results were mediated by group and task effects, such that talkers with PD and DBS were more likely to see intelligibility benefits at slower self-selected speech rates and less likely to see detriments at faster rates, and these differences were amplified in monologues compared to sentences. Conclusion Findings suggest differences in the ways in which slower and faster speech rate adjustments impact speech intelligibility in people with PD with and without DBS, with the latter demonstrating greater magnitudes of change.
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Affiliation(s)
- Thea Knowles
- Department of Communicative Disorders and Sciences, University at Buffalo, NY
| | - Scott G Adams
- School of Communication Sciences and Disorders, Western University, London, Ontario, Canada
- Health and Rehabilitation Sciences, Western University, London, Ontario, Canada
- Department of Clinical Neurological Sciences, University Hospital, London, Ontario, Canada
| | - Mandar Jog
- Department of Clinical Neurological Sciences, University Hospital, London, Ontario, Canada
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Mendoza Ramos V, Paulyn C, Van den Steen L, Hernandez‐Diaz Huici ME, De Bodt M, Van Nuffelen G. Effect of boost articulation therapy (BArT) on intelligibility in adults with dysarthria. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2021; 56:271-282. [PMID: 33484095 PMCID: PMC8048921 DOI: 10.1111/1460-6984.12595] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/01/2020] [Accepted: 12/11/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND The articulatory accuracy of patients with dysarthria is one of the most affected speech dimensions with a high impact on speech intelligibility. Behavioural treatments of articulation can either involve direct or indirect approaches. The latter have been thoroughly investigated and are generally appreciated for their almost immediate effects on articulation and intelligibility. The number of studies on (short-term) direct articulation therapy is limited. AIMS To investigate the effects of short-term, boost articulation therapy (BArT) on speech intelligibility in patients with chronic or progressive dysarthria and the effect of severity of dysarthria on the outcome. METHODS & PROCEDURES The study consists of a two-group pre-/post-test design to assess speech intelligibility at phoneme and sentence level and during spontaneous speech, automatic speech and reading a phonetically balanced text. A total of 17 subjects with mild to severe dysarthria participated in the study and were randomly assigned to either a patient-tailored, intensive articulatory drill programme or an intensive minimal pair training. Both training programmes were based on the principles of motor learning. Each training programme consisted of five sessions of 45 min completed within one week. OUTCOMES & RESULTS Following treatment, a statistically significant increase of mean group intelligibility was shown at phoneme and sentence level, and in automatic sequences. This was supported by an acoustic analysis that revealed a reduction in formant centralization ratio. Within specific groups of severity, large and moderate positive effect sizes with Cohen's d were demonstrated. CONCLUSIONS & IMPLICATIONS BArT successfully improves speech intelligibility in patients with chronic or progressive dysarthria at different levels of the impairment. What this paper adds What is already known on the subject Behavioural treatment of articulation in patients with dysarthria mainly involves indirect strategies, which have shown positive effects on speech intelligibility. However, there is limited evidence on the short-term effects of direct articulation therapy at the segmental level of speech. This study investigates the effectiveness of BArT on speech intelligibility in patients with chronic or progressive dysarthria at all severity levels. What this paper adds to existing knowledge The intensive and direct articulatory therapy programmes developed and applied in this study intend to reduce the impairment instead of compensating it. This approach results in a significant improvement of speech intelligibility at different dysarthria severity levels in a short period of time while contributing to exploit and develop all available residual motor skills in persons with dysarthria. What are the potential or actual clinical implications of this work? The improvements in intelligibility demonstrate the effectiveness of a BArT at the segmental level of speech. This makes it to be considered a suitable approach in the treatment of patients with chronic or progressive dysarthria.
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Affiliation(s)
- Viviana Mendoza Ramos
- Department of Otorhinolaryngology, Head and Neck Surgery and Communication DisordersUniversity Hospital of AntwerpEdegemBelgium
- Faculty of Medicine and Health SciencesUniversity of AntwerpWilrijkAntwerpBelgium
| | - Charlotte Paulyn
- Faculty of Medicine and Social Health SciencesUniversity of GhentGhentBelgium
| | - Leen Van den Steen
- Department of Otorhinolaryngology, Head and Neck Surgery and Communication DisordersUniversity Hospital of AntwerpEdegemBelgium
| | | | - Marc De Bodt
- Department of Otorhinolaryngology, Head and Neck Surgery and Communication DisordersUniversity Hospital of AntwerpEdegemBelgium
- Faculty of Medicine and Health SciencesUniversity of AntwerpWilrijkAntwerpBelgium
- Faculty of Medicine and Social Health SciencesUniversity of GhentGhentBelgium
| | - Gwen Van Nuffelen
- Department of Otorhinolaryngology, Head and Neck Surgery and Communication DisordersUniversity Hospital of AntwerpEdegemBelgium
- Faculty of Medicine and Health SciencesUniversity of AntwerpWilrijkAntwerpBelgium
- Faculty of Medicine and Social Health SciencesUniversity of GhentGhentBelgium
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Whillans C, Lawrie M, Cardell EA, Kelly C, Wenke R. A systematic review of group intervention for acquired dysarthria in adults. Disabil Rehabil 2020; 44:3002-3018. [PMID: 33356634 DOI: 10.1080/09638288.2020.1859629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE This review aimed to evaluate the evidence for group therapy in improving speech production in adults with acquired dysarthria. Secondary outcomes included communication effectiveness and/or wellbeing. MATERIALS AND METHODS A review protocol was prospectively published on PROSPERO. Fourteen electronic databases were searched to identify experimental studies investigating adults with acquired dysarthria participating in group intervention with outcomes related to communication and/or wellbeing. The quality of included studies was assessed using the Mixed Methods Appraisal Tool (MMAT) or the McMaster University's Critical Review Form, and the TIDieR template for intervention description and replication. RESULTS 21 studies were identified involving 330 individuals with dysarthria, from mostly Parkinson's disease (PD) (97%; n = 321). Treatment approaches included singing therapy (n = 10), loudness therapy (n = 5) and multi-components therapy (including a combination of impairment and/or compensatory approaches) (n = 4). Studies varied in intensity and outcome measures used. Statistically significant improvements to speech production and/or wellbeing were reported following most approaches. CONCLUSION There is some preliminary moderate-quality evidence to suggest that group therapy may improve speech production and in some cases communication effectiveness or wellbeing in people with dysarthria following PD, with more consistent improvements being found for loudness approaches. Singing approaches were frequently studied in PD with some improvements to intelligibility evident. Further well-designed controlled studies including individuals with non-progressive aetiologies is warranted to establish the effectiveness of group treatment.IMPLICATIONS FOR REHABILITATIONGroup therapy may be an effective means of improving speech production and/or wellbeing in individuals with dysarthria following Parkinson's disease.Studies' employing loudness-based group therapy for PD demonstrated more consistent improvements to intensity measures.Some controlled studies utilising singing group therapy resulted in improved intelligibility in PD.PROSPERO registration number: CRD42015029374.
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Affiliation(s)
- Chelsea Whillans
- Speech Pathology & Audiology Services, Gold Coast Health, Southport, Australia
| | - Melissa Lawrie
- Speech Pathology & Audiology Services, Gold Coast Health, Southport, Australia.,School of Allied Health Sciences, Griffith University, Southport, Australia
| | - Elizabeth A Cardell
- School of Allied Health Sciences, Griffith University, Southport, Australia.,Menzies Institute Queensland, Southport, Australia
| | - Crystal Kelly
- School of Allied Health Sciences, Griffith University, Southport, Australia
| | - Rachel Wenke
- Speech Pathology & Audiology Services, Gold Coast Health, Southport, Australia.,School of Allied Health Sciences, Griffith University, Southport, Australia
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Khan T, Lundgren LE, Anderson DG, Nowak I, Dougherty M, Verikas A, Pavel M, Jimison H, Nowaczyk S, Aharonson V. Assessing Parkinson's disease severity using speech analysis in non-native speakers. COMPUT SPEECH LANG 2020. [DOI: 10.1016/j.csl.2019.101047] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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13
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Acoustic features to characterize sentence accent production in dysarthric speech. Biomed Signal Process Control 2020. [DOI: 10.1016/j.bspc.2019.101750] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Broadfoot CK, Abur D, Hoffmeister JD, Stepp CE, Ciucci MR. Research-based Updates in Swallowing and Communication Dysfunction in Parkinson Disease: Implications for Evaluation and Management. PERSPECTIVES OF THE ASHA SPECIAL INTEREST GROUPS 2019; 4:825-841. [PMID: 32104723 PMCID: PMC7043100 DOI: 10.1044/2019_pers-sig3-2019-0001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE Individuals with Parkinson disease (PD) present with complex and variable symptoms, with recent findings suggesting that the etiology of PD extends beyond the involvement of just the basal ganglia. These symptoms include significant impairments in the speech and swallowing domains, which can greatly affect quality of life and therefore require therapeutic attention. This research-based update reviews the neurophysiological basis for swallowing and speech changes in PD, the effectiveness of various types of treatments, and implications for symptom evaluation and management. CONCLUSION The mechanisms responsible for swallowing and speech symptoms in PD remain largely unknown. Dopaminergic medication and deep-brain-stimulation do not provide consistent benefits for these symptoms suggesting a non-dopaminergic network is involved. Importantly, evidence suggests that symptoms of dysphagia and hypokinetic dysarthria may be early indications of PD, so it is critical to investigate the cause of these changes.
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Affiliation(s)
- C K Broadfoot
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI
| | - D Abur
- Department of Speech, Language, and Hearing Sciences, Boston University, Boston, MA
| | - J D Hoffmeister
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI
| | - C E Stepp
- Department of Speech, Language, and Hearing Sciences, Boston University, Boston, MA
- Department of Biomedical Engineering, Boston University, Boston, MA
- Department of Otolaryngology, Boston University, Boston, MA
| | - M R Ciucci
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI
- Department of Surgery-Division of Otolaryngology Head & Neck Surgery, University of Wisconsin-Madison, Madison, WI
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Kearney E, Haworth B, Scholl J, Faloutsos P, Baljko M, Yunusova Y. Treating Speech Movement Hypokinesia in Parkinson's Disease: Does Movement Size Matter? JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2018; 61:2703-2721. [PMID: 30383207 PMCID: PMC6693569 DOI: 10.1044/2018_jslhr-s-17-0439] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 04/19/2018] [Accepted: 05/29/2018] [Indexed: 06/08/2023]
Abstract
Purpose This study evaluates the effects of a novel speech therapy program that uses a verbal cue and gamified augmented visual feedback regarding tongue movements to address articulatory hypokinesia during speech in individuals with Parkinson's disease (PD). Method Five participants with PD participated in an ABA single-subject design study. The treatment aimed to increase tongue movement size using a combination of a verbal cue and augmented visual feedback and was conducted in 10 45-min sessions over 5 weeks. The presence of visual feedback was manipulated during treatment. Articulatory working space of the tongue was the primary outcome measure and was examined during treatment and in cued and uncued sentences pre- and posttreatment. Changes in speech intelligibility in response to a verbal cue pre- and posttreatment were also examined. Results During treatment, 4/5 participants showed a beneficial effect of visual feedback on tongue articulatory working space. At the end of the treatment, they used larger tongue movements when cued, relative to their pretreatment performance. None of the participants, however, generalized the effect to the uncued sentences. Speech intelligibility of cued sentences was judged as superior posttreatment only in a single participant. Conclusions This study demonstrated that using an augmented visual feedback approach is beneficial, beyond a verbal cue alone, in addressing articulatory hypokinesia in individuals with PD. An optimal degree of articulatory expansion might, however, be required to elicit a speech intelligibility benefit.
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Affiliation(s)
- Elaine Kearney
- Department of Speech-Language Pathology, University of Toronto, Ontario, Canada
- University Health Network—Toronto Rehabilitation Institute, Ontario, Canada
| | - Brandon Haworth
- University Health Network—Toronto Rehabilitation Institute, Ontario, Canada
- Department of Electrical Engineering and Computer Science, York University, Toronto, Ontario, Canada
| | - Jordan Scholl
- Department of Speech-Language Pathology, University of Toronto, Ontario, Canada
- University Health Network—Toronto Rehabilitation Institute, Ontario, Canada
| | - Petros Faloutsos
- University Health Network—Toronto Rehabilitation Institute, Ontario, Canada
- Department of Electrical Engineering and Computer Science, York University, Toronto, Ontario, Canada
| | - Melanie Baljko
- University Health Network—Toronto Rehabilitation Institute, Ontario, Canada
- Department of Electrical Engineering and Computer Science, York University, Toronto, Ontario, Canada
| | - Yana Yunusova
- Department of Speech-Language Pathology, University of Toronto, Ontario, Canada
- University Health Network—Toronto Rehabilitation Institute, Ontario, Canada
- Sunnybrook Research Institute, Biological Sciences, Toronto, Ontario, Canada
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