Views of children with cerebral palsy and their parents on the effectiveness and acceptability of intensive speech therapy

Abstract

Purpose: To understand children and parents' views of the effectiveness and acceptability of intensive dysarthria therapy. Materials and Methods: Twenty-two children with cerebral palsy and dysarthria joined a pilot RCT comparing intensive therapy and usual care. Children (n ¼ 11) allocated to dysarthria therapy comprising three 40-minute sessions per week for six weeks and their parents (n ¼ 11) were interviewed two weeks before and six weeks after therapy. Interviews were transcribed verbatim and analysed thematically. Results: Analysis revealed five themes: Motivations, My new voice; The new me; I can do more; Success rooted in therapy design. Children had received little therapy for speech and were keen to improve intelligibility. Overall, therapy was viewed as effective. Participants described changes in children's speech production, which they associated with increased speech intelligibility. Children were described as more confident following the therapy, to have more successful conversations, with a wider range of partners in more environments, thereby increasing their social participation. The programme was viewed as acceptable, despite its intensity, due to the short term commitment and wider benefits for the child. Parents valued the organised structure and individualisation of the programme and inclusion in the therapy process. Conclusion: Families found the intervention acceptable and effective. A definitive trial of its clinical effectiveness is warranted. ä IMPLICATIONS FOR REHABILITATION Children with cerebral palsy who have dysarthria and their parents reported that intensive speech therapy focussing on creating a stronger voice and a steady speech rate increased the clarity of children's voice and the intelligibility of their speech. Therapy may have additional benefits for children's self-confidence and social participation. The programme of therapy comprising three sessions per week for six weeks was seen as manageable by families in view of the results achieved.

Intensive Voice Treatment (Lee Silverman Voice Treatment [LSVT LOUD]) for Children With Down Syndrome: Phase I Outcomes

“…The general responses showed that treatment intensity was well tolerated, although parents were concerned about maintaining practice time needed to maintain healthy voice quality and generalization of skills to everyday communication. The qualitative analyses of POST interviews and treatment ratings show some initial evidence of intensive treatment effectiveness and parents' desire and willingness to commit and participate in the structured LSVT LOUD protocol similar to other groups of parents who participated in LSVT LOUD or an intensive Speech Systems Approach with children who have CP Fox & Boliek, 2012Pennington et al, 2019.…”

“…The need to assess parent perceptions of treatment and treatment results is in line with the need to describe patient-reported outcomes in the more general context of today's health care models (de Riesthal & Ross, 2015). Moreover, as Pennington et al point out (Pennington et al, 2019), qualifying child and parent views on treatment and perceived outcomes is an important component toward establishing treatment effectiveness in later stages of evidence (Robey, 2004).…”

Protocol for SonoSpeech Cleft Pilot: a mixed-methods pilot randomized control trial of ultrasound visual biofeedback versus standard intervention for children with cleft lip and palate

“…Each focus group will include up to 10 participants. Responses to the focus groups will be analyzed by an RA using thematic analysis, following the same methods employed in a similar study with children with cerebral palsy [ 31 ], that is, inductive thematic analysis.…”

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

“…In this treatment, participants focused on the stabilization of respiration, phonation and speech rate at various linguistic levels. Positive gains in speech intelligibility have been reported following treatment in both younger children (Pennington et al., 2013) and older children (Pennington et al., 2010a) with CP. However, a possible limitation of this treatment approach is its use of multiple instructions, a potential confounding factor in light of the comorbid language‐learning deficits commonly noted in individuals with CP (Beckung & Hagberg, 2002).…”

“…This approach targets improved functioning of several speech subsystems (e.g., phonation, respiration, prosody), without directly targeting articulatory skills. It is based on the notion that speech sound production and overall intelligibility are impacted by impaired functioning at the levels of the respiration, phonation and prosody (Pennington et al., 2010a). In this treatment, participants focused on the stabilization of respiration, phonation and speech rate at various linguistic levels.…”