1
|
Kuschmann A, Schölderle T, Haas E. Clinical Practice in Childhood Dysarthria: An Online Survey of German-Speaking Speech-Language Pathologists. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:2802-2826. [PMID: 37707370 DOI: 10.1044/2023_ajslp-23-00076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
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.
Collapse
Affiliation(s)
- Anja Kuschmann
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, United Kingdom
| | - Theresa Schölderle
- Clinical Neuropsychology Research Group, Institute of Phonetics and Speech Processing, Ludwig-Maximilians-Universität, Munich, Germany
| | - Elisabet Haas
- Clinical Neuropsychology Research Group, Institute of Phonetics and Speech Processing, Ludwig-Maximilians-Universität, Munich, Germany
| |
Collapse
|
2
|
Wang EW, Grigos MI. Naive Listener Ratings of Speech Intelligibility Over the Course of Motor-Based Intervention in Children With Childhood Apraxia of Speech. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023:1-15. [PMID: 37486797 DOI: 10.1044/2023_jslhr-22-00656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
PURPOSE The aim of this study was to describe changes in speech intelligibility and interrater and intrarater reliability of naive listeners' ratings of words produced by young children diagnosed with childhood apraxia of speech (CAS) over a period of motor-based intervention (dynamic temporal and tactile cueing [DTTC]). METHOD A total of 120 naive listeners (i.e., listeners without experience listening to children with speech and/or language impairments; age range: 18-45 years) orthographically transcribed single-word productions by five children (age range: 2;6-3;11 [years;months]) across three time points over an intervention period (baseline, post-treatment, maintenance). Changes in intelligibility and interrater and intrarater reliability were examined within and across time points. RESULTS Speech intelligibility significantly increased in children with CAS over the course of treatment, and these gains were also maintained at 6 weeks posttreatment. There was poor-to-fair consistency between listeners (interrater reliability) and excellent consistency within listeners (intrarater reliability) in ratings of speech intelligibility within and across time points. CONCLUSIONS Motor-based intervention increases speech intelligibility following a period of DTTC treatment. Variability among naive listeners of speech intelligibility was also present, with intrarater reliability (within listeners) yielding greater consistency than interrater reliability (between listeners). The implications for including naive listeners as raters of speech intelligibility for research and clinical purposes are discussed.
Collapse
Affiliation(s)
- Emily W Wang
- Department of Communicative Sciences and Disorders, New York University, New York
| | - Maria I Grigos
- Department of Communicative Sciences and Disorders, New York University, New York
| |
Collapse
|
3
|
Korkalainen J, McCabe P, Smidt A, Morgan C. Motor Speech Interventions for Children With Cerebral Palsy: A Systematic Review. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:110-125. [PMID: 36623233 DOI: 10.1044/2022_jslhr-22-00375] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
PURPOSE Dysarthria is common among children with cerebral palsy (CP) and results in poor speech intelligibility and subsequently low communicative participation. Neuroplasticity evidence suggests that adherence to principles of motor learning (PML) improves motor speech intervention outcomes. Motor speech interventions aim to improve speech intelligibility and ultimately facilitate participation, but the effectiveness of these interventions and their inclusion of PML are not clear. Aims are as follows: (a) evaluate the effectiveness motor speech interventions in improving speech intelligibility; (b) summarize the aims, outcome measures, and outcomes relating to the International Classification of Functioning and Disability Child and Youth; and (c) summarize the principles of motor learning used in the intervention. METHOD Eight databases were searched, complemented by a hand search. Studies of any level of evidence were included if they used a motor speech intervention and measured speech in children with CP aged 0-18 years. Studies before 2000 or not in English were excluded. The review was conducted and reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Study quality was rated using the Single Case Experimental Design Scale and Physiotherapy Evidence Database-P rating scales. The strength of evidence was evaluated with Grading of Recommendations, Assessment, Development and Evaluation. RESULTS Of 1,036 initial articles, 21 were included. Eight interventions were identified including 131 participants aged 3-18 years. All studies aimed to improve speech intelligibility or articulation and reported improvement at sound, word, or sentence level. One study reported improvements in communicative participation. The strength of evidence ranged from very low to moderate for one intervention. Adherence to PML was inconsistent. CONCLUSIONS The quality of evidence is very low to moderate. More research on motor speech interventions that adhere to PML is required. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21817959.
Collapse
Affiliation(s)
| | - Patricia McCabe
- The University of Sydney, Camperdown, New South Wales, Australia
| | - Andy Smidt
- The University of Sydney, Camperdown, New South Wales, Australia
| | - Catherine Morgan
- Cerebral Palsy Alliance Research Institute, Brain Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| |
Collapse
|
4
|
Implementation of an Early Communication Intervention for Young Children with Cerebral Palsy Using Single-Subject Research Design. J Clin Med 2022; 12:jcm12010232. [PMID: 36615031 PMCID: PMC9821676 DOI: 10.3390/jcm12010232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 12/31/2022] Open
Abstract
The implementation of an intervention protocol aimed at increasing vocal complexity in three pre-linguistic children with cerebral palsy (two males, starting age 15 months, and one female, starting age 16 months) was evaluated utilising a repeated ABA case series design. The study progressed until the children were 36 months of age. Weekly probes with trained and untrained items were administered across each of three intervention blocks. Successive blocks targeted more advanced protophone production and speech movement patterns, individualised for each participant. Positive treatment effects were seen for all participants in terms of a greater rate of achievement of target protophone categories and speech movement patterns. Tau coefficients for trained items demonstrated overall moderate to large AB phase contrast effect sizes, with limited evidence of generalisation to untrained items. Control items featuring protophones and speech movements not targeted for intervention showed no change across phases for any participant. Our data suggest that emerging speech-production skills in prelinguistic infants with CP can be positively influenced through a multimodal intervention focused on capitalising on early periods of plasticity when language learning is most sensitive.
Collapse
|
5
|
PROMPT to improve speech motor abilities in children with cerebral palsy: a wait-list control group trial protocol. BMC Neurol 2022; 22:246. [PMID: 35794522 PMCID: PMC9258135 DOI: 10.1186/s12883-022-02771-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 06/27/2022] [Indexed: 11/10/2022] Open
Abstract
Background Children with cerebral palsy (CP) often have communication impairments, including speech altered intelligibility. Multiple levels of disrupted speech have been reported in CP, which negatively impact on participation and quality of life, with increase of care needs. Augmentative Alternative Communication (AAC) is an option, with debated benefits and limitations, in particular for its functional use. This is supported by a substantial lack of defined evidences in favor of direct speech articulation intervention in CP. Motor learning-based interventions are effective in CP and are the basis of speech motor interventions such as PROMPT (Prompts for Restructuring Oral Muscular Phonetic Targets). The PROMPT speech motor treatment provides tactile-kinesthetic inputs to facilitate articulatory movements by dynamic modelling, resulting in more efficient motor patterns that can be integrated into speech and communication. In CP, exploratory evidences support the feasibility and preliminarily advantages on intelligibility of motor speech treatments, such as PROMPT, with increased speech motor control, also documented by kinematic analyses. Methods A randomized waitlist-control trial will be conducted in children aged between 3- and 10-years having CP and dysarthria (estimated sample size = 60 children). Children will be allocated in the immediate intervention or in the waitlist control group. The intervention consists of an intensive 3 weeks period of twice-a-day administration of PROMPT. Standard care will be administered in the control (waitlist) group. After repeated baseline assessments (T0), the PROMPT treated group will undergo the experimental 3-week intervention period, with T1 assessment at the end. A further T2 assessment will be provided at medium term (3 months after the end of the intervention) for evaluating the stability of intervention. Primary and secondary speech clinical and kinematics outcome measures will be collected at T0, T1 and T2. Discussion This paper describes the study protocol consisting of a RCT with two main objectives: (1) to evaluate the or short-term benefits of an intensive speech motor intervention on speech and intelligibility in children with CP and the stability of the intervention at medium term; (2) to describe the kinematic correlates of speech motor control modifications. Trial registration Trial registration date 06/12/2019; ClinicalTrials.gov Identifier: NCT04189159.
Collapse
|
6
|
Fiori S, Pannek K, Podda I, Cipriani P, Lorenzoni V, Franchi B, Pasquariello R, Guzzetta A, Cioni G, Chilosi A. Neural Changes Induced by a Speech Motor Treatment in Childhood Apraxia of Speech: A Case Series. J Child Neurol 2021; 36:958-967. [PMID: 34315296 PMCID: PMC8461047 DOI: 10.1177/08830738211015800] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We report a case series of children with childhood apraxia of speech, by describing behavioral and white matter microstructural changes following 2 different treatment approaches.Five children with childhood apraxia of speech were assigned to a motor speech treatment (PROMPT) and 5 to a language, nonspeech oral motor treatment. Speech assessment and brain MRI were performed pre- and post-treatment. The ventral (tongue/larynx) and dorsal (lips) corticobulbar tracts were reconstructed in each subject. Mean fractional anisotropy and mean diffusivity were extracted. The hand corticospinal tract was assessed as a control pathway. In both groups speech improvements paralleled changes in the left ventral corticobulbar tract fractional anisotropy. The PROMPT treated group also showed fractional anisotropy increase and mean diffusivity decrease in the left dorsal corticobulbar tract. No changes were detected in the hand tract. Our results may provide preliminary support to the possible neurobiologic effect of a multimodal speech motor treatment in childhood apraxia of speech.
Collapse
Affiliation(s)
- Simona Fiori
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy,Simona Fiori, MD, PhD, Department of Developmental Neuroscience, Stella Maris Foundation, Viale del Tirreno 331, 56128, Pisa, Italy.
| | - Kerstin Pannek
- CSIRO, Health and Biosecurity, Australian E-Health Research Centre, Brisbane, Australia
| | - Irina Podda
- Parole al Centro, Studio di Logopedia e Neuropsicomotricità, Genova, Italy
| | - Paola Cipriani
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
| | - V. Lorenzoni
- Institute of Management, Scuola Superiore Sant’Anna, Pisa, Italy
| | - Beatrice Franchi
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
| | - Rosa Pasquariello
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
| | - Andrea Guzzetta
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy,Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Giovanni Cioni
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy,Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Anna Chilosi
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
| |
Collapse
|
7
|
Veenhuis SJG, van OS NJH, van Gerven MHJC, van Haaften L, Mulder EH, Weemaes CMR, Willemsen MAAP. Dysarthria in children and adults with ataxia telangiectasia. Dev Med Child Neurol 2021; 63:450-456. [PMID: 33521952 PMCID: PMC7986845 DOI: 10.1111/dmcn.14811] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/08/2020] [Indexed: 12/25/2022]
Abstract
AIM To investigate the characteristics and severity of dysarthria in children and adults with ataxia telangiectasia. METHOD All children and adults with ataxia telangiectasia who visited our multidisciplinary outpatient clinic for ataxia telangiectasia were asked to participate in this study, which took place in March 2019. To evaluate dysarthria, we used the Radboud Dysarthria Assessment in adults (older than 18y) and the paediatric Radboud Dysarthria Assessment in children (5-18y), including the observational tasks 'conversation' and 'reading', and the speech-related maximum performance tasks 'repetition rate', 'phonation time', 'fundamental frequency range', and 'phonation volume'. Speech intelligibility was measured using the Intelligibility in Context Scale. RESULTS Twenty-two individuals (15 children [5-17y], seven adults [19-47y]; 14 males and eight females; mean age 19y, SD 15y 2mo) participated. Dysarthria was present in all participants and characterized by ataxic components in adults and similar uncontrolled movements in children. In most participants, speech was mildly to mildly/severely affected. Almost all participants had an abnormal score for at least one maximum performance task. INTERPRETATION Dysarthria in ataxia telangiectasia is characterized by uncontrolled, ataxic, and involuntary movements, resulting in monotonous, unstable, slow, hypernasal, and chanted speech. WHAT THIS PAPER ADDS Dysarthria in ataxia telangiectasia is characterized by uncontrolled, ataxic, and involuntary movements. Dysarthria in ataxia telangiectasia results in monotonous, unstable, slow, hypernasal, and chanted speech. Dysarthria in ataxia telangiectasia can be assessed using the Radboud Dysarthria Assessment and the paediatric Radboud Dysarthria Assessment.
Collapse
Affiliation(s)
- Stefanie J G Veenhuis
- Department of PediatricsAmalia Children’s HospitalRadboud University Medical CenterNijmegenthe Netherlands
| | - Nienke J H van OS
- Department of Pediatric NeurologyRadboud University Medical CenterNijmegenthe Netherlands
| | - Marjo H J C van Gerven
- Donders Institute for BrainCognition and BehaviourDepartment of RehabilitationRadboud UniversityNijmegenthe Netherlands
| | - Leenke van Haaften
- Donders Institute for BrainCognition and BehaviourDepartment of RehabilitationRadboud UniversityNijmegenthe Netherlands
| | - Elisabeth H Mulder
- Donders Institute for BrainCognition and BehaviourDepartment of RehabilitationRadboud UniversityNijmegenthe Netherlands
- Faculty of Arts at Radboud UniversityNijmegenthe Netherlands
| | - Corry M R Weemaes
- Department of Pediatric Infectious Diseases and ImmunologyRadboud University Medical CenterNijmegenthe Netherlands
| | - Michèl A A P Willemsen
- Department of PediatricsAmalia Children’s HospitalRadboud University Medical CenterNijmegenthe Netherlands
- Department of Pediatric NeurologyRadboud University Medical CenterNijmegenthe Netherlands
| |
Collapse
|
8
|
Namasivayam AK, Huynh A, Granata F, Law V, van Lieshout P. PROMPT intervention for children with severe speech motor delay: a randomized control trial. Pediatr Res 2021; 89:613-621. [PMID: 32357364 PMCID: PMC7979536 DOI: 10.1038/s41390-020-0924-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 04/01/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Currently, there is limited information on the intervention efficacy for children with speech motor delay (SMD). This randomized control trial (RCT) study examined the effectiveness of Prompts for Restructuring Oral Muscular Phonetic Targets (PROMPT) intervention to improve the outcomes in children with SMD. We hypothesized that children with SMD receiving PROMPT intervention would improve more in the measured outcomes than those waitlisted and receiving home training. METHODS Using a two-arm, parallel group, RCT, 49 children with SMD were allocated to either an intervention group (N = 24) that received 45 min of PROMPT intervention two times a week for 10 weeks or were waitlisted for the same duration and received only home training instructions (N = 25). Outcome measures for speech motor control, articulation, speech intelligibility (word and sentence levels), and functional communication were assessed at baseline and at a 10-week follow-up. RESULTS PROMPT intervention was associated with notable improvements in speech motor control, speech articulation, and word-level speech intelligibility. Intervention allocation yielded weak improvements in sentence-level speech intelligibility and functional communication. CONCLUSIONS PROMPT intervention is a clinically effective intervention approach for children with SMD. IMPACT Currently, there is limited information on the intervention efficacy for children with SMD. We report on the findings of a phase III intervention efficacy study on children with SMD using an RCT design. PROMPT intervention is a clinically effective intervention approach for children with SMD. Results of the study will be fundamental to the delivery of effective services for this population. These findings may facilitate the development of an evidence-based care pathway for children with severe speech sound disorders.
Collapse
Affiliation(s)
- Aravind K. Namasivayam
- grid.17063.330000 0001 2157 2938Oral Dynamics Laboratory, Department of Speech–Language Pathology, University of Toronto, Toronto, ON Canada ,grid.415526.10000 0001 0692 494XToronto Rehabilitation Institute, Toronto, ON Canada
| | - Anna Huynh
- grid.17063.330000 0001 2157 2938Oral Dynamics Laboratory, Department of Speech–Language Pathology, University of Toronto, Toronto, ON Canada
| | - Francesca Granata
- grid.17063.330000 0001 2157 2938Oral Dynamics Laboratory, Department of Speech–Language Pathology, University of Toronto, Toronto, ON Canada
| | - Vina Law
- grid.17063.330000 0001 2157 2938Oral Dynamics Laboratory, Department of Speech–Language Pathology, University of Toronto, Toronto, ON Canada
| | - Pascal van Lieshout
- grid.17063.330000 0001 2157 2938Oral Dynamics Laboratory, Department of Speech–Language Pathology, University of Toronto, Toronto, ON Canada ,grid.415526.10000 0001 0692 494XToronto Rehabilitation Institute, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Rehabilitation Sciences Institute, University of Toronto, Toronto, ON Canada
| |
Collapse
|
9
|
Beckers LWME, Stal RA, Smeets RJEM, Onghena P, Bastiaenen CHG. Single-case Design Studies in Children with Cerebral Palsy: A Scoping Review. Dev Neurorehabil 2020; 23:73-105. [PMID: 31411523 DOI: 10.1080/17518423.2019.1645226] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Aim: To critically evaluate single-case design (SCD) studies performed within the population of children/adolescents with cerebral palsy (CP).Methods: A scoping review of SCD studies of children/adolescents with CP. Demographic, methodological, and statistical data were extracted. Articles were evaluated using the Risk of Bias in N-of-1 Trials (RoBiNT) Scale and the Consolidated Standards of Reporting Trials (CONSORT) extension for N-of-1 trials (CENT 2015). Comments regarding strengths and limitations were analyzed.Results: Studies investigated the effects of a wide range of interventions on various outcomes. Most SCD types were adopted in multiple studies. All studies used visual inspection rather than visual analysis, often complemented with basic statistical descriptives. Risk of bias was high, particularly concerning internal validity. Many CENT items were insufficiently reported. Several benefits and limitations of SCD were identified.Conclusions: The quality of evidence from results of SCD studies needs to be increased through risk of bias reduction.
Collapse
Affiliation(s)
- Laura W M E Beckers
- Department of Rehabilitation Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands.,Centre of Expertise in Rehabilitation and Audiology, Adelante, Hoensbroek, Netherlands
| | - Rosalinde A Stal
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Rob J E M Smeets
- Department of Rehabilitation Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands.,CIR Revalidatie, Location Eindhoven, Eindhoven, Netherlands
| | - Patrick Onghena
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Caroline H G Bastiaenen
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| |
Collapse
|
10
|
Namasivayam AK, Pukonen M, Goshulak D, Granata F, Le DJ, Kroll R, van Lieshout P. Investigating intervention dose frequency for children with speech sound disorders and motor speech involvement. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2019; 54:673-686. [PMID: 30941860 DOI: 10.1111/1460-6984.12472] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 03/06/2019] [Accepted: 03/08/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Treatment outcome data for children with severe speech sound disorders with motor speech involvement (SSD-MSI) are derived from Phase I clinical research studies. These studies have demonstrated positive improvements in speech production. Currently there is no research examining the optimal treatment dose frequency for this population. The results of this study, which is the first of its kind, will inform the delivery of effective services for this population. AIMS To investigate optimal treatment dose frequency for the Motor Speech Treatment Protocol (MSTP) for children with SSD-MSI. METHODS & PROCEDURES A total of 48 children (aged 43-47 months) with SSD-MSI participated in the study. Participants received 45-min MSTP intervention sessions either once per week (lower dose frequency) or twice per week (higher dose frequency) for a 10-week period. Blinded outcome assessments were carried out at pre- and post-intervention. OUTCOMES & RESULTS Treatment-related change was assessed at body structures, functions and activities participation level as per the World Health Organization's International Classification of Functioning framework: Children and Youth Version (ICF-CY) framework WHO (2007). These measures are related to articulation, functional communication and speech intelligibility. One-way analysis of variance (ANOVA) revealed that for all variables the baseline scores were not statistically different (p > 0.05) between the two dose-frequency groups. Overall, there was a significant main effect of Time (pre-post) across all variables (p < 0.01). However, repeated-measures ANOVA did not result in any statistical interactions (Time × Dose frequency) for any of the variables tested (p > 0.05). Only marginal clinical advantages (< 4% change in intelligibility) were noted with the 10 extra sessions. CONCLUSIONS & IMPLICATIONS Overall, the MSTP intervention approach in conjunction with home practice led to significant positive changes for all measures in children with SSD-MSI. No statistical differences between high- and low-dose-frequency groups were observed for any of the variables. Clinical effects were examined using effect sizes, as well as changes in articulation, speech intelligibility and functional communication; these differed marginally between the two dose frequencies. This suggests limited benefits of 10 additional sessions per block. Thus, it is recommended that caregivers, speech-language therapists and policy-makers perform a cost-benefit analysis before determining the dose frequency, when considering additional sessions per block.
Collapse
Affiliation(s)
- Aravind K Namasivayam
- Oral Dynamics Lab, Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada
- Toronto Rehabilitation Institute, Toronto, ON, Canada
| | - Margit Pukonen
- The Speech and Stuttering Institute, Toronto, ON, Canada
| | - Debra Goshulak
- The Speech and Stuttering Institute, Toronto, ON, Canada
| | - Francesca Granata
- Oral Dynamics Lab, Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada
| | - D James Le
- Oral Dynamics Lab, Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada
| | - Robert Kroll
- The Speech and Stuttering Institute, Toronto, ON, Canada
| | - Pascal van Lieshout
- Oral Dynamics Lab, Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada
- Toronto Rehabilitation Institute, Toronto, ON, Canada
- Department of Psychology, University of Toronto Mississauga, Mississauga, ON, Canada
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
11
|
Murray E, Iuzzini-Seigel J. Efficacious Treatment of Children With Childhood Apraxia of Speech According to the International Classification of Functioning, Disability and Health. ACTA ACUST UNITED AC 2017. [DOI: 10.1044/persp2.sig2.61] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
There is increasing evidence for treatment approaches designed for children with childhood apraxia of speech (CAS). Despite this, no treatment has conclusive evidence to date. The CAS population is heterogeneous, with children presenting with varying symptom profiles, severity levels, and comorbidities. Consequently, treatment planning for children with CAS represents a clinical challenge. To assist clinicians in providing optimal care, this paper uses the International Classification of Functioning, Disability and Health (ICF) as a framework for identifying the body structures and functions, activities, and personal/environmental factors that should be considered when working with children with CAS. Evidence-based interventions are described and resources outlined to help guide the treatment planning process.
Collapse
Affiliation(s)
- Elizabeth Murray
- Faculty of Health Sciences, The University of Sydney
Lidcombe NSW, Australia
| | - Jenya Iuzzini-Seigel
- Communication, Movement and Learning Lab, Department of Speech Pathology and Audiology, Marquette University
Milwaukee, WI
| |
Collapse
|
12
|
Pennington L, Parker NK, Kelly H, Miller N. Speech therapy for children with dysarthria acquired before three years of age. Cochrane Database Syst Rev 2016; 7:CD006937. [PMID: 27428115 PMCID: PMC6457859 DOI: 10.1002/14651858.cd006937.pub3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Children with motor impairments often have the motor speech disorder dysarthria, a condition which effects the tone, strength and co-ordination of any or all of the muscles used for speech. Resulting speech difficulties can range from mild, with slightly slurred articulation and breathy voice, to profound, with an inability to produce any recognisable words. Children with dysarthria are often prescribed communication aids to supplement their natural forms of communication. However, there is variation in practice regarding the provision of therapy focusing on voice and speech production. Descriptive studies have suggested that therapy may improve speech, but its effectiveness has not been evaluated. OBJECTIVES To assess whether any speech and language therapy intervention aimed at improving the speech of children with dysarthria is more effective in increasing children's speech intelligibility or communicative participation than no intervention at all , and to compare the efficacy of individual types of speech language therapy in improving the speech intelligibility or communicative participation of children with dysarthria. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2015 , Issue 7 ), MEDLINE, EMBASE, CINAHL , LLBA, ERIC, PsychInfo, Web of Science, Scopus, UK National Research Register and Dissertation Abstracts up to July 2015, handsearched relevant journals published between 1980 and July 2015, and searched proceedings of relevant conferences between 1996 to 2015. We placed no restrictions on the language or setting of the studies. A previous version of this review considered studies published up to April 2009. In this update we searched for studies published from April 2009 to July 2015. SELECTION CRITERIA We considered randomised controlled trials and studies using quasi-experimental designs in which children were allocated to groups using non-random methods. DATA COLLECTION AND ANALYSIS One author (LP) conducted searches of all databases, journals and conference reports. All searches included a reliability check in which a second review author independently checked a random sample comprising 15% of all identified reports. We planned that two review authors would independently assess the quality and extract data from eligible studies. MAIN RESULTS No randomised controlled trials or group studies were identified. AUTHORS' CONCLUSIONS This review found no evidence from randomised trials of the effectiveness of speech and language therapy interventions to improve the speech of children with early acquired dysarthria. Rigorous, fully powered randomised controlled trials are needed to investigate if the positive changes in children's speech observed in phase I and phase II studies are generalisable to the population of children with early acquired dysarthria served by speech and language therapy services. Research should examine change in children's speech production and intelligibility. It must also investigate children's participation in social and educational activities, and their quality of life, as well as the cost and acceptability of interventions.
Collapse
Affiliation(s)
- Lindsay Pennington
- Newcastle UniversityInstitute of Health and SocietySir James Spence Institute ‐ Royal Victoria InfirmaryQueen Victoria RoadNewcastle upon TyneUKNE1 4LP
| | - Naomi K Parker
- Newcastle UniversityInstitute of Health and SocietySir James Spence Institute ‐ Royal Victoria InfirmaryQueen Victoria RoadNewcastle upon TyneUKNE1 4LP
| | - Helen Kelly
- Newcastle UniversityInstitute of Health and SocietySir James Spence Institute ‐ Royal Victoria InfirmaryQueen Victoria RoadNewcastle upon TyneUKNE1 4LP
| | - Nick Miller
- Newcastle UniversityInstitute of Health and SocietySir James Spence Institute ‐ Royal Victoria InfirmaryQueen Victoria RoadNewcastle upon TyneUKNE1 4LP
| | | |
Collapse
|
13
|
Kearney E, Granata F, Yunusova Y, van Lieshout P, Hayden D, Namasivayam A. Outcome Measures in Developmental Speech Sound Disorders with a Motor Basis. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2015. [DOI: 10.1007/s40474-015-0058-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
14
|
Landa S, Pennington L, Miller N, Robson S, Thompson V, Steen N. Association between objective measurement of the speech intelligibility of young people with dysarthria and listener ratings of ease of understanding. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2014; 16:408-416. [PMID: 25011400 DOI: 10.3109/17549507.2014.927922] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE This study aimed to investigate the association between listeners' ratings of how much effort it took to understand the speech of young people with cerebral palsy and the percentage of words listeners actually understood. METHOD Thirty-one young people with dysarthria and cerebral palsy (16 males, 15 females; mean age = 11 years, SD = 3) were audio recorded repeating single words and producing speech. Objective measures of intelligibility were calculated for multiple familiar and unfamiliar listeners using a forced choice paradigm for single words and verbatim orthographic transcriptions for connected speech. Listeners rated how much effort it took to understand speech in each condition using a 5-point ordinal ease of listening (EOL) scale. RESULTS Agreement on EOL within rater groups was high (ICC > 0.71). An effect of listener was observed for familiar listeners, but not for unfamiliar listeners. EOL agreement between familiar and unfamiliar listeners was weak-moderate (ICC = 0.46). EOL predicted the percentage of speech actually understood by familiar and unfamiliar listeners (r > 0.56, p < 0.001 for all predictions). Strongest associations between EOL and intelligibility were observed for speakers with mild and profound impairments. CONCLUSIONS The findings of this study demonstrate that listeners can judge how well they have understood dysarthric speech. EOL is associated with listener familiarity, speech task and speech impairment severity. EOL is appropriate for use in clinical practice as a measure of communication activity.
Collapse
|
15
|
Morgan AT, Hodge M, Pennington L. Scientific forum topic: translating knowledge to practice in childhood dysarthria. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2014; 16:335-336. [PMID: 25011398 DOI: 10.3109/17549507.2014.930176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Angela T Morgan
- Language and Literacy Group, Murdoch Childrens Research Institute , Melbourne, Victoria , Australia
| | | | | |
Collapse
|