Fidelity

Overview

Approximately 35% of children with cerebral palsy have speech difficulties because of weakness and slowness of the muscles controlling breathing, the vocal cords, tongue, mouth and jaw. This type of speech problem is called dysarthria. Dysarthria makes speech difficult to understand.

Improving speech has been identified as a priority by both people with cerebral palsy and their families.

The therapy used in the FIDELITY study was developed by Dr Lindsay Pennington, Professor Nick Miller and research speech and language therapist Sheila Robson in 2007. The therapy focusses on controlling breathing for speech, keeping the voice at a loud and steady level and slowing the rate of speech to increase how easy it is to be understood. It uses principles of motor learning, such as giving lots of practice and reducing feedback when children can speak at a steady volume and rate, to help children learn skills quickly and retain them. Two previous studies using this therapy have already taken place - one with older children (aged 11-17) in 2010 and one with younger children (aged 5-11) in 2013. The therapy sessions took place at home or school for 6 weeks and the results showed a 12-15% improvement in the participants' intelligibility.

In Fidelity we have worked with 22 young children who have speech disorder as part of their cerebral palsy. The children were randomly allocated to receive either treatment as usual or six weeks of individual therapy, given three times per week by a research therapist over the internet. Children’s speech was recorded at five time points: six weeks and one week before therapy started; one, six and twelve weeks after therapy had finished. Children were recorded repeating single words and saying short sentences. Children and their parents were interviewed about their experiences of receiving the therapy via the internet and about taking part in the study. Families randomised to receive treatment as usual were offered the new therapy at the end of the study.

Findings so far

We are currently analysing the results of the study, which we hope will inform the development of a randomised controlled trial to test if the therapy is generally effective for children with speech disorders and cerebral palsy.