Abstract
BackgroundTreating motor speech dysfunction in children with CP requires an understanding of the mechanism underlying speech motor control. However, there is a lack of literature in quantitative measures of motor control, which may potentially characterize the nature of the speech impairments in these children. This study investigated speech motor control in children with cerebral palsy (CP) using kinematic analysis.MethodsWe collected 10 children with mild spastic CP, aged 4.8 to 7.5 years, and 10 age-matched children with typical development (TD) from rehabilitation department at a tertiary hospital. All children underwent analysis of percentage of consonants correct (PCC) and kinematic analysis of speech tasks: poly-syllable (PS) and mono-syllable (MS) tasks using the Vicon Motion 370 system integrated with a digital camcorder. Kinematic parameters included spatiotemporal indexes (STIs), and average values and coefficients of variation (CVs) of utterance duration, peak oral opening displacement and velocity. An ANOVA was conducted to determine whether PCC and kinematic data significantly differed between groups.ResultsCP group had relatively lower PCCs (80.0-99.0%) than TD group (p = 0.039). CP group had higher STIs in PS speech tasks, but not in MS tasks, than TD group did (p = 0.001). The CVs of utterance duration for MS and PS tasks of children with CP were at least three times as large as those of TD children (p < 0.01). However, average values of utterance duration, peak oral opening displacement and velocity and CVs of other kinematic data for both tasks did not significantly differ between two groups.ConclusionHigh STI values and high variability on utterance durations in children with CP reflect deficits in relative spatial and/or especially temporal control for speech in the CP participants compared to the TD participants. Children with mild spastic CP may have more difficulty in processing increased articulatory demands and resulted in greater oromotor variability than normal children. The kinematic data such as STIs can be used as indices for detection of speech motor control impairments in children with mild CP and assessment of the effectiveness in the treatment.
Highlights
Treating motor speech dysfunction in children with cerebral palsy (CP) requires an understanding of the mechanism underlying speech motor control
Children with mild spastic CP showed greater spatiotemporal indexes (STIs) in PS tasks, but not in MS tasks, than children with typical development (TD) do. These findings suggest that children with CP have more difficulty in processing increased articulatory demands
High STI values and high variability on utterance durations in children with CP reflect deficits in relative spatial and/or especially temporal control for speech in the CP participants compared to the TD participants
Summary
Treating motor speech dysfunction in children with CP requires an understanding of the mechanism underlying speech motor control. There is a lack of literature in quantitative measures of motor control, which may potentially characterize the nature of the speech impairments in these children. This study investigated speech motor control in children with cerebral palsy (CP) using kinematic analysis. Disturbed neuromuscular control of speech mechanism often result in communication disorders, especially poor speech production in patients with CP [2]. Children with spastic CP commonly exhibit dysarthria of varying severities. Some fairly stable features of CP dysarthria include inaccurate articulatory place and manner of consonants [6]. At the phonemic level, patients with dysarthria display anterior lingual place inaccuracy, reduced precision of fricative and affricate manners, and inability to achieve the extreme positions in the vowel articulatory space [6]. Previous studies revealed that speakers with CP exhibit smaller vowel working space areas compared to age-matched controls and that the width of vowel working space area significantly correlates with vowel and word intelligibility [7]
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