Therapeutic Intervention in a Case of Ataxic Dysarthria Associated With a History of Amateur Boxing

Abstract

The goals of this study were to (a) describe the presenting features of ataxic dysarthria present in a participant with a long history of amateur boxing, (b) describe a novel application of behavioral principles in the treatment of this participant, and (c) discuss implications in the treatment of ataxic dysarthria secondary to boxing. The participant was a 36-year-old male with ataxic dysarthria associated with a 15-year history of amateur boxing. Perceptual intelligibility, perceptual severity, communication attitudes, and communication effectiveness were evaluated. As a result of treatment, the participant eliminated the ataxic characteristics of his speech within structured tasks. Speech patterns were controlled through loudness practice and a gradual increase in utterance length and complexity. This study offers speech-language pathologists an introduction to the topic of amateur boxing and associated neurologic consequences as well as a description of the use of behavioral principles in the treatment of ataxic dysarthria.

Articulation Rate, Pauses, and Disfluencies in Professional Fighters: Potential Speech Biomarkers for Repetitive Head Injury

“…Reduced speech rate is associated with several types of dysarthria due to neurological damage,10 including those caused by damage to 1 or both cerebral hemispheres (unilateral upper motor neuron and spastic dysarthrias), the basal ganglia control circuit (hypokinetic dysarthria), and the cerebellar control circuit (ataxic dysarthria). The finding of significantly reduced articulation rate is consistent with results of 2 previous case studies of speech in boxers 8,9…”

“…The finding of significantly reduced articulation rate is consistent with results of 2 previous case studies of speech in boxers. 8,9 Interruptions in the forward flow of speech, pauses and disfluencies, were also measured in this study. Two types of speech pauses were documented in this study: SA) pauses in locations such as at the ends of sentences and between clauses, and SI pauses in grammatically unexpected locations (eg, within prepositional phrases, between nouns and verbs).…”

“…They found, for example, that Ali's speech rate declined by 26% from 1968 to 1981, from more than 4 syllables per second to 3 syllables per second. In another account of impaired speech in boxers, McMicken et al9 described an amateur boxer with ataxia who exhibited slow and slurred “inebriated” speech. Because speech production is a complex motor behavior requiring precisely timed, rapid, and accurate movements coordinated by several neurological systems, speech changes may serve as the earliest signs of neurological disease 10.…”

Volunteerism: Speech-Language Pathology with the Homeless

“…Often the rehabilitation is not a choice but court ordered in lieu of a prison sentence. I have evaluated and treated numerous residents of the mission's programs who present with communication disorders such as long term stuttering [1], ataxic dysarthria post amateur boxing [2] hyperkinetic dysarthria post cocaine abuse [3], in addition to delayed language, Huntington's chorea, swallowing disorders, and cognitive disorders post traumatic brain injury. The possibilities for positive life changes through rehabilitative intervention are infinite.…”

Editorial on Case Studies

“…The value of a well-designed, evidence-based, carefully documented report of assessment and treatment cannot be overestimated, as case studies teach what was done and can be done, individually, to augment the rehabilitation process. As an active researcher, I have recently published 5 research papers [1][2][3][4][5] using the format of case histories. It has been an invaluable process, documenting unique cases in unique settings or a rare case in a surprising setting.…”