Pausing and Sentence Stress in Children with Dysarthria due to Cerebral Palsy

Clinical Practice in Childhood Dysarthria: An Online Survey of German-Speaking Speech-Language Pathologists

PURPOSE

This survey study aimed to establish current clinical practices of German-speaking speech-language pathologists (SLPs) regarding their assessment and treatment of communication disorders in children with neurological conditions, with a particular focus on the management of childhood dysarthria.

METHOD

A 23-question cross-sectional online survey was disseminated to practicing SLPs in Germany, Austria, and Switzerland via relevant professional bodies. SLPs were invited to provide information on their current assessment and treatment practices. Demographic data including case load and clinical settings were also gathered to contextualize practices.

RESULTS

One hundred two SLPs responded to the survey, of which 68 valid responses were analyzed. German-speaking SLPs comprehensively assess and treat various aspects of overall communication, language, and swallowing functions in children with neurological conditions. Speech motor aspects did not represent a main intervention focus. In cases where the dysarthric component was targeted, specific approaches for childhood dysarthria were rarely used. Instead, SLPs reported using approaches developed for speech disorders other than dysarthria.

CONCLUSIONS

German-speaking SLPs working with children with neurological conditions use various assessment and treatment methods to support children's communication. However, dysarthria-specific approaches were not an established part of clinical practice. Results of the survey highlight the need for access to relevant developments in German and for evaluation of current curricula for speech-language pathology students and continuing education opportunities for practicing clinicians.

Acoustic Identification of Sentence Accent in Speakers with Dysarthria: Cross-Population Validation and Severity Related Patterns

Dysprosody is a hallmark of dysarthria, which can affect the intelligibility and naturalness of speech. This includes sentence accent, which helps to draw listeners’ attention to important information in the message. Although some studies have investigated this feature, we currently lack properly validated automated procedures that can distinguish between subtle performance differences observed across speakers with dysarthria. This study aims for cross-population validation of a set of acoustic features that have previously been shown to correlate with sentence accent. In addition, the impact of dysarthria severity levels on sentence accent production is investigated. Two groups of adults were analysed (Dutch and English speakers). Fifty-eight participants with dysarthria and 30 healthy control participants (HCP) produced sentences with varying accent positions. All speech samples were evaluated perceptually and analysed acoustically with an algorithm that extracts ten meaningful prosodic features and allows a classification between accented and unaccented syllables based on a linear combination of these parameters. The data were statistically analysed using discriminant analysis. Within the Dutch and English dysarthric population, the algorithm correctly identified 82.8 and 91.9% of the accented target syllables, respectively, indicating that the capacity to discriminate between accented and unaccented syllables in a sentence is consistent with perceptual impressions. Moreover, different strategies for accent production across dysarthria severity levels could be demonstrated, which is an important step toward a better understanding of the nature of the deficit and the automatic classification of dysarthria severity using prosodic features.