Morgan A T, Liegeois F, Occomore L
Developmental Cognitive Neuroscience Unit, UCL Institute of Child Health, UK.
Brain Inj. 2007 Oct;21(11):1183-93. doi: 10.1080/02699050701649573.
Dysarthria with severe articulatory impairment is a common and debilitating sequelae following severe traumatic brain injury (TBI). Eectropalatography (EPG) is an instrumental treatment technique allowing visual feedback of tongue to palate movement during real time articulation. The present study investigated the effectiveness of EPG in treating the articulatory component of dysarthria post-TBI.
STUDY DESIGN/METHODS: The articulatory component of dysarthria post-TBI was treated once per week with EPG over a 10-week period in three adolescents (aged 14 years 10 months-15 years 1 month). A multiple case series ABA treatment design was used. Perceptual (articulation, intelligibility) and EPG (spatial, durational) assessments were conducted pre- and post-treatment to determine outcome.
RESULTS/DISCUSSION: Perceptual improvement was noted for phoneme precision and length. Spatial EPG measures confirmed increased precision of phoneme production. No clear pattern of change for phoneme duration occurred. Intelligibility increased at word and sentence level, with little change reported in everyday speech intelligibility.
This preliminary study indicates that EPG treatment may be effective for improving speech at the isolated phoneme, word or sentence level of articulation. These preliminary results are encouraging, being the first study to report speech changes post-treatment in participants with severe TBI and persistent dysarthria. Further research is required, however, in order to understand the regenerative capacity of articulatory function post-brain injury and to determine optimal treatment parameters for achieving generalization of therapy to everyday connected speech.
构音障碍伴严重构音障碍是重度创伤性脑损伤(TBI)后常见且使人衰弱的后遗症。腭电图描记法(EPG)是一种仪器治疗技术,可在实时发音过程中提供舌与腭运动的视觉反馈。本研究调查了EPG治疗TBI后构音障碍的构音成分的有效性。
研究设计/方法:在10周内,对三名青少年(年龄14岁10个月至15岁1个月)每周使用EPG治疗一次TBI后构音障碍的构音成分。采用多病例系列ABA治疗设计。在治疗前后进行感知(发音、可懂度)和EPG(空间、时长)评估以确定结果。
结果/讨论:在音素精度和长度方面发现了感知改善。空间EPG测量结果证实了音素产生的精度提高。音素时长没有明显的变化模式。在单词和句子层面可懂度有所提高,日常言语可懂度变化不大。
这项初步研究表明,EPG治疗可能对改善孤立音素、单词或句子层面的发音有效。这些初步结果令人鼓舞,这是第一项报告重度TBI和持续性构音障碍参与者治疗后言语变化的研究。然而,需要进一步研究,以了解脑损伤后构音功能的再生能力,并确定实现治疗向日常连贯言语泛化的最佳治疗参数。