Intonation patterns in older children with cerebral palsy before and after speech intervention

Kuschmann, Anja; Miller, Nick; Lowit, Anja; Pennington, Lindsay

doi:10.1080/17549507.2016.1216601

Cited by 3 publications

(8 citation statements)

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“…Prosody is often affected, with the nature of the disturbance depending on the language. Specific effects have been described for intonation and stress patterns in English (Kuschmann et al, 2017;Patel, 2003Patel, , 2004Patel, Hustad, Connaghan, & Furr, 2012), tone production in Cantonese (Ciocca, Whitehill, & Ng, 2002;Ciocca, Whitehill, & Yin, 2004), tone production in Mandarin (Jeng et al, 2006), prosody in German (Schölderle et al, 2016), and prosody in Spanish (Puyuelo & Rondal, 2005). It is clear from these studies that prosody is a vulnerable feature of the speech disorder in CP, and cross-language comparisons may illuminate language variations in these disturbances.…”

Section: Effects Of Cp On Speech Production Across Languagesmentioning

confidence: 88%

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Dysarthria in Mandarin-Speaking Children With Cerebral Palsy: Speech Subsystem Profiles

Chen

Hustad

Kent

et al. 2018

J Speech Lang Hear Res

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Section: Effects Of Cp On Speech Production Across Languagesmentioning

confidence: 88%

“…Moreover, it is important to understand how interventions targeting a particular subsystem lead to improvements in speech intelligibility or quality. Promising results have been reported in several studies (Kuschmann, Miller, Lowit, & Pennington, 2017;Levy, 2014;Miller et al, 2014;Netsell, 1984;Netsell & Daniel, 1979;Pennington, Miller, Robson, & Steen, 2010).…”

mentioning

confidence: 81%

Dysarthria in Mandarin-Speaking Children With Cerebral Palsy: Speech Subsystem Profiles

Chen

Hustad

Kent

et al. 2018

J Speech Lang Hear Res

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“…We previously observed modest changes in overall voice quality, speech rate, pitch and intensity (perceived by listeners as loudness), which were insufficient to account for changes in intelligibility. 16 This study will examine if the increased intelligibility observed in some children following intervention focussing on breath support and speech rate is associated with the ability to differentiate individual sounds within words.…”

Section: Fundingmentioning

confidence: 99%

“…After the Speech Systems Approach, children produced longer breath groups (mean = 1.1 sec) and produced more syllables per second, 37 but the melodic intonation of their speech showed no change. 16 Children's voice was rated as stronger after the Speech Systems Approach on the GRBAS (Grade, Roughness, Breathiness, Asthenia, Scale) four-point rating scale of voice disorder, 54 by therapists blinded to the time of recordings (mean reduction in asthenia was 0.3). 55 The impact of individual acoustic changes following LSVT on children's intelligibility has not been tested to date.…”

Section: Evidence Reviewmentioning

confidence: 99%

The impact of the Speech Systems Approach on intelligibility for children with cerebral palsy: a secondary analysis

Pennington,

Cunningham,

Hiu

et al. 2023

Efficacy Mech Eval

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Background The motor speech disorder, dysarthria, is common in cerebral palsy. The Speech Systems Approach therapy programme, which focuses on controlling breath supply and speech rate, has increased children’s intelligibility. Objective To ascertain if increased intelligibility is due to better differentiation of the articulation of individual consonants in words spoken in isolation and in connected speech. Design Secondary analysis. Setting University. Participants Forty-two children with cerebral palsy and dysarthria aged 5–18 years, Gross Motor Function Classification System I–V. Intervention The Speech Systems Approach is a motor learning therapy delivered to individuals by a speech and language therapist in 40-minute sessions, three times per week for 6 weeks. Intervention focuses on production of a strong, clear voice and speaking at a steady rate. Practice changes from single words to increasingly longer utterances in tasks with increasing cognitive load. Main outcome measures Unfamiliar listeners’ identification of singleton consonants (e.g. nap) and clusters of consonants (e.g. stair, end) at the start and end of words when hearing single words in forced choice tasks and connected speech in free transcription tasks. Acoustic measures of sound intensity and duration. Data sources Data collected at 1-week pre- and 1-week post-therapy from three studies: two interrupted time series design, one feasibility randomised controlled trial. Results Word initial and word final singleton consonants and consonant clusters were better identified post-therapy. The extent of improvement differed across word initial and word final singleton consonant subtypes. Improvement was greater for single words than connected speech. Change in sound identification varied across children, particularly in connected speech. Sound intensity and duration increases also were inconsistent. Limitations The small sample size did not allow for analysis of cerebral palsy type. Acoustic data were not available for all children, limiting the strength of conclusions that can be drawn. The different but phonetically balanced word lists, used in the original research, created variability in single words spoken across recordings analysed. Low frequencies of plosives, fricatives and affricates necessitated their combination for analysis preventing investigation of the effect of specific consonants. Connected speech was spontaneous, again creating variability within the data analysed. The estimated effects of therapy may therefore be partially explained by differences in the spoken language elicited. Conclusions The Speech Systems Approach helped children generate greater breath supply and a steady rate, leading to increased intensity and duration of consonant sounds in single words, thereby aiding their identification by listeners. Transfer of the motor behaviour to connected speech was inconsistent. Future work Refining the Speech Systems Approach to focus on connected speech early in the intervention. Personalisation of cues according to perceptual and acoustic speech measures. Creation of a battery of measures that can be repeated across children and multiple recordings. Study registration This trial is registered as Research Registry 6117. Funding This project was funded by the National Institute for Health and Care Research (NIHR) Efficacy and Mechanism Evaluation programme (NIHR130967) and will be published in full in Efficacy and Mechanism Evaluation; Vol. 10, No. 4. See the NIHR Journals Library website for further project information.

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“…Respiratory and phonatory deficits may include reduced respiratory control, difficulty with coordination of respiration and phonation (Pennington et al., 2018), reduced vocal intensity (Allison & Hustad, 2018), reduced vocal quality, and impaired variation and control of fundamental frequency (Pennington et al., 2010a; Schölderle et al., 2016). Resonance and prosodic impairment have also been documented among individuals with CP, characterized by hyper‐ or hypo‐nasality (Schölderle et al., 2016), as well as reduced speech rate and impaired intonational patterns (Allison & Hustad, 2018; Kuschmann et al., 2017), respectively. Articulatory deficits are typically characterized by impaired production of both consonants (Allison & Hustad, 2018; Ansel & Kent, 1992) and vowels (Higgins & Hodge, 2002; Levy et al., 2016).…”

Section: Speech Production In Cerebral Palsymentioning

confidence: 99%

Speech treatment for Hebrew‐speaking adolescents and young adults with developmental dysarthria: A comparison of mSIT and Beatalk

Carl

Levy

Icht

2022

Intl J Lang & Comm Disor

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Background Individuals with developmental dysarthria typically demonstrate reduced functioning of one or more of the speech subsystems, which negatively impacts speech intelligibility and communication within social contexts. A few treatment approaches are available for improving speech production and intelligibility among individuals with developmental dysarthria. However, these approaches have only limited application and research findings among adolescents and young adults. Aims To determine and compare the effectiveness of two treatment approaches, the modified Speech Intelligibility Treatment (mSIT) and the Beatalk technique, on speech production and intelligibility among Hebrew‐speaking adolescents and young adults with developmental dysarthria. Methods & Procedures Two matched groups of adolescents and young adults with developmental dysarthria participated in the study. Each received one of the two treatments, mSIT or Beatalk, over the course of 9 weeks. Measures of speech intelligibility, articulatory accuracy, voice and vowel acoustics were assessed both pre‐ and post‐treatment. Outcomes & Results Both the mSIT and Beatalk groups demonstrated gains in at least some of the outcome measures. Participants in the mSIT group exhibited improvement in speech intelligibility and voice measures, while participants in the Beatalk group demonstrated increased articulatory accuracy and gains in voice measures from pre‐ to post‐treatment. Significant increases were noted post‐treatment for first formant values for select vowels. Conclusions & Implications Results of this preliminary study are promising for both treatment approaches. The differentiated results indicate their distinct application to speech intelligibility deficits. The current findings also hold clinical significance for treatment among adolescents and young adults with motor speech disorders and application for a language other than English. What this paper adds What is already known on the subject Developmental dysarthria (e.g., secondary to cerebral palsy) is a motor speech disorder that negatively impacts speech intelligibility, and thus communication participation. Select treatment approaches are available with the aim of improving speech intelligibility in individuals with developmental dysarthria; however, these approaches are limited in number and have only seldomly been applied specifically to adolescents and young adults. What this paper adds to existing knowledge The current study presents preliminary data regarding two treatment approaches, the mSIT and Beatalk technique, administered to Hebrew‐speaking adolescents and young adults with developmental dysarthria in a group setting. Results demonstrate the initial effectiveness of the treatment approaches, with different gains noted for each approach across speech and voice domains. What are the potential or actual clinical implications of this work? The findings add to the existing literature on potential treatment approaches aiming to improve speech production and intelligibilit...

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Intonation patterns in older children with cerebral palsy before and after speech intervention

Cited by 3 publications

References 41 publications

Dysarthria in Mandarin-Speaking Children With Cerebral Palsy: Speech Subsystem Profiles

Dysarthria in Mandarin-Speaking Children With Cerebral Palsy: Speech Subsystem Profiles

The impact of the Speech Systems Approach on intelligibility for children with cerebral palsy: a secondary analysis

Speech treatment for Hebrew‐speaking adolescents and young adults with developmental dysarthria: A comparison of mSIT and Beatalk

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