Objective: To examine treatment-related acoustic and perceptual changes after LSVT LOUD ® in two adult speakers with dysarthria secondary to cerebral palsy (CP).

Background: Cerebral palsy is a group of developmental disorders that affects movement and posture. In children, CP constitutes the most common motor disability and it is estimated to occur at 1.5-4 per 1,000 live births worldwide [1]. The motor speech disorder of dysarthria is most frequently associated with CP [2] and it has been reported to affect over 50% of children with this medical condition [3]. Despite the increased life expectancy observed in CP, sparse attention has been paid in the literature to the speech of adults with this neurological condition or to the effect of speech treatment on their vocal function [4].

Method: Speakers: A 36-year-old female with severe spastic dysarthria and a 24-year-old male with severe hyperkinetic dysarthria secondary to CP participated in the study.
Procedures: Both speakers received four sessions of the intensive voice-based treatment LSVT LOUD[5] for four weeks. Speakers were recorded three times before treatment and twice after treatment to examine a variety of vocal measures: mean fundamental frequency (F0), maximum phonation time (MPT), mean maximum phonational frequency range (MPFR), jitter, and shimmer.

Results: Female speaker: Most acoustic variables significantly improved following LSVT LOUD: mean F0 (F(1,28) = 22.588, p= <.001); MPT (F(1,28) = 57.018, p= <.001); mean MPFR (F(1,28) = 32.874, p= <.001); and jitter (F(1,28) = 4.165, p= .010). Shimmer, which reflects amplitude perturbation of the speech signal, decreased post-treatment, albeit not significantly.
Male speaker: A 38.7% change was found for MPT (from 4.9s to 6.8s), while mean F0 slightly increased by 0.56% (from 136.95Hz to 137.72Hz). Highest and lowest pitch were also found to increase post-treatment. Acoustic data from these speakers were consistent with treatment perceptual reports.

Conclusion: The significant post-treatment changes in the majority of the acoustic measures analyzed for the female speaker and the preliminary results for the male speaker suggest LSVT LOUD has the potential to improve vocal function in adults with dysarthria secondary to CP. Together with the perceptual data and previous positive outcomes of LSVT LOUD applied to CP[6], these findings motivate continued research in this area.

References: 1. Centers for Disease Control and Prevention (2018). Data & Statistics for Cerebral Palsy. Retrieved from https://www.cdc.gov/ncbddd/cp/data.html. 2. Schölderle, T., Staiger, A., Lampe, R., Strecker, K., & Ziegler, W. (2016). Dysarthria in adults with cerebral palsy: Clinical presentation and impacts on communication. Journal of Speech, Language, and Hearing Research, 59, 216-229. 3. Nordberg, A., Miniscalco, C., Lohmander, A., & Himmelmann, K. (2013). Speech problems affect more than one in two children with cerebral palsy: Swedish population-based study. Acta Paediatrica, 102, 161–166. 4. Haak, P., Lenski, M., Hidecker, M. J., Li, M., & Paneth, N. (2009). Cerebral palsy and aging. Developmental Medicine & Child Neurology, 51, 16-23. 5. Ramig, L. O., Sapir, S., Countryman, S., Pawlas, A. A., O’Brien, C., Hoehn, M., & Thompson, L. L. (2001). Intensive voice treatment (LSVT) for patients with Parkinson’s disease: a 2 year follow up. Journal of Neurology, Neurosurgery & Psychiatry, 71, 493-498. 6. Fox, C. M., & Boliek, C. A. (2012). Intensive Voice Treatment (LSVT LOUD) for children with spastic cerebral palsy and dysarthria. Journal of Speech, Language, and Hearing Research, 55, 930-945.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/lsvt-loud-applied-to-adults-with-cerebral-palsy-two-single-subject-studies/