Implementing two treatment approaches to childhood dysarthria

Levy, Erika S.

doi:10.3109/17549507.2014.894123

Cited by 39 publications

(18 citation statements)

References 26 publications

(47 reference statements)

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“…2015), to the best of our knowledge, no published studies have described dysarthria characteristics in French‐speaking children with CP, nor have any examined the effects of treatment strategies on the children's intelligibility. Even speech treatment for English‐speaking children with dysarthria has received attention in only a small number of studies (e.g., Fox and Boliek 2012, Levy 2014, 2018, Levy et al . 2012, Miller et al .…”

Section: Introductionmentioning

confidence: 99%

“…2013, 2014). Moreover, training vocal intensity is a key element of Ramig et al .’s (2001) Lee Silverman Voice Treatment (LSVT) LOUD, which has been found to increase speech function in small studies of English‐speaking children with dysarthria (Fox and Boliek 2012, Levy 2014, Levy et al . 2012).…”

Section: Introductionmentioning

confidence: 99%

“…The strong voice cue was expected to increase primarily vocal intensity (Fox and Boliek 2012, Levy 2014, Levy et al . 2012, 2017), but also duration (Tjaden et al .…”

Section: Introductionmentioning

confidence: 99%

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Effects of speech cues in French‐speaking children with dysarthria

Levy

Moya‐Galé

Chang

et al. 2020

Intl J Lang & Comm Disor

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Background: Articulatory excursion and vocal intensity are reduced in many children with dysarthria due to cerebral palsy (CP), contributing to the children's intelligibility deficits and negatively affecting their social participation. However, the effects of speech-treatment strategies for improving intelligibility in this population are understudied, especially for children who speak languages other than English. In a cueing study on English-speaking children with dysarthria, acoustic variables and intelligibility improved when the children were provided with cues aimed to increase articulatory excursion and vocal intensity. While French is among the top 20 most spoken languages in the world, dysarthria and its management in French-speaking children are virtually unexplored areas of research. Information gleaned from such research is critical for providing an evidence base on which to provide treatment. Aims: To examine acoustic and perceptual changes in the speech of French-speaking children with dysarthria, who are provided with speech cues targeting greater articulatory excursion (French translation of 'speak with your big mouth') and vocal intensity (French translation of 'speak with your strong voice'). This study investigated whether, in response to the cues, the children would make acoustic changes and listeners would perceive the children's speech as more intelligible. Methods & Procedures: Eleven children with dysarthria due to CP (six girls, five boys; ages 4;11-17;0 years; eight with spastic CP, three with dyskinetic CP) repeated pre-recorded speech stimuli across three speaking conditions (habitual, 'big mouth' and 'strong voice'). Stimuli were sentences and contrastive words in phrases. Acoustic analyses were conducted. A total of 66 Belgian-French listeners transcribed the children's utterances orthographically and rated their ease of understanding on a visual analogue scale at sentence and word levels.Outcomes & Results: Acoustic analyses revealed significantly longer duration in response to the big mouth cue at sentence level and in response to both the big mouth and strong voice cues at word level. Significantly higher vocal sound-pressure levels were found following both cues at sentence and word levels. Both cues elicited significantly higher first-formant vowel frequencies and listeners' greater ease-of-understanding ratings at word level. Increases in the percentage of words transcribed correctly and in sentence ease-of-understanding ratings, however, did not reach statistical significance. Considerable variability between children was observed. Conclusions & Implications: Speech cues targeting greater articulatory excursion and vocal intensity yield significant acoustic changes in French-speaking children with dysarthria. However, the changes may only aid listeners' ease of understanding at word level. The significant findings and great inter-speaker variability are generally consistent with studies on English-speaking children with dysarthria, although changes appear more constrained in ...

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effects of speech cues in French‐speaking children with dysarthria

Levy

Moya‐Galé

Chang

et al. 2020

Intl J Lang & Comm Disor

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“…The few studies of intervention for children with dysarthria using a systems-based approach focusing on respiration, phonatory control, phrase length, and speech rate (e.g., Levy, 2014;Levy et al, 2012;Pennington et al, 2013;Pennington, Smallman, & Farrier, 2006) have found promising improvement in intelligibility in children with dysarthria. Similarly, LSVT LOUD yielded benefits to ratings of articulatory precision and acoustic measures in this population (Fox & Boliek, 2012;Levy et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

Vowel Intelligibility in Children With and Without Dysarthria

Levy

Leone

Moya‐Galé

et al. 2015

Communication Disorders Quarterly

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Children with dysarthria due to cerebral palsy (CP) present with decreased vowel space area and reduced word intelligibility. Although a robust relationship exists between vowel space and word intelligibility, little is known about the intelligibility of vowels in this population. This exploratory study investigated the intelligibility of American English (AE) vowels produced by children with dysarthria and typically developing children (TD). Three CP and five TD repeated words with contrastive vowels /i-ɪ/, /æ-ɛ/, /ɑ-ʌ/, /o-u/ produced by a native AE adult. Adult listeners transcribed the utterances orthographically and rated their ease of understanding. Overall, CP presented with less-intelligible vowels than TD. For CP, a trend was found with the lowest intelligibility for /ɑ/ (CP = 7%, TD = 66%), /ɪ/ (CP = 30%, TD = 82%), and /ʌ/ (CP = 38%, TD = 99%), and more heterogeneous vowel confusions; however, intelligibility differences between vowels did not reach statistical significance. Clinical implications include that, unless further studies show vowel-specific effects, treatment targeting the entire vowel system may be warranted for increasing intelligibility.

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“…Given that both speech motor control and cognitive-linguistic skills may be impaired in children with CP, speech rate and its characteristics likely develop differently in children with CP than their typically developing peers (e.g., Cockerill et al, 2014;Hustad et al, 2010;Mei et al, 2014Mei et al, , 2016Nordberg et al, 2013;Pakula, Van Naarden Braun, & Yeargin-Allsopp, 2009;Parkes et al, 2010). It is important to understand the development of speech rate and its characteristics in children with CP because speech rate is a common target in speech intervention to improve intelligibility in children with CP (Levy, 2014;Pennington, Miller, Robson, & Steen, 2010;Pennington et al, 2013;Pennington, Smallman, & Farrier, 2006) and habitual articulation rate and pausing patterns may significantly impact intervention success. Hustad and Sassano (2002) found that, by training adults with CP (N = 2) to insert pauses between each word of a sentence, the resultant decrease in speech rate resulted in intelligibility gains.…”

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confidence: 99%

Characteristics of Speech Rate in Children With Cerebral Palsy: A Longitudinal Study

Darling-White

Sakash

Hustad

2018

J Speech Lang Hear Res

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Purpose The purpose of this longitudinal study was to examine the effect of time and sentence length on speech rate and its characteristics, articulation rate and pauses, within 2 groups of children with cerebral palsy (CP). Method Thirty-four children with CP, 18 with no speech motor involvement and 16 with speech motor involvement, produced sentences of varying lengths at 3 time points that were 1 year apart (mean age = 56 months at first time point). Dependent measures included speech rate, articulation rate, proportion of time spent pausing, and average number and duration of pauses. Results There were no significant effects of time. For children with no speech motor involvement, speech rate increased with longer sentences due to increased articulation rate. For children with speech motor involvement, speech rate did not change with sentence length due to significant increases in the proportion of time spent pausing and average number of pauses in longer sentences. Conclusions There were no significant age-related differences in speech rate in children with CP regardless of group membership. Sentence length differentially impacted speech rate and its characteristics in both groups of children with CP. This may be due to cognitive–linguistic and/or speech motor control factors.

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Implementing two treatment approaches to childhood dysarthria

Cited by 39 publications

References 26 publications

Effects of speech cues in French‐speaking children with dysarthria

Effects of speech cues in French‐speaking children with dysarthria

Vowel Intelligibility in Children With and Without Dysarthria

Characteristics of Speech Rate in Children With Cerebral Palsy: A Longitudinal Study

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