Intervention for dysarthria associated with acquired brain injury in children and adolescents (Protocol)

Healthy Development [Theme], Language & Literacy, Murdoch Childrens Research Institute, Parkville, Melbourne, Victoria, Australia, 3052.
Cochrane database of systematic reviews (Online) (Impact Factor: 6.03). 07/2008; 3(3):CD006279. DOI: 10.1002/14651858.CD006279.pub2
Source: PubMed


Dysarthria is a disorder of speech production that can make it harder for people to be understood by others. Dysarthria is a common and often chronic outcome associated with brain injury suffered in childhood (also known as paediatric acquired brain injury (ABI) ). This research examines the efficacy of treatment for dysarthria in children following ABI. Although this research reports that positive gains have been reported from a case-based study of a child with dysarthria following ABI (specifically with traumatic brain injury), there are currently too few studies performed in this area to draw any conclusions about the efficacy of treatment for dysarthria in children and teenagers. This review therefore calls for Speech Language Pathologists/Speech Language Therapists (SLPs/SLTs) working in this area to perform studies of the natural history and treatment efficacy of this group.

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    • "As regards the clinical effectiveness of treatment , whilst case studies do suggest that change in speech function is possible following treatment for acquired dysarthria in childhood ( Morgan et al . , 2007 ; Murdoch , Pitt , Theodoros , & Ward , 1999 ) , there is no high level evidence available to suggest that treatment is effective ( Morgan & Vogel , 2008 ) . Future studies should deter - mine whether participants had considered treatment , and explore the child and families ' perspective on the impact of their dysarthria on everyday functioning and quality of life . "
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    ABSTRACT: Dysarthria following surgical resection of childhood posterior fossa tumour (PFT) is most commonly documented in a select group of participants with mutism in the acute recovery phase, thus limiting knowledge of post-operative prognosis for this population of children as a whole. Here we report on the speech characteristics of 13 cases seen long-term after surgical treatment for childhood PFT, unselected for the presence of post-operative mutism (mean time post-surgery=6y10m, range 1;4-12;6 years, two had post-operative mutism), and examine factors affecting outcome. Twenty-six age- and sex- matched healthy controls were recruited for comparison. Participants in both groups had speech assessments using detailed perceptual and acoustic methods. Over two-thirds of the group (69%) with removal of PFT had a profile of typically mild dysarthria. Prominent speech deficits included consonant imprecision, reduced rate, monopitch and monoloudness. We conclude that speech deficits may persist even up to 10 years post-surgery in participants who have not shown mutism in the acute phase. Of cases with unilateral lesions, poorer outcomes were associated with right cerebellar tumours compared to left, consistent with the notion based on adult data that speech is controlled by reciprocal right cerebellar/left frontal interactions. These results confirm the important role of the cerebellum in the control of fine speech movements in children.
    Brain and Language 02/2011; 117(2):69-76. DOI:10.1016/j.bandl.2011.01.002 · 3.22 Impact Factor
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    • "SLT input was variable for each patient, but occurred no more intensively than one session per week or fortnight. It should be noted that there is currently no high level evidence available to support the efficacy of any dysarthria treatments in children (Morgan & Vogel, 2008, 2009; Pennington, Miller, & Robson, 2009). "
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    ABSTRACT: Hemispherectomy (disconnection or removal of an entire cerebral hemisphere) is a rare surgical procedure used for the relief of drug-resistant epilepsy in children. After hemispherectomy, contralateral hemiplegia persists whereas gross expressive and receptive language functions can be remarkably spared. Motor speech deficits have rarely been examined systematically, thus limiting the accuracy of postoperative prognosis. We describe the speech profiles of hemispherectomized participants characterizing their intelligibility, articulation, phonological speech errors, dysarthric features, and execution and sequencing of orofacial speech and non-speech movements. Thirteen participants who had undergone hemispherectomy (six left, seven right; nine with congenital, four with acquired hemiplegia; operated between four months and 13 years) were investigated. Results showed that all participants were intelligible but showed a mild dysarthric profile characterized by neuromuscular asymmetry and reduced quality and coordination of movements, features that are characteristic of adult-onset unilateral upper motor neuron dysarthria, flaccid-ataxic variant. In addition, one left and four right hemispherectomy cases presented with impaired production of speech and non-speech sequences. No participant showed evidence of verbal or oral dyspraxia. It is concluded that mild dysarthria is persistent after left or right hemispherectomy, irrespective of age at onset of hemiplegia. These results indicate incomplete functional re-organization for the control of fine speech motor movements throughout childhood, and provide no evidence of hemispheric differences.
    Brain and Language 08/2010; 114(2):126-34. DOI:10.1016/j.bandl.2009.12.004 · 3.22 Impact Factor
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