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The Cochrane Database of Systematic... 2002Dysarthria is a common sequel of non-progressive brain damage (typically stroke and traumatic brain damage). Impairment-based therapy and a wide variety of compensatory... (Review)
Review
BACKGROUND
Dysarthria is a common sequel of non-progressive brain damage (typically stroke and traumatic brain damage). Impairment-based therapy and a wide variety of compensatory management strategies are undertaken by speech and language therapists with this patient population.
OBJECTIVES
To determine the efficacy of speech and language therapy interventions for adults with dysarthria following non-progressive brain damage.
SEARCH STRATEGY
This review has drawn on the search strategies developed for the following Cochrane Groups as a whole: Stroke, Injuries, Movement Disorders and Infectious Diseases. Relevant trials were identified in the Specialised Registers of Controlled Trials (see Review Group details for more information). We also searched the trials register of the Cochrane Rehabilitation and Related Therapies Field. The Trials Registers were last searched in December 2001. The Cochrane Controlled Trials Register (Cochrane Library 2002, Issue 1), MEDLINE (1966-December 2001), EMBASE (1980-December 2001), CINAHL (1983-December 2001), PsycINFO (1974-February 2002) and Linguistics and Language Behavior Abstracts (1983-October 2001) were searched electronically. We handsearched the International Journal of Language and Communication Disorders (1966-2002, Issue 1) and selected conference proceedings, and scanned the reference lists of relevant articles. Colleagues were approached to identify other possible published and unpublished studies.
SELECTION CRITERIA
Unconfounded randomised controlled trials.
DATA COLLECTION AND ANALYSIS
One reviewer assessed trial quality. Two co-reviewers were available to examine any potential trials for possible inclusion in the review.
MAIN RESULTS
No trials of the required standard were identified.
REVIEWER'S CONCLUSIONS
There is no evidence of the quality required by this review to support or refute the effectiveness of Speech and Language Therapy interventions for dysarthria following non-progressive brain damage. There is an urgent need for good quality research in this area.
Topics: Adult; Brain Injury, Chronic; Dysarthria; Humans; Language Therapy; Speech Therapy; Stroke
PubMed: 12519567
DOI: 10.1002/14651858.CD002088 -
Journal of Speech, Language, and... Mar 2018This study explored the speech characteristics of Mandarin-speaking children with cerebral palsy (CP) and typically developing (TD) children to determine (a) how...
PURPOSE
This study explored the speech characteristics of Mandarin-speaking children with cerebral palsy (CP) and typically developing (TD) children to determine (a) how children in the 2 groups may differ in their speech patterns and (b) the variables correlated with speech intelligibility for words and sentences.
METHOD
Data from 6 children with CP and a clinical diagnosis of moderate dysarthria were compared with data from 9 TD children using a multiple speech subsystems approach. Acoustic and perceptual variables reflecting 3 speech subsystems (articulatory-phonetic, phonatory, and prosodic), and speech intelligibility, were measured based on speech samples obtained from the Test of Children's Speech Intelligibility in Mandarin (developed in the lab for the purpose of this research).
RESULTS
The CP and TD children differed in several aspects of speech subsystem function. Speech intelligibility scores in children with CP were influenced by all 3 speech subsystems, but articulatory-phonetic variables had the highest correlation with word intelligibility. All 3 subsystems influenced sentence intelligibility.
CONCLUSION
Children with CP demonstrated deficits in speech intelligibility and articulation compared with TD children. Better speech sound articulation influenced higher word intelligibility, but did not benefit sentence intelligibility.
Topics: Cerebral Palsy; Child; Child Language; Child, Preschool; Dysarthria; Female; Humans; Linguistics; Male; Preliminary Data; Speech; Speech Production Measurement
PubMed: 29471380
DOI: 10.1044/2017_JSLHR-S-17-0065 -
Presse Medicale (Paris, France : 1983) Nov 2003The treatment of speech impairment, a factor of loneliness, speech therapy to treat dysarthria in Parkinson's disease is a fundamental aspect of patient management. The... (Review)
Review
The treatment of speech impairment, a factor of loneliness, speech therapy to treat dysarthria in Parkinson's disease is a fundamental aspect of patient management. The impact of medicinal treatment of dysarthria is controversial and surgery appears to worsen the problem. Various speech therapy approaches are relaxation, postural rehabilitation, respiration, phonation, articulation and prosodic re-education. AN INTERESTING METHOD: This overview underlines the fundamental principles of speech therapy in Parkinson's disease and compares the main methods and their results. We particularly insist on the Lee Silverman Voice Treatment (LSVT), phonation re-education method that has been widely developed in the United-States. Our aim is to provide better knowledge on this re-education method in France.
Topics: Dysarthria; France; Humans; Parkinson Disease; Relaxation Therapy; Speech Therapy; Treatment Outcome; United States
PubMed: 14663391
DOI: No ID Found -
Folia Phoniatrica Et Logopaedica :... 2022Evaluation of multiple domains, such as language, articulation, and cognitive function, is frequently required in neurological communicative disorders. The purpose of...
INTRODUCTION
Evaluation of multiple domains, such as language, articulation, and cognitive function, is frequently required in neurological communicative disorders. The purpose of this study was to investigate the performance of a 10-min screening scale for estimating aphasia, dysarthria, and cognitive dysfunction using a multicenter, large-sized consecutive series.
METHODS
We conducted a multicenter validation study that included 314 patients with brain injury between February 1 and June 31, 2018, from 20 medical centers across Japan. The Screening Test for Aphasia and Dysarthria (STAD) was developed in Japan in 2009, and a previous smaller-scale retrospective study established its high to moderate validity. All patients had undergone the STAD, and 212 of them underwent the Western Aphasia Battery or Assessment of Motor Speech for Dysarthria. The effect size on all 29 items and receiver operating curves of 3 sections of the STAD were analyzed based on external criteria, which were decided considering the clinical diagnosis of aphasia, dysarthria, and cognitive dysfunction. Correlations between the STAD and reference tests were calculated.
RESULTS
The phi coefficients of 23 out of 29 items exceeded the moderate effect size of 0.3 toward the targeted disorder. Overall, there was a good balance between sensitivity (82-92%) and specificity (77-78%), with moderate to large positive and negative likelihood ratios (3.7-4.19 and 0.1-0.23). The Pearson's r between the verbal section and Western Aphasia Battery Aphasia Quotient, the articulation section and Assessment of Motor Speech for Dysarthria, and the nonverbal section and Western Aphasia Battery Nonlinguistic Skills were 0.89, 0.70, and 0.79, respectively.
CONCLUSION
We demonstrated that the STAD has acceptable content and concurrent validity for the assessment of communicative function in patients with brain injury. This short screening tool can be useful in specific contexts, such as in early bedside investigations, to obtain a quick summary of communicative function prior to the administration of other tests, and in cases where more in-depth testing is not feasible.
Topics: Aphasia; Brain Injuries; Communication Disorders; Dysarthria; Humans; Japan; Retrospective Studies
PubMed: 34510047
DOI: 10.1159/000519381 -
Journal of the Neurological Sciences Mar 2015
Topics: Ataxia; Dysarthria; Female; Fingolimod Hydrochloride; Humans; Immunosuppressive Agents; Middle Aged; Syndrome; Treatment Outcome
PubMed: 25676590
DOI: 10.1016/j.jns.2015.01.023 -
Otolaryngologia Polska = the Polish... 2007Parkison's disease causes damage to the central nervous system resulting in bradykinesia, muscle rigidity, rest tremor and dysarthric speech. In clinical terms... (Review)
Review
Parkison's disease causes damage to the central nervous system resulting in bradykinesia, muscle rigidity, rest tremor and dysarthric speech. In clinical terms dysarthria denotes the dysfunction of articulation, phonation and respiration. It is brought about by the impairment of neural paths innervating the speech apparatus, thus causing a decreased ability to communicate. The study was conducted by the Center for Speech and Language Processing (CSLP), Adam Mickiewicz University, Poznań and the Chair and Department of Phoniatrics and Audiology, the Medical University, Poznań within the interdisciplinary research project grant called "Speech and Language Virtual Therapist for Individuals with Parkinson's Disease". Apart from traditional voice and speech therapies, one of the ways of treating speech disturbances accompanying Parkinson's disease is an innovative Lee Silverman Voice Treatment (LSVT). The purpose of this innovative method introduced by dr L. Ramig and colleagues in 1987-1988, is to teach the patient to speak loud. As a result of co-operation between CLSP and the Center for Spoken Language Research (CSLR) at the University of Colorado, Boulder, USA, a Polish version of LSVT Virtual Therapist computer programme was created (LSVTVT). The programme is based on the principles of LSVT. The positive outcomes of the therapy give hope to Parkinson's disease patients with dysarthria, as well as to speech therapists.
Topics: Dysarthria; Humans; Parkinson Disease; Poland; Speech Therapy; Voice Training
PubMed: 18552005
DOI: 10.1016/s0030-6657(07)70511-5 -
Neural Networks : the Official Journal... Jul 2021Recently, we have witnessed Deep Learning methodologies gaining significant attention for severity-based classification of dysarthric speech. Detecting dysarthria,...
Recently, we have witnessed Deep Learning methodologies gaining significant attention for severity-based classification of dysarthric speech. Detecting dysarthria, quantifying its severity, are of paramount importance in various real-life applications, such as the assessment of patients' progression in treatments, which includes an adequate planning of their therapy and the improvement of speech-based interactive systems in order to handle pathologically-affected voices automatically. Notably, current speech-powered tools often deal with short-duration speech segments and, consequently, are less efficient in dealing with impaired speech, even by using Convolutional Neural Networks (CNNs). Thus, detecting dysarthria severity-level based on short speech segments might help in improving the performance and applicability of those systems. To achieve this goal, we propose a novel Residual Network (ResNet)-based technique which receives short-duration speech segments as input. Statistically meaningful objective analysis of our experiments, reported over standard Universal Access corpus, exhibits average values of 21.35% and 22.48% improvement, compared to the baseline CNN, in terms of classification accuracy and F1-score, respectively. For additional comparisons, tests with Gaussian Mixture Models and Light CNNs were also performed. Overall, the values of 98.90% and 98.00% for classification accuracy and F1-score, respectively, were obtained with the proposed ResNet approach, confirming its efficacy and reassuring its practical applicability.
Topics: Dysarthria; Humans; Neural Networks, Computer; Normal Distribution; Severity of Illness Index; Speech; Speech Recognition Software; Time Factors
PubMed: 33684609
DOI: 10.1016/j.neunet.2021.02.008 -
Journal of Speech, Language, and... Aug 2023In current clinical practice, intelligibility of dysarthric speech is commonly assessed by speech-language therapists (SLTs), in most cases by the therapist caring for...
PURPOSE
In current clinical practice, intelligibility of dysarthric speech is commonly assessed by speech-language therapists (SLTs), in most cases by the therapist caring for the patient being diagnosed. Since SLTs are familiar with dysarthria in general and with the speech of the individual patient to be assessed in particular, they have an adaptation advantage in understanding the patient's utterances. We examined whether and how listeners' assessments of communication-related speech parameters vary as a function of their familiarity with dysarthria in general and with the diagnosed patients in particular.
METHOD
Intelligibility, speech naturalness, and perceived listener effort were assessed in 20 persons with dysarthria (PWD). Patients' speech samples were judged by the individual treating therapists, five dysarthria experts who were unfamiliar with the patients, and crowdsourced naïve listeners. Adaptation effects were analyzed using (a) linear mixed models of overall scoring levels, (b) regression models of severity dependence, (c) network analyses of between-listener and between-parameter relationships, and (d) measures of intra- and interobserver consistency.
RESULTS
Significant advantages of dysarthria experts over laypeople were found in all parameters. An overall advantage of the treating therapists over nonfamiliar experts was only seen in listening effort. Severity-dependent adaptation effects occurred in all parameters. The therapists' responses were heterogeneous and inconsistent with those of the unfamiliar experts and the naïve listeners.
CONCLUSIONS
The way SLTs evaluate communication-relevant speech parameters of the PWD whom they care for is influenced not only by adaptation benefits but also by therapeutic biases. This finding weakens the validity of assessments of communication-relevant speech parameters by the treating therapists themselves and encourages the development and use of alternative methods.
Topics: Humans; Dysarthria; Speech Intelligibility; Adaptation, Physiological; Cognition; Speech Perception; Speech Production Measurement
PubMed: 37486782
DOI: 10.1044/2023_JSLHR-23-00105 -
American Journal of Speech-language... Aug 2023Ataxic dysarthria has presented with considerable heterogeneity in the presentation of speech characteristics. Converging evidence supports the existence of subgroups,...
PURPOSE
Ataxic dysarthria has presented with considerable heterogeneity in the presentation of speech characteristics. Converging evidence supports the existence of subgroups, specifically related to the instability and inflexibility of motor patterns as a possible explanation of this variability.
METHOD
To further examine the alignment of the speech characteristics of ataxic dysarthria with the instability/inflexibility framework, 23 graduate student listeners participated in an auditory free classification task and a guided classification task. Listeners grouped 15 speakers with ataxic dysarthria based on their judgment of the most salient perceptual characteristics during two speaking tasks: alternating motion rates (AMRs) and connected speech (one to two sentences). Listener ratings were then compared with a priori determinations of speakers who fit the instability subgroup profile and the inflexibility subgroup profile.
RESULTS
Results of both the free classification and guided classification listening paradigms provided supportive evidence of subgroups, particularly for the AMR task, in the context of strong inter- and intrarater reliability.
CONCLUSION
This study adds to the growing evidence of the existence of instability and inflexibility subgroups in ataxic dysarthria and serves as a proof of concept for use of the auditory free classification paradigm in dysarthria subgroup research.
Topics: Humans; Dysarthria; Reproducibility of Results; Speech; Speech Production Measurement; Auditory Perception; Speech Intelligibility; Speech Perception
PubMed: 36417768
DOI: 10.1044/2022_AJSLP-22-00159 -
Neurology Jun 1987Ten patients are presented with severe dysarthria from a right hemisphere stroke, 4 with autopsies, emphasizing that this lesion alone is compatible with severely...
Ten patients are presented with severe dysarthria from a right hemisphere stroke, 4 with autopsies, emphasizing that this lesion alone is compatible with severely slurred speech. Most had oropharyngeal weakness; the accompanying hemiparesis was of variable severity. Superficial or deep infarctions were responsible, the smallest involving the right frontal operculum.
Topics: Cerebral Infarction; Cerebrovascular Disorders; Dysarthria; Humans; Speech Disorders
PubMed: 3587630
DOI: 10.1212/wnl.37.6.1061