An evaluation of the effectiveness of PROMPT therapy in improving speech production accuracy in six children with cerebral palsy

Abstract

This study evaluates perceptual changes in speech production accuracy in six children (3–11 years) with moderate-to-severe speech impairment associated with cerebral palsy before, during, and after participation in a motor-speech intervention program (Prompts for Restructuring Oral Muscular Phonetic Targets). An A1BCA2 single subject research design was implemented. Subsequent to the baseline phase (phase A1), phase B targeted each participant's first intervention priority on the PROMPT motor-speech hierarchy. Phase C then targeted one level higher. Weekly speech probes were administered, containing trained and untrained words at the two levels of intervention, plus an additional level that served as a control goal. The speech probes were analysed for motor-speech-movement-parameters and perceptual accuracy. Analysis of the speech probe data showed all participants recorded a statistically significant change. Between phases A1–B and B–C 6/6 and 4/6 participants, respectively, recorded a statistically significant increase in performance level on the motor speech movement patterns targeted during the training of that intervention. The preliminary data presented in this study make a contribution to providing evidence that supports the use of a treatment approach aligned with dynamic systems theory to improve the motor-speech movement patterns and speech production accuracy in children with cerebral palsy.

Keywords::

• Cerebral palsy
• PROMPT
• motor-speech control
• intervention

Acknowledgements

This research was completed as part of a Doctoral Program completed in March 2012. The authors wish to acknowledge the families and staff at the Centre for Cerebral Palsy for their participation in this study. In addition, the authors acknowledge Dr Marie Blackmore (The Centre for Cerebral Palsy), Associate Professor Anne Ozanne and Dr Beverly Joffe (LaTrobe University) for their contributions to the research design and earlier phases of the study, and Peter McKinnon (Statistician, School of Physiotherapy) for support with the statistics. This study was made possible in part due to funding from the Centre for Cerebral Palsy, The CP Trust of the Centre for Cerebral Palsy and Non-Government Centre Support funding.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.