Speech Therapy Approaches Research Articles

EFFECTIVE APPROACHES TO ENHANCING CONNECTED SPEECH IN PREOPERATIVE CHILDREN WITH OPEN ORGANIC RHINOLALIA

Children with open organic rhinolalia, a condition often resulting from structural anomalies such as cleft palate, face unique challenges in speech development, particularly in the preoperative period. This article examines the methods, techniques, and strategies used to improve connected speech in these children before undergoing surgical intervention. Focusing on evidence-based practices, the article explores various speech therapy approaches, including breathing exercises, articulation drills, and resonance training, all tailored to address the specific needs of children with hypernasal speech. The goal of preoperative speech therapy is not only to prepare children for surgery but also to enhance their overall communication skills by developing more transparent and fluent speech. By reviewing current research and case studies, this article provides insights into effective treatment methods that can be applied in clinical settings to support children with open organic rhinolalia.

KEY ASPECTS OF SPEECH THERAPY FOR VOICE RESTORATION IN CASES OF VOCAL CORD DYSFUNCTION AND FAILURE

This article investigates the underlying causes of vocal fold and hypo dissolution and their pathological impact on the acoustic properties of the voice and respiratory function. It delineates the characteristic symptoms experienced by individuals with vocal fold dysfunction, highlighting the adverse effects on voice quality and communication challenges. It addresses complications associated with vocal fold dysfunction and outlines a structured speech therapy approach to mitigate voice disorders. The therapeutic approach emphasizes integrating interdisciplinary techniques to achieve optimal corrective outcomes. Given its relevance, this issue holds significant importance in both healthcare and pedagogical contexts, particularly in treating and rehabilitating individuals with vocal fold dysfunction.

Personalized, performance-specific speech intervention in children with a cleft palate: A systematic review protocol.

The provision of speech intervention in children requires personalized, child-tailored approaches. Different speech-intervention approaches exist to eliminate cleft-related speech errors in children with a cleft palate. However, it is unclear what approach works best for the subtypes of cleft-related speech errors. To describe a protocol for a systematic review that provides speech-language pathologists with the current literature concerning more individualized speech intervention in children with a cleft palate. A systematic literature review was performed following the preferred reporting items for systematic reviews and meta-analyses. Two speech-language pathologists with clinical and scientific experience in cleft speech searched different electronic databases for relevant studies. No limit regarding publication date was set. Specific eligibility criteria were defined and used to include or exclude the studies. All included studies were evaluated with a risk-of-bias assessment tool and levels of evidence. Relevant data were extracted from the studies (study design, study population characteristics, intervention characteristics and outcome characteristics) and a narrative synthesis was performed. The findings of this systematic review will significantly contribute to the evidence on personalized speech intervention in children with a cleft palate. The study will inform speech-language pathologists on the possibilities to tailor treatment plans more to the specific subtype of cleft-related speech errors. The planned systematic review also makes recommendations for further cleft speech intervention research. What is already known on this subject At present, there is growing evidence for different speech therapy approaches in children with a cleft palate. Despite the recognized need for personalized, child-tailored therapy, there is no consensus on the best speech therapy approach per different subtype of compensatory cleft speech characteristic. What this study adds to the existing knowledge This paper provides a protocol for a systematic literature review of this topic. Specifically, it searches the literature for the use of personalized speech therapy approaches in children with different subtypes of compensatory cleft speech characteristics. What are the practical and clinical implications of this work? The systematic literature review provides speech-language pathologists with the current literature concerning personalized, performance-specific speech intervention in children with a cleft palate. Besides, the results will support therapy decision-making in children with a cleft palate in different speech-related clinical contexts.

Effectiveness of Game-Based Interactive Approach Using Deep Learning Framework for Dyslogia."

Traditional speech therapy approaches have long been considered revolutionary for treating speech disorders. However, as the younger generation becomes increasingly disengaged from these methods, their effectiveness is diminishing. This study identifies the need to revitalize traditional practices by integrating them into virtual environments and incorporating gamification elements. The motivation behind this work is to enhance engagement and improve therapy outcomes by making the process more appealing to children. Our proposed solution involves converting conventional speech therapy exercises into interactive virtual modules that incorporate game-like features to sustain interest and foster a competitive spirit. The method includes developing these virtual modules and testing their effectiveness through user trials. Results indicate a significant increase in engagement and a corresponding improvement in therapy outcomes, suggesting that this approach holds promise for enhancing the effectiveness of speech therapy in the digital age.

Detection and Segmentation of Mouth Region in Stereo Stream Using YOLOv6 and DeepLab v3+ Models for Computer-Aided Speech Diagnosis in Children

This paper describes a multistage framework for face image analysis in computer-aided speech diagnosis and therapy. Multimodal data processing frameworks have become a significant factor in supporting speech disorders’ treatment. Synchronous and asynchronous remote speech therapy approaches can use audio and video analysis of articulation to deliver robust indicators of disordered speech. Accurate segmentation of articulators in video frames is a vital step in this agenda. We use a dedicated data acquisition system to capture the stereovision stream during speech therapy examination in children. Our goal is to detect and accurately segment four objects in the mouth area (lips, teeth, tongue, and whole mouth) during relaxed speech and speech therapy exercises. Our database contains 17,913 frames from 76 preschool children. We apply a sequence of procedures employing artificial intelligence. For detection, we train the YOLOv6 (you only look once) model to catch each of the three objects under consideration. Then, we prepare the DeepLab v3+ segmentation model in a semi-supervised training mode. As preparation of reliable expert annotations is exhausting in video labeling, we first train the network using weak labels produced by initial segmentation based on the distance-regularized level set evolution over fuzzified images. Next, we fine-tune the model using a portion of manual ground-truth delineations. Each stage is thoroughly assessed using the independent test subset. The lips are detected almost perfectly (average precision and F1 score of 0.999), whereas the segmentation Dice index exceeds 0.83 in each articulator, with a top result of 0.95 in the whole mouth.

Pengaruh Cedera Otak Kecil (Cerebellum) terhadap Perkembangan Bahasa Anak

The aim of this research is to understand the impact of cerebellar injury on children's language development. This study uses a library research approach. The findings indicate that injuries to the cerebellum have the potential to disrupt language development in children. The cerebellum, although small in size, plays a crucial role in coordinating movements and cognitive processes, including language. The effects of cerebellar injury include difficulties in articulation, disruptions in speech fluency, challenges in language comprehension and expression, and impairments in non-verbal communication. These issues arise due to disruptions in the fine motor coordination of the muscles needed for proper speech and language expression. The importance of appropriate intervention and treatment, such as physical therapy, speech therapy, and special educational approaches, is highlighted to help children overcome these difficulties and support their language development. In conclusion, a deeper understanding of the relationship between cerebellar injury and children's language development can aid in providing more effective interventions to improve outcomes for children affected by cerebellar injuries.

Effects of speech rate modifications on phonatory acoustic outcomes in Parkinson's disease.

Speech rate reduction is a global speech therapy approach for speech deficits in Parkinson's disease (PD) that has the potential to result in changes across multiple speech subsystems. While the overall goal of rate reduction is usually improvements in speech intelligibility, not all people with PD benefit from this approach. Speech rate is often targeted as a means of improving articulatory precision, though less is known about rate-induced changes in other speech subsystems that could help or hinder communication. The purpose of this study was to quantify phonatory changes associated with speech rate modification across a broad range of speech rates from very slow to very fast in talkers with and without PD. Four speaker groups participated: younger and older healthy controls, and people with PD with and without deep brain stimulation of the subthalamic nucleus (STN-DBS). Talkers read aloud standardized sentences at 7 speech rates elicited using magnitude production: habitual, three slower rates, and three faster rates. Acoustic measures of speech intensity, cepstral peak prominence, and fundamental frequency were measured as a function of speech rate and group. Overall, slower rates of speech were associated with differential effects on phonation across the four groups. While all talkers spoke at a lower pitch in slow speech, younger talkers showed increases in speech intensity and cepstral peak prominence, while talkers with PD and STN-DBS showed the reverse pattern. Talkers with PD without STN-DBS and older healthy controls behaved in between these two extremes. At faster rates, all groups uniformly demonstrated increases in cepstral peak prominence. While speech rate reductions are intended to promote positive changes in articulation to compensate for speech deficits in dysarthria, the present results highlight that undesirable changes may be invoked across other subsystems, such as at the laryngeal level. In particular, talkers with STN-DBS, who often demonstrate speech deterioration following DBS surgery, demonstrated more phonatory detriments at slowed speech rates. Findings have implications for speech rate candidacy considerations and speech motor control processes in PD.

Optimasi Kemampuan Komunikasi Anak Berkebutuhan Khusus dengan Aplikasi Comm-Screen

Background: Communication needs in children with special needs (ABK) are absolute things to strive for as optimally as possible. One speech therapy approach in facilitating these needs is alternative & augmentative communication (AAC). The development of AAC offers great potential to improve the effectiveness of nonverbal CwSN (Children with Special Needs) communication. Based on surveys, AAC is most widely used for patients with non/minimal verbal such as ASD (Autism Spectrum Disorders) or other conditions. Objective: this study aims to develop a mobile application-based AAC media innovation called Comm-Screen. Method: research is carried out quantitatively with tiered surveys and literature studies to design a prototype of the Comm-Screen application. The Comm-Screen application can display symbols (images) and output audio (sounds) that have been adapted to the culture and speech therapy interventions in Indonesia. The Comm-Screen application is also designed based on appropriate interventions and has been studied in the speech therapy profession to treat communication disorders in nonverbal CwSN. Results: From 54 respondents, 97% of them realized the importance of application-based AAC media in Indonesia as one of the preferred methods for learning communication for nonverbal CwSN. 97.7% of respondents stated that the Comm-Screen application prototype is effectively used as a medium for nonverbal CwSN communication intervention in Indonesia. Conclusion: There is hope from speech therapy practitioners for the advancement of AAC media with the Comm-Screen application that can meet the criteria and objectives of speech therapy interventions in Indonesia. Improvements and development of Comm-Screen applications are still needed as the need for future interventions increases. 
 
 Keywords: AAC, Communication, Nonverbal, Speech therapy

Exploring the Relationship Between Resilience and the Adverse Impact of Stuttering in Children.

People who stutter often experience significant adverse impact related to stuttering. However, it is unclear how adverse impact develops in children who stutter (CWS) and whether there are protective factors that may mitigate its development. This study examined the relationship between resilience, a potentially protective factor, and stuttering's adverse impact in CWS. Resilience comprises external factors, such as family support and access to resources as well as personal attributes, making it a comprehensive protective factor to explore. One hundred forty-eight CWS aged 5-18 years completed the age-appropriate version of the Child and Youth Resilience Measure (CYRM) and the Overall Assessment of the Speaker's Experience of Stuttering. Parents completed a caregiver version of the CYRM and a behavioral checklist for their child. The adverse impact of stuttering was modeled as a function of resilience (external, personal, and total), controlling for child age and behavioral checklist score. We also estimated correlations between child-report and parent-report CYRM measures to assess rater agreement. Children reporting greater external, personal, or total resilience were more likely to experience lower degrees of adverse impact related to their stuttering. We documented stronger correlations between younger child and parent ratings of resilience and weaker correlations between older child and parent ratings. These results yield valuable insight into the variability of adverse impact experienced by CWS and offer empirical support for strength-based speech therapy approaches. We discuss the factors that contribute to a child's resilience and provide practical suggestions for how clinicians can incorporate resilience-building strategies into intervention for children experiencing significant adverse impact from their stuttering. https://doi.org/10.23641/asha.23582172.

A Communication Partner Training Program Delivered via Telehealth for People Living With Parkinson's (Better Conversations With Parkinson's): Protocol for a Feasibility Study.

Parkinson's can impact people's speech, cognition, pragmatics, and language, significantly affecting their conversations with others. The speech and language therapy approach called communication partner training (CPT) is effective for a range of communication difficulties. However, speech and language therapy interventions for people with Parkinson's predominantly focus on impairments, with little provision of CPT for this population. Better Conversations is a CPT approach that involves working with a dyad (the person with the communication difficulty and a conversation partner [CP]) to build conversation skills. It is effective at reducing barriers to conversation, and for some, it significantly increases targeted facilitatory strategies. Some approaches to CPT have been adapted to be delivered via telehealth. This can maximize ecological validity and convenience. Furthermore, telehealth is widely accepted as a delivery method for other interventions for Parkinson's. This study presents the protocol for a pilot feasibility study of a Better Conversations CPT delivered via telehealth to people living with Parkinson's and their CPs, called Better Conversations with Parkinson's (BCP). The primary aim is to evaluate the feasibility of the BCP program delivered via telehealth with a treatment group from a collaborating National Health Service (NHS) site to establish for a main trial whether BCP can be delivered as intended in an NHS setting. The aim is to establish: (1) the acceptability of the program for people living with Parkinson's, family members, and speech and language therapists (SLTs); (2) the feasibility of delivering the BCP program; (3) the recruitment and retention rates; (4) a sample size calculation; and (5) the most appropriate primary outcome measure. Ethical approval for this study was obtained from London-Central Research Ethics Committee (reference: 22/LO/0332). This case-series feasibility pilot study will recruit 10-12 dyads to ensure 10 complete data sets. Participants will be recruited by a collaborating NHS site located in England. Participants will be involved for 16 weeks (weeks 1-2 preintervention measures, weeks 3-8 intervention, weeks 10-12 postintervention measures, week 16 follow-up interview). Quantitative and qualitative methods will be used to analyze the study data. Speech, communication, and quality of life assessment data will be analyzed statistically to determine a suitably sensitive outcome measure. Descriptive statistics will be used to report on recruitment, attendance, and attrition. Finally, acceptability and feasibility will be evaluated using participant feedback, interviews, and the reflective diary and feedback of the SLT administering the therapy (by the research assistant who is the first author). This data will be analyzed using descriptive statistics and reflexive thematic analysis. This study was approved for funding from Parkinson's UK. Study recruitment commenced in July 2022. The results of the data analysis are expected to be available by September 2024. Insights from this study will provide valuable information about the acceptability and feasibility of a remotely delivered Better Conversations CPT approach for people living with Parkinson's and their CPs. An outcome of this study will be a manualized BCP program coproduced by people living with Parkinson's, their families, and a group of expert SLTs. The study results will guide the next stages of intervention development. PRR1-10.2196/41416.

Opiniile specialiștilor privind utilizarea umorului în terapia tulburărilor de limbaj și comunicare

This paper addresses an important and innovative subject for the speech language therapy settings and it is the first research study which investigates specialists’ opinions on the use of humour in the Romanian speech and language therapy domain. The design of the study implies the development of a new questionnaire created during the research. Data were collected through this survey in an on-line format and thematic analysis method for data analysis was performed. In this research participants were SLTs (N=210) who work in different urban and rural areas in Romania. The research results highlight the presence of humour in SLTs settings and the interest in this field among specialists, suggesting that humour has notable implications in SLT’s domain. Access to humour for people with language impairment is dependent on: age; level of language development; specificity of language impairment; type of humour used. The main difficulties in understanding and using humour for children with language disorders are related to: understanding abstract linguistic concepts; vocabulary limits and constraints; poor executive functions; understanding social rules; accepting another person’s perspective. Humour can be incorporated into speech and language therapy activities in a variety of ways and used at different stages of the speech and language therapy approach.

Hospital speech-language pathology approach in oropharyngeal dysphagia and its motor and etiological associations

Objective: To identify the profile of speech-language pathology in patients with oropharyngeal dysphagia at a University Hospital and the associations between health conditions and the etiology of swallowing disorders. Methods: A cross-sectional and descriptive study, with analysis of medical records of patients with oropharyngeal dysphagia treated at a University Hospital, of both sexes, attended from February to December 2018. A descriptive and association analysis of the evaluated variables was carried out, with a significance level of 0.05. Results: It was identified in the sample, consisting of 26 (51%) females and 25 (49%) males, with a mean of 57.1 years (± 18.6), presence of progressive neurogenic oropharyngeal dysphagia (39.2 %), idiopathic (31.4%) and non-progressive (29.4%), in which the most performed speech-language pathology procedures were assessment (100%), giving support to observational issues during the fiberoptic endoscopic evaluation of swallowing (96.1%), management of dysphagia (92.2%) and return and discharge conducts (49% and 25.5%, respectively). The multi-professional participation has conducted better decision-making for an adequate diagnosis and speech therapy approach that had aimed at the management of oropharyngeal dysphagia, as well the intervention approaches with techniques aimed at maneuvers, and neuromuscular conditioning in relation to disorders of the biomechanics of swallowing. There was a significant association between the presence of motor and balance changes with neurogenic oropharyngeal dysphagia and difficulty in swallowing and choking symptoms as a sign of oropharyngeal dysphagia.

Lee Silverman Voice Treatment to Improve Speech in Parkinson's Disease: A Systemic Review and Meta-Analysis.

Background Speech changes occur in the early stages of Parkinson's disease (PD) and cause communication difficulties, leading to social isolation. Lee Silverman voice treatment (LSVT) is a speech therapy approach designed to improve patients' language and voice capabilities. Objective The effectiveness of the LSVT was compared with that of other speech interventions or no treatment to evaluate PD patients with dysarthria. Design Systematic review with meta-analysis of randomized trials. Data Sources: PubMed, Embase, Cochrane Library, CNKI, and SinoMed library were searched from inception to December 2021 related to PD and LSVT. Method s were screened and reviewed against the eligibility criteria (intervention group participants were PD assessed based on LSVT (LSVT Loud) and randomized control). Result Ten randomized controlled trials were identified on speech symptoms in patients with PD. Compared with the respiratory therapy (RET) exercise, or no training group, a significant improvement was detected in the sound press level (SPL) after immediate treatment during the reading of vowel and rainbow passages and an increase in semitone standard deviation (STSD). Furthermore, the LSVT training significantly increased the participants' scores on unified Parkinson's disease rating scale (UPDRS-III) and speech intelligibility. Conclusion This meta-analysis demonstrated the efficacy of LSVT in increasing vocal loudness and functional communication among individuals with PD. However, most studies included participants with mild-moderate PD. Thus, additional randomized controlled trials (RCTs) with large sample sizes are needed to validate the efficacy of LSVT in patients with different progressions of PD, including severe PD.

Multidisciplinary speech and language therapy approach in a child with multiple disabilities including blindness due to retinopathy of prematurity: a case study with a one year follow-up

Aim: This study aims to show speech and language, sensory-motor, and emotional progress after one year of therapy according to the needs of and resources for a child with multiple disabilities and blindness due to retinopathy of prematurity (ROP). Methods: A 45-month-old boy was examined by a multidisciplinary team and assessed using the Sensory Profile 2, The Vineland Adaptive Behavior Scale II, The Communication Matrix, and The Scale for Evaluation of Psychophysiological Abilities of Children Aged 0–7. After a year of daily individually adopted speech and language therapy followed by supplementary therapeutics method, based on a multidisciplinary approach, the child was reassessed using the same battery of tests. Results: The obtained results might indicate the importance of factors such as a multidisciplinary approach, individualization, communication pathways, therapist’s characteristics, and trust when working with children with multiple disabilities. Conclusion: Taking into account all the features of multiple disabilities during the treatment course, continuous monitoring, modification, and adaptation of applied therapy method proved successful in this case.

A survey of interventions used by speech-language pathologists for children with speech sound disorders in the Middle East

Purpose While many examples of speech pathology intervention approaches for children with speech sound disorders (SSDs) exist in English and some other European languages, approaches with children in other languages are largely unknown. The aim was to determine current speech-language pathologists (SLPs) intervention practices with children with SSDs in the ME, and to then compare these with international practices. Methods Data were collected by online questionnaire using Qualtrics. One hundred and eighty-nine SLPs completed the survey. Participants were required to be Arabic first language speaking SLPs practicing in the ME (e.g. Kuwait, Saudi Arabia, UAE, and Egypt), working with children with SSDs. Results The respondents reported a frequent use of phonological awareness, traditional articulation therapy, auditory discrimination, minimal pairs, and whole language therapy approaches in the treatment of children with SSDs, like their counterparts in Australia, the USA, UK, and Portugal. Gaps between research recommendations for evidence-based practice and actual clinical practice are identified, and discussed. Conclusions Future research should investigate the efficacy of speech-therapy approaches to improve service delivery for Arabic-speaking children with SSDs in the ME.

Improving speech characteristics of young adults with congenital dysarthria: An exploratory study comparing articulation training and the Beatalk method

IntroductionThis exploratory study compared the effects of two speech therapy approaches on speech characteristics of young adults with congenital dysarthria resulting from various etiologies: a) articulation training focusing on consonant articulation exercises at various levels (isolation, syllables, and words), and b) the Beatalk method, based on human beatboxing, i.e., producing various instrumental sounds in an a-cappella musical context. Both interventions were designed to increase participants’ speech intelligibility. MethodsTwelve adults with congenital dysarthria and reduced speech intelligibility participated in treatment groups for eight weeks. Six participants were assigned to the articulation training group, and six to the Beatalk group. Intelligibility of single words and continuous speech, voice measures, and oral-diadochokinesis rates were measured before and after the treatment. ResultsThe results showed that the Beatalk intervention yielded a significant overall pre- to post-treatment effect. Specifically, it resulted in gains in articulatory accuracy and intelligibility for single words. Improvements were not noted following articulation training. ConclusionsThe results present initial evidence of the positive effect of the Beatalk method as an intervention tool for adults with congenital dysarthria. This relatively easy-to-learn technique shows promise, as it involves intense and repetitive production of speech sounds while controlling rhythm and breathing in an enjoyable context.

To the question about the features of the grammatic impairment of statement in children with bilingualism and speech disorders

Modern political and economic trends in the development of society have made certain adjustments to the system of domestic education, which, in turn, has led to the emergence of problems, the existence of which no one even suspected twenty years ago. One of these problems is teaching children in the state language in state schools, for whom the language of everyday communication is not Russian, but the language of one of the small peoples of the Russian Federation. When involved in the educational process, these children find themselves in a forced bilingualism system, which becomes a risk factor for learning difficulties. When two different languages are used in different situations, the dominant language system has a significant effect on the other, as a result of which they mix, the result of which is the child’s speech and language difficulties, the most noticeable of which are systemic errors in the grammatical structuring of the oral and, later, written utterance. In many respects, the grammatical problems of children with bilingualism intersect with the problems of grammatical design of speech by children with hearing and speech impairments, however, it is not possible to fully implement correctional and speech therapy approaches to overcoming grammatical disorders in the oral and written speech of children with bilingualism, since the violation is determined by other mechanisms.

Automatic boost articulation therapy in adults with dysarthria: Acceptability, usability and user interaction.

ABSTRACTBackgroundImprecise articulation has a negative impact on speech intelligibility. Therefore, treatment of articulation is clinically relevant in patients with dysarthria. In order to be effective and according to the principles of motor learning, articulation therapy needs to be intensive, well organized, with adequate feedback and requires frequent practice.AimsThe aims of this pilot study are (1) to evaluate the feasibility of a virtual articulation therapy (VAT) to guide patients with dysarthria through a boost articulation therapy (BArT) program; (2) to evaluate the acoustic models’ performance used for automatic phonological error detection; and (3) to validate the system by end‐users from their perspective.Methods & ProceduresThe VAT provides an extensive and well‐structured package of exercises with visual and auditory modelling and adequate feedback on the utterances. The tool incorporates automated methods to detect phonological errors, which are specifically designed to analyse Dutch speech production. A total of 14 subjects with dysarthria evaluated the acceptability, usability and user interaction with the VAT based on two completed therapy sessions using a self‐designed questionnaire.Outcomes & ResultsIn general, participants were positive about the new computer‐based therapy approach. The algorithm performance for phonological error detection shows it to be accurate, which contributes to adequate feedback of utterance production. The results of the study indicate that the VAT has a user‐friendly interface that can be used independently by patients with dysarthria who have sufficient cognitive, linguistic, motoric and sensory skills to benefit from speech therapy. Recommendations were given by the end‐users to further optimize the program and to ensure user engagement.Conclusions & ImplicationsThe initial implementation of an automatic BArT shows it to be feasible and well accepted by end‐users. The tool is an appropriate solution to increase the frequency and intensity of articulation training that supports traditional methods.What this paper addsWhat is already known on the subject Behavioural interventions to improve articulation in patients with dysarthria demand intensive treatments, repetitive practice and feedback. However, the current treatments are mainly limited in time to the interactive sessions in the presence of speech–language pathology. Automatic systems addressing the needs of individuals with dysarthria are scarce. This study evaluates the feasibility of a VAT program and investigates its acceptability, usability and user interaction. What this paper adds to existing knowledge The computer‐based speech therapy approach developed and applied in this study intends to support intensive articulation training of patients with dysarthria. The virtual speech therapy offers the possibility of an individualized and customized therapy programme, with an extensive database of exercises, visual and auditory models of the target utterances, and providing adequate feedback based on automatic acoustic analysis of speech. What are the potential or actual clinical implications of this work? The automatic BArT overcomes the limitation in time of face‐to‐face traditional speech therapy. It offers patients the opportunity to have access to speech therapy more intensively and frequently in their home environment.

Effectiveness of Speech Intervention in Patients With a Cleft Palate: Comparison of Motor-Phonetic Versus Linguistic-Phonological Speech Approaches.

Purpose The purpose of this study was to compare the effect of two different speech therapy approaches, a traditional motor-phonetic approach and a linguistic-phonological approach, on the speech and health-related quality of life in Dutch-speaking children with a cleft palate with or without a cleft lip (CP ± L) between 4 and 12 years old. Method A block-randomized, sham-controlled design was used. Fourteen children with a CP ± L (M age = 7.71 years) were divided into two groups using block randomization stratified by age and gender: one receiving motor-phonetic intervention (n = 7) and one receiving linguistic-phonological intervention (n = 7). Each group received 10 hr of speech therapy divided over 2 weeks. Perceptual speech assessments were performed on several baseline and posttreatment data points. The psychosocial effects of the intervention were assessed using the patient-reported Velopharyngeal Insufficiency Effects on Life Outcomes questionnaire. Both groups were compared over time using (generalized) linear mixed models. Within-group effects of time were determined using pairwise comparisons with post hoc Bonferroni correction. Results Significant Time × Group interactions with large effect sizes were revealed in terms of consonant proficiency, indicating significant differences in evolution over time among the two groups. Only in the group receiving linguistic-phonological intervention, percentage of correctly produced consonants and places significantly improved after the treatment. Total Velopharyngeal Insufficiency Effects on Life Outcomes scores of the parents significantly improved in both groups after the intervention. Conclusions Both motor-phonetic and linguistic-phonological speech interventions can have a positive impact on the occurrence of cleft speech characteristics and consonant proficiency in children with a CP ± L. A linguistic-phonological approach, however, was observed to be more effective in terms of improving these speech outcomes compared with a motor-phonetic approach. Speech intervention, irrespective of the used approach, significantly improved the participant's health-related quality of life.

Noninvasive brain stimulation in the rehabilitation of patients with post-stroke aphasia

Over the past decade, non-invasive brain stimulation, in particular transcranial stimulation by direct electric current (TES), has been increasingly included in the array of methods used for rehabilitation of patients with post-stroke impairments (motor, speech, cognitive). Development of stimulation protocols with determination of the zones of exposure, as well as better understanding of the patterns of restoration of functional systems, became possible due to basic research using functional MRI paradigm. However, the complexity of the organization of the speech system, the variety of forms of aphasia that occur when it is damaged, the individual variability of neuroplastic processes, motivated a search for optimal stimulation protocols that contribute to the personification of the rehabilitation process. Portability, low cost of equipment, a good safety and tolerance profile, as well as a proven effect on neuroplasticity processes, are the undoubted advantages of TES-therapy. There is reason to believe that further study and clinical testing of this technique will turn it into the promising tool for enhancing the effectiveness of classical speech therapy approaches in patients with post-stroke aphasia.