Perceptual and Acoustic Effects of Dual-Focus Speech Treatment in Children With Dysarthria

Abstract

Purpose Children with dysarthria secondary to cerebral palsy may experience reduced speech intelligibility and diminished communicative participation. However, minimal research has been conducted examining the outcomes of behavioral speech treatments in this population. This study examined the effect of Speech Intelligibility Treatment (SIT), a dual-focus speech treatment targeting increased articulatory excursion and vocal intensity, on intelligibility of narrative speech, speech acoustics, and communicative participation in children with dysarthria. Method American English–speaking children with dysarthria ( n = 17) received SIT in a 3-week summer camplike setting at Columbia University. SIT follows motor-learning principles to train the child-friendly, dual-focus strategy, “Speak with your big mouth and strong voice.” Children produced a story narrative at baseline, immediate posttreatment (POST), and at 6-week follow-up (FUP). Outcomes were examined via blinded listener ratings of ease of understanding ( n = 108 adult listeners), acoustic analyses, and questionnaires focused on communicative participation. Results SIT resulted in significant increases in ease of understanding at POST, that were maintained at FUP. There were no significant changes to vocal intensity, speech rate, or vowel spectral characteristics, with the exception of an increase in second formant difference between vowels following SIT. Significantly enhanced communicative participation was evident at POST and FUP. Considerable variability in response to SIT was observed between children . Conclusions Dual-focus treatment shows promise for improving intelligibility and communicative participation in children with dysarthria, although responses to treatment vary considerably across children. Possible mechanisms underlying the intelligibility gains, enhanced communicative participation, and variability in treatment effects are discussed.

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

“…This selection was also influenced by the novelty of the applied treatment approaches, allowing for detection of treatment effects in various speech subsystems. The chosen measures follow those recorded in previous intervention studies, including measures of voice quality (Miller et al., 2014; Pennington et al., 2018), articulation (Icht, 2021), speech intelligibility (Levy et al., 2021; Pennington et al., 2013) and vowel acoustics (Langlois et al., 2020; Levy et al., 2021).…”

“…For the words from which vowels were extracted, see Table 3. For further details of measure calculation, see Carl and Icht (2021: appx B): First and second formants (F1, F2): A comparison of vowel formants across all three corner vowels (/a/, /i/, /u/) from pre‐ to post‐treatment was conducted, in order to determine any change in vowel space area (e.g., Levy et al., 2021; Mou et al., 2019). Triangular vowel space area ( t VSA): The area of the acoustic space (F1 × F2) enclosed by the three corner vowels (/a/, /i/, /u/), with formants averaged across multiple repetitions of each vowel.…”

“…Similar to LSVT LOUD, this approach also involves the use of global cues for the treatment of intelligibility deficits among children with developmental dysarthria. Designed for children with CP, SIT is a dual‐focus approach (Levy et al., 2017, 2021; Moya‐Galé et al., 2021b) in which both speech loudness and articulatory excursions are targeted. On the one hand, it aims for the benefits of increasing vocal intensity through the ‘strong voice’ instruction, as detailed above (see LSVT LOUD).…”

“…The SIT approach includes both individual and group sessions, and uses an intense camp‐like treatment schedule, consisting of 6.5 h of treatment daily, 5 days per week, for a total of 3 weeks. Recent evidence has demonstrated the efficacy of this treatment protocol on the intelligibility of connected speech (within narrative production) in both English‐ (Levy et al., 2021) and French‐speaking children with CP (Moya‐Galé et al., 2021b).…”

“…The goal of the current study was to determine the effectiveness of two speech intelligibility treatment approaches, the modified Speech Intelligibility Treatment ( m SIT; based on Levy et al. (2021) and the Beatalk technique (Icht, 2019), among Hebrew‐speaking adolescents with developmental dysarthria, and to compare the benefits of each.…”