Speech Breathing in Able-Bodied Children and Children With Cerebral Palsy

Solomon, Nancy Pearl; Charron, Sandy

doi:10.1044/1058-0360.0702.61

Cited by 31 publications

(4 citation statements)

References 66 publications

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“…Frequent inspiration 32,38,39 Inappropriate phrasing 5 Low speech volume 5 Inappropriate volume 5 Reduced intensity 40…”

Section: Respiratorymentioning

confidence: 99%

“…Post-therapy we observed increases in the identification of place of articulation in either word initial or word final consonants, and a slight overall mean increase in word identification (mean change = 5%, range -4 to 15%). Group 3 comprised 11 children: (21,23,24,27,31,32,36,38,46,48,49). Listeners identified 50-83% of their SWs pre-therapy.…”

Section: Radar Plotsmentioning

confidence: 99%

“…Group 6 comprised ten children (2,5,15,16,19,23,26,27,32,53). These children also made improvements post-therapy but started with higher pre-therapy word identification scores (29-46%) and VPM in word initial and word final consonants (25-50%) than Group 5.…”

Section: Radar Plotsmentioning

confidence: 99%

“…Children with dysarthria associated with spastic or dyskinetic CP, respiration is often shallow 32 and lacks co-ordination with phonation, generating weak or inconsistent subglottal pressure. Vocal folds may vibrate slowly and irregularly; air may leak through the folds when they should be adducted, reducing the intraoral pressure and weakening the sound source.…”

Section: Introduction and Aimsmentioning

confidence: 99%

See 3 more Smart Citations

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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“…Frequent inspiration 32,38,39 Inappropriate phrasing 5 Low speech volume 5 Inappropriate volume 5 Reduced intensity 40…”

Section: Respiratorymentioning

confidence: 99%

Section: Radar Plotsmentioning

confidence: 99%

Section: Radar Plotsmentioning

confidence: 99%

Section: Introduction and Aimsmentioning

confidence: 99%

See 2 more Smart Citations

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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Instrumental Analysis of Speech Production

Ménard,

Tiede

2024

The Handbook of Clinical Linguistics, Second Edition

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Development of The Viking Speech Scale to classify the speech of children with cerebral palsy

Pennington

Virella

Mjøen

et al. 2013

Research in Developmental Disabilities

134

127

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A B S T R A C TSurveillance registers monitor the prevalence of cerebral palsy and the severity of resulting impairments across time and place. The motor disorders of cerebral palsy can affect children's speech production and limit their intelligibility. We describe the development of a scale to classify children's speech performance for use in cerebral palsy surveillance registers, and its reliability across raters and across time. Speech and language therapists, other healthcare professionals and parents classified the speech of 139 children with cerebral palsy (85 boys, 54 girls; mean age 6.03 years, SD 1.09) from observation and previous knowledge of the children. Another group of health professionals rated children's speech from information in their medical notes. With the exception of parents, raters reclassified children's speech at least four weeks after their initial classification. Raters were asked to rate how easy the scale was to use and how well the scale described the child's speech production using Likert scales. Inter-rater reliability was moderate to substantial (k > .58 for all comparisons). Test-retest reliability was substantial to almost perfect for all groups (k > .68). Over 74% of raters found the scale easy or very easy to use; 66% of parents and over 70% of health care professionals judged the scale to describe children's speech well or very well. We conclude that the Viking Speech Scale is a reliable tool to describe the speech performance of children with cerebral palsy, which can be applied through direct observation of children or through case note review. ß

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Speech Breathing in Able-Bodied Children and Children With Cerebral Palsy

Cited by 31 publications

References 66 publications

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

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

Instrumental Analysis of Speech Production

Development of The Viking Speech Scale to classify the speech of children with cerebral palsy

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