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

Abstract

Primary 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.Study design/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.Results/discussion: 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.Conclusion: 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.