treatment effectiveness

Although a number of articles describing treatment approaches for developmental dysarthria were published over the years, to date only few studies were conducted to test whether dysarthria intervention in children with CP is actually effective.

A series of therapy studies conducted by Lindsay Pennington’s research group in Newcastle addressed this research gap. Pennington, Smallman and Farrier (2006) started off with a small scale intervention study in which six children with CP received individual dysarthria therapy targeting breath support and volume across utterances. Improvement was measured by means of intelligibility of single words and connected speech. Four of the six children were more intelligible directly after therapy, although improvement was only maintained in one speaker seven weeks later.

This study was followed by a more extensive investigation in 2010. Pennington and colleagues wanted to find out whether a systems approach targeting breath support, phonation and speech rate can increase the speech intelligibility of older children with CP. Sixteen children with moderate to severe dysarthria aged 12 to 18 years attended three therapy sessions per week over a period of six weeks. As in the previous study, improvement was measured in terms of intelligibility in single words and connected speech across four time points (6 and 1 week pre-therapy, and 1 and 6 weeks post-therapy). The intervention was found to increase speech intelligibility for familiar and unfamiliar listeners for both measures. Importantly, changes were maintained after 6 weeks, indicating acquisition of stable motor patterns.

A recent study by the same lead author examined intensive dysarthria therapy for younger children with CP. Just as the previous study, the intervention targeted breath support, phonation and speech rate. Fifteen children were recruited aged 5 to 11 years. The therapy success was measured in terms of intelligibility and participation in conversational interactions across five points: 6 and 1 week pre-therapy and 1, 6 and 12 weeks post-therapy. Overall, gains in intelligibility and participation in interaction were observed, although scores in the latter did not correlate with changes in the former. This finding shows that some children interacted more following therapy - perhaps due to increased confidence - irrespective of how much their speech intelligibility improved.

Pennington, L., Smallman, C., & Farrier, F. (2006). Intensive dysarthria therapy for older children with cerebral palsy: Findings from six cases. Child Language Teaching & Therapy, 22, 255–273.

Pennington, L., Miller, N., Robson, S. & Steen, N. (2010). Intensive speech and language therapy for older children with cerebral palsy: a systems approach. Developmental Medicine & Child Neurology, 52, 337–344.

Pennington, L., Roelant, E., Thompson, V., Robson, S., Steen, N. & Miller, N. (2013). Intensive dysarthria therapy for younger children with cerebral palsy. Developmental Medicine & Child Neurology, 55, 464–71.