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Purpose: This article describes the effects of a new intensive dysarthria treatment program (Be Clear ) on speech intelligibility in adults with dysarthria secondary to stroke and traumatic brain injury.
Method: A small group-repeated measures research design was used to examine the effects of treatment on the speech of 8 participants with nonprogressive dysarthria. Treatment consisted of a 1-hr prepractice session followed by 1-hr therapy sessions, 4 times per week, for 4 weeks (16 sessions). Paired-comparison ratings of speech intelligibility served as the primary outcome measure for the study. Perceptual data, quality of life, and communication partner opinion were obtained at 3 time intervals: (a) prior to treatment, (b) immediately posttreatment, and (c) 1-3 months posttreatment.
Results: Following treatment, group data demonstrated substantial improvements in speech intelligibility as perceived by naive listeners on a paired-comparison rating task. Word intelligibility was clinically significantly improved posttreatment and sentence intelligibility demonstrated statistically significant improvement. Communication partner ratings of speech intelligibility and overall communicative function were statistically significantly improved posttreatment.
Conclusions: The results of this study suggest that this new intensive treatment may have potential as an effective intervention for nonprogressive dysarthria. However, controlled studies are required to establish treatment efficacy.
Approximately 41.5% of individuals who have experienced a stroke (Lawrence et al., 2001) and 23%-65% of individuals who have experienced a traumatic brain injury (TBI; Yorkston, Honsinger, Mitsuda, & Hammen, 1989) will present with dysarthria. This motor speech disorder is characterized by slow, weak, imprecise, and uncoordinated movements of the speech musculature (Yorkston, 1996). All components of the speech mechanism may be affected differentially, leading to deviant perceptual speech features associated with respiration, phonation, articulation, resonance, and prosody (Duffy, 2013). The decreased speech intelligibility associated with dysarthria can cause difficulties with participation in everyday activities (Dykstra, Hakel, & Adams, 2007), resulting in psychosocial issues and significantly decreased quality of life (Dickson, Barbour, Brady, Clark, & Paton, 2008).
There are currently many treatment techniques used in the clinical setting to treat dysarthria. Therapy may focus on reducing the physiological impairment of a particular speech subsystem by increasing the strength and range of movement of the musculature (Robertson, 2001), implementing behavioral change such as decreasing speaking rate to improve intelligibility (Yorkston, Hakel, Beukelman, & Fager, 2007) or providing assistive...