An Intensive Total Speech Treatment Using Principles of Motor Learning in an Individual with Dysarthria

Objective: Dysarthria is a motor speech disorder that is characterized by weak, slow, and imprecise movements. Previous research has shown that behavioral treatment can improve speech characteristics and have a positive impact on the intelligibility of people with dysarthria; however, data about the impact of specific treatment approaches is lacking. The purpose of this study is to examine the feasibility of a novel behavioral speech treatment that incorporates principles of motor learning and its impact on communication characteristics of an individual with spastic dysarthria secondary to a traumatic brain injury (TBI). Method: This study used a single subject pre-post treatment design to investigate the impact of an intensive behavioral treatment on communication and pragmatic behaviors. The treatment consisted of 24 one-hour sessions administered four times a week for six weeks. Results: The results showed that speech intelligibility scores improved for sentences. Analysis of discourse showed small increases in humor, assertive routines, narrative, and questions. Perceptual measures of voice and speech showed that listeners preferred the participant’s treated speech to his non-treated speech at the sentence level. Articulation measures for the F2 of corner vowels increased following treatment. Statistically significant increases in dB SPL were found for single words and sentence repetition (p<0.01). dB SPL also increased for reading paragraph reading, and picture description, but these were not statistically significant. Responses to the Visual Analog Scale showed that there were large increases in both the participant’s and his wife’s perception of the participant’s speech characteristics, including an increase in loudness of his speech, participation in conversations, and speaking so that others can understand. Conclusions: These data suggest that people with dysarthria secondary to traumatic brain injury can respond positively to an intensive speech treatment implementing principles of motor learning. They also suggest that positive changes in behaviors that are associated with speech may result in improved communication.