Effect of boost articulation therapy (BArT) on intelligibility in adults with dysarthria

Abstract

Background: The articulatory accuracy of patients with dysarthria is one of the most affected speech dimensions with a high impact on speech intelligibility. Behavioural treatments of articulation can either involve direct or indirect approaches. The latter have been thoroughly investigated and are generally appreciated for their almost immediate effects on articulation and intelligibility. The number of studies on (short-term) direct articulation therapy is limited. Aims: To investigate the effects of short-term, boost articulation therapy (BArT) on speech intelligibility in patients with chronic or progressive dysarthria and the effect of severity of dysarthria on the outcome. Methods & Procedures: The study consists of a two-group pre-/post-test design to assess speech intelligibility at phoneme and sentence level and during spontaneous speech, automatic speech and reading a phonetically balanced text. A total of 17 subjects with mild to severe dysarthria participated in the study and were randomly assigned to either a patient-tailored, intensive articulatory drill programme or an intensive minimal pair training. Both training programmes were based on the principles of motor learning. Each training programme consisted of five sessions of 45 min completed within one week. Outcomes & Results: Following treatment, a statistically significant increase of mean group intelligibility was shown at phoneme and sentence level, and in automatic sequences. This was supported by an acoustic analysis that revealed a reduction in formant centralization ratio. Within specific groups of severity, large and moderate positive effect sizes with Cohen's d were demonstrated. Conclusions & Implications: BArT successfully improves speech intelligibility in patients with chronic or progressive dysarthria at different levels of the impairment.

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

“…In a previous study, this particular approach (figure 1) resulted in significant improvements of intelligibility at different levels of speech in a group of adults with dysarthria (Mendoza et al . 2021). The extensive, well‐structured and hierarchical practice package of exercises recommended in that previous study is implemented in the VAT.…”

“…The intervention design (Mendoza et al . 2021). The components labelled (1) are exclusively intended for the intervention articulatory drill.…”

“…A more recent study demonstrated that boost articulation therapy (BArT), in which participants perform intensive articulatory drill and minimal pairs exercises for 5 consecutive days, has a significant positive effect on speech intelligibility in patients with dysarthria (Mendoza et al . 2021). However, the current treatments of articulation are mainly limited in time to the interactive sessions in the presence of speech–language pathology (SLP).…”

“…Extensive research in the speech therapy domain suggests that providing large amounts of practice over a shorter period can lead to better results/outcomes for adults with communication disorders (Bhogal et al 2003, Fox et al 2006. A more recent study demonstrated that boost articulation therapy (BArT), in which participants perform intensive articulatory drill and minimal pairs exercises for 5 consecutive days, has a significant positive effect on speech intelligibility in patients with dysarthria (Mendoza et al 2021). However, the current treatments of articulation are mainly limited in time to the interactive sessions in the presence of speech-language pathology (SLP).…”

An Investigation to Identify Optimal Setup for Automated Assessment of Dysarthric Intelligibility using Deep Learning Technologies

“…This impairment can be caused by physical injuries that damage the neural cells in the brain, stroke, etc., and is a symptom of neurological disorders such as Parkinson's disease and cerebral palsy [2]. The lack of articulatory control and muscle weakness associated with dysarthria affect the speaking rate, varied amplitude and pitch dynamics, and articulation, all of which result in unintelligible speech that is more difficult to understand due to imprecise articulation of phonemes or abnormal variations in speech [3]. Intelligibility can be thought of as the quality of speech indicating how well healthy speakers can understand the spoken words [4]; dysarthric individuals may have reduced intelligibility, and variation in dysarthria severity can lead to speech of differing degrees of intelligibility that can significantly reduce the patient's communication abilities.…”