Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY.
School of Psychology, Speech and Hearing and New Zealand Institute of Language, Brain and Behaviour, University of Canterbury, Christchurch, New Zealand.
J Speech Lang Hear Res. 2021 Jun 18;64(6S):2301-2316. doi: 10.1044/2020_JSLHR-20-00301. Epub 2021 Mar 3.
Purpose Children with dysarthria secondary to cerebral palsy may experience reduced speech intelligibility and diminished communicative participation. However, minimal research has been conducted examining the outcomes of behavioral speech treatments in this population. This study examined the effect of Speech Intelligibility Treatment (SIT), a dual-focus speech treatment targeting increased articulatory excursion and vocal intensity, on intelligibility of narrative speech, speech acoustics, and communicative participation in children with dysarthria. Method American English-speaking children with dysarthria ( = 17) received SIT in a 3-week summer camplike setting at Columbia University. SIT follows motor-learning principles to train the child-friendly, dual-focus strategy, "Speak with your big mouth and strong voice." Children produced a story narrative at baseline, immediate posttreatment (POST), and at 6-week follow-up (FUP). Outcomes were examined via blinded listener ratings of ease of understanding ( = 108 adult listeners), acoustic analyses, and questionnaires focused on communicative participation. Results SIT resulted in significant increases in ease of understanding at POST, that were maintained at FUP. There were no significant changes to vocal intensity, speech rate, or vowel spectral characteristics, with the exception of an increase in second formant difference between vowels following SIT. Significantly enhanced communicative participation was evident at POST and FUP. Considerable variability in response to SIT was observed between children Conclusions Dual-focus treatment shows promise for improving intelligibility and communicative participation in children with dysarthria, although responses to treatment vary considerably across children. Possible mechanisms underlying the intelligibility gains, enhanced communicative participation, and variability in treatment effects are discussed.
患有脑瘫导致的构音障碍的儿童可能会出现言语可懂度降低和交流参与度下降的情况。然而，针对该人群的行为言语治疗效果的研究甚少。本研究旨在检验言语可懂度治疗（SIT）对患有构音障碍儿童的叙事言语的可懂度、言语声学和交流参与的影响。
来自哥伦比亚大学的 17 名患有构音障碍的美国英语儿童参加了为期 3 周的夏令营式 SIT 治疗。SIT 遵循运动学习原则，训练儿童友好型、双重焦点策略“用大嘴巴和强声音说话”。儿童在基线、即时治疗后（POST）和 6 周随访（FUP）时进行故事叙述。通过 108 名成人听众的盲听理解评分、声学分析和关注交流参与的问卷调查来评估结果。
SIT 可显著提高 POST 时的理解度，且在 FUP 时保持。发声强度、言语速度或元音频谱特征没有显著变化，除了 SIT 后元音的第二共振峰差异增加。POST 和 FUP 时的交流参与度显著增强。
双重焦点治疗有望提高患有构音障碍儿童的言语可懂度和交流参与度，尽管儿童对治疗的反应差异很大。可懂度提高、交流参与度增强以及治疗效果的可变性的潜在机制正在讨论中。
