Speech therapy for children with dysarthria acquired before three years of age

Pennington, Lindsay; Parker, Naomi K; Kelly, Helen; Miller, Nick

doi:10.1002/14651858.cd006937.pub3

Cited by 40 publications

(21 citation statements)

References 66 publications

(4 reference statements)

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“…Treatment should involve learning or skill acquisition (e.g., as evidenced by improved intelligibility), mode of delivery should be intensive and should include significant repetitions and opportunities for practice, and task complexity should increase over time. Traditional CP treatments that do not implement these key elements have been ineffective in treating children with CP and dysarthria [Pennington et al, ]. Our results strengthen the evidence for neuroplasticity following LSVT LOUD [Liotti et al, ; Narayana et al, ].…”

Section: Resultssupporting

confidence: 81%

Changes in brain activity following intensive voice treatment in children with cerebral palsy

et al. 2017

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Eight children (3 females; 8-16 years) with motor speech disorders secondary to cerebral palsy underwent 4 weeks of an intensive neuroplasticity-principled voice treatment protocol, LSVT LOUD , followed by a structured 12-week maintenance program. Children were asked to overtly produce phonation (ah) at conversational loudness, cued-phonation at perceived twice-conversational loudness, a series of single words, and a prosodic imitation task while being scanned using fMRI, immediately pre- and post-treatment and 12 weeks following a maintenance program. Eight age- and sex-matched controls were scanned at each of the same three time points. Based on the speech and language literature, 16 bilateral regions of interest were selected a priori to detect potential neural changes following treatment. Reduced neural activity in the motor areas (decreased motor system effort) before and immediately after treatment, and increased activity in the anterior cingulate gyrus after treatment (increased contribution of decision making processes) were observed in the group with cerebral palsy compared to the control group. Using graphical models, post-treatment changes in connectivity were observed between the left supramarginal gyrus and the right supramarginal gyrus and the left precentral gyrus for the children with cerebral palsy, suggesting LSVT LOUD enhanced contributions of the feedback system in the speech production network instead of high reliance on feedforward control system and the somatosensory target map for regulating vocal effort. Network pruning indicates greater processing efficiency and the recruitment of the auditory and somatosensory feedback control systems following intensive treatment. Hum Brain Mapp 38:4413-4429, 2017. © 2017 Wiley Periodicals, Inc.

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Section: Resultssupporting

confidence: 81%

Changes in brain activity following intensive voice treatment in children with cerebral palsy

et al. 2017

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“…[1][2][3] Rapid advances in discovery are anticipated over the coming decade, unraveling the complex genetic, environmental, and neural origins. [23][24][25][26][27][28][29] What is the clinical course?…”

Section: Sources and Selection Criteriamentioning

confidence: 99%

Identifying and managing common childhood language and speech impairments

Reilly

McKean

Morgan

et al. 2015

BMJ

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“…Recruitment may not be representative of Trusts in other parts of the UK. However, to our knowledge no research is being conducted on children’s speech elsewhere in the UK and there is sparse research internationally 20. Families participating in this study used their own laptops/tablets for the remote therapy and may represent a ‘tech-savvy’ group.…”

Section: Discussionmentioning

confidence: 99%

“…Small-scale studies of therapy to control respiratory effort for speech and coordinating exhalation with phonation to generate a clearer speech signal and a steady speech rate have shown increases in intelligibility, utterance duration and communicative participation 16–19. However, as yet no randomised controlled trials (RCT) of this type of intervention for children with cerebral palsy have been reported 20…”

Section: Introductionmentioning

confidence: 99%

Internet delivery of intensive speech and language therapy for children with cerebral palsy: a pilot randomised controlled trial

et al. 2019

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ObjectivesTo test the feasibility of recruitment, retention, outcome measures and internet delivery of dysarthria therapy for young people with cerebral palsy in a randomised controlled trial.DesignMixed methods. Single blind pilot randomised controlled trial, with control offered Skype therapy at end of study. Qualitative study of the acceptability of therapy delivery via Skype.SettingNine speech and language therapy departments in northern England recruited participants to the study. Skype therapy was provided in a university setting.ParticipantsTwenty-two children (14 M, 8 F) with dysarthria and cerebral palsy (mean age 8.8 years (SD 3.2)) agreed to take part. Participants were randomised to dysarthria therapy via Skype (n=11) or treatment as usual (n=11).InterventionsChildren received either usual speech therapy from their local therapist for 6 weeks or dysarthria therapy via Skype from a research therapist. Usual therapy sessions varied in frequency, duration and content. Skype dysarthria therapy focused on breath control and phonation to produce clear speech at a steady rate, and comprised three 40 min sessions per week for 6 weeks.Primary and secondary outcome measuresFeasibility and acceptability of the trial design, intervention and outcome measures.ResultsDepartments recruited two to three participants. All participants agreed to random allocation. None withdrew from the study. Recordings of children’s speech were made at all time points and rated by listeners. Families allocated to Skype dysarthria therapy judged internet delivery of the therapy to be acceptable. All families reported that the study design was acceptable. Treatment integrity checks suggested that the phrases practised in one therapy exercise should be reduced in length.ConclusionsA delayed treatment design, in which dysarthria therapy is offered at the end of the study to families allocated to treatment as usual, is acceptable. A randomised controlled trial of internet delivered dysarthria therapy is feasible.

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Speech therapy for children with dysarthria acquired before three years of age

Cited by 40 publications

References 66 publications

Changes in brain activity following intensive voice treatment in children with cerebral palsy

Changes in brain activity following intensive voice treatment in children with cerebral palsy

Identifying and managing common childhood language and speech impairments

Internet delivery of intensive speech and language therapy for children with cerebral palsy: a pilot randomised controlled trial

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