As indicated in earlier blogs there is a desperate need for intervention
research in developmental dysarthria to find out which interventions lead to
meaningful changes in speech, and if so why.
Hot off the press is an article by Erika Levy and colleagues
that compares the effects of two interventions:
LSVT Loud and speech subsystems approach (what they termed traditional approach). Levy and colleagues
recruited three girls with spastic type CP (aged 3-9 years) with mild to
moderate dysarthria. The allocation to intervention was somewhat arbitrary with
those girls who could commit to therapy 4 days a week getting LSVT Loud,
whereas one girl received therapy following the traditional approach twice a
week. LSVT focused on increasing loudness; the traditional approach targeted
posture, speech clarity and breath control.
Changes - measured by means of caregiver questionnaires,
articulation tests and listener perception tests of single words and
spontaneous speech – were positive: caregivers reported a positive impact of
therapy on speech, articulation tests showed greater articulatory precision,
and listeners preferred the post-therapy speech samples. Interestingly, LSVT
seemed to increase speech function and loudness, whereas the traditional
approach resulted in better speech but had no effect on loudness.
Although overall results suggest an improvement in speech
function, individual performances show a highly variable picture. For instance,
in terms of loudness one girl undergoing LSVT treatment improved at word level,
whereas the other one showed improvements in spontaneous speech. This is not
the only reason why the results of the study should be interpreted carefully:
- The interventions were administered by different therapists/students
- It is unclear whether the frequency of intervention had an effect
- The allocation to intervention was arbitrary
- Relation of the findings to intelligibility were not examined
- Results were not tested for statistical significance
The study is a step into the right direction, and raises one
important issue: How can we predict which intervention approach is the best for
a particular child?
Levy, E. S., Ramig, L. O. & Camarata, S. (2012) The
Effects of Two Speech Interventions on Speech Function in Pediatric Dysarthria.
Journal of Medical Speech-Language
Pathology, 20(4), 82-87.
