Electropalatography treatment for articulation impairment in children with dysarthria post-traumatic brain injury.
OBJECTIVE
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.


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.


CONCLUSIONS
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.


CONCLUSIONS
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.
Morgan
A  T
A
Developmental Cognitive Neuroscience Unit, UCL Institute of Child Health, UK. angela.morgan@mcri.edu.au
Liegeois
F
F
Occomore
L
L
D000293:Adolescent; D001676:Biofeedback, Psychology / Q000379:methods*; D001930:Brain Injuries / Q000150:complications*; D004401:Dysarthria / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D004568:Electrodiagnosis / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D009068:Movement; D021362:Palate, Hard / Q000503:physiopathology*; D015203:Reproducibility of Results; D013062:Speech Articulation Tests; D013065:Speech Intelligibility; D013813:Therapy, Computer-Assisted / Q000379:methods; D014059:Tongue / Q000503:physiopathology; D016896:Treatment Outcome