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Childhood Dysarthria: Treatment

Considerations in the treatment of childhood dysarthria
by

Kara Frances

on 27 March 2013

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Transcript of Childhood Dysarthria: Treatment

Treatment Childhood Dysarthria Goals Developing a course of treatment Therapy Plan Organized The Goal: Intelligibility Articulatory Competence NOT accuracy Goals will usually focus on improving an area of speech development:
A. Laryngeal
B. Respiratory
C. Velopharyngeal
D. Articulatory Respiratory You want to improve one area of speech in order to improve overall intelligibility What are some examples of a goal for each? The "energy" of speech A. Limited Breath Support for speech
First changes are usually to the environment
Seating-*The child should have postural support for breathing
Breath capacity-*Goals targeting lung capacity require a respiratory therapist
B. Using limited breath support efficiently is often a goal:
1. Maximum inhalation
2. Maintaining phonation
C. Speaking short phrases
1. Greater than normal inhalations
2. judge the number of words/syllables that can be spoken on one breath

*its important that the child be taught to pace themselves An organized therapy plan will most likely address all areas of speech; starting with breath support and simultaneously addressing laryngeal, vp, and articulatory
concerns should they exist. Laryngeal Therapy Strategies It is extremely difficult for children with dysarthria to modify their voicing symptoms.
1. It is "unseen" and abstract for these children
2. the biological/neurological abilities may not exist for modulation Laryngeal Loudness
Increasing loudness is synonymous with increasing subglottic pressure
Failing that, amplification devices should be considered Laryngeal-Pitch In dysarthric children there are usually 3 goals:
1. lower pitch
2. increase pitch
3. increase pitch flexibility Use of appropriate stress and
pitch patterns tends to help
increase intellgibility Velopharyngeal Three basic therapeutic approaches for VP insufficiency A. Palatal Exercises
stimulation of the soft palate to achieve an
involuntary elevation
B. Pharyngeal flap
Surgical correction where a portion of the
posterior pharyngeal wall is connected to the velum
C. Prosthesis
a device is made specifically for the child and inserted Pre and Post Flap Surgery Articulatory STIMUBILITY RULES! Similar to traditional therapuetic approaches, the following should be considered:
A. For what phonemes is the child stimuable
B. Phonemes where the child is stimuable in at least one position are worked on over phonemes where the child is not stimuable in any position
C. Distortions are corrected over substitutions/omissions
D. Easily visable sounds are chosen over less visable
E. Early developing (which tend to be most visable/concrete) chosen over later developing sounds


Articulation Con't How to ..... Training consonants that are produced correctly prevocalically but not post vocalically
Intensive training of distortions; more likely to be able to make the focal articulatory contact necessary
use of multisensory cuing strategies
voiced-voiceless contrasts; slow down speech to help teach the voiceless consonants
compensatory approaches
The motoric impairment of the system often means that the child will not ever be completely intelligible and/or accurate
It is very important to KEEP THE GOAL in mind AT ALL TIMES!

THE GOAL IS ALWAYS EFFECTIVE COMMUNICATION

Remember the WHO model of disability: an effective communication program should focus on:
1. Speech intelligibility
2. Unaided AAC
3. Aided AAC
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