Use of the extended therapy outcome measure for children with dysarthria

Figures & data

Table I. Techniques for intervention in dysarthria classified by the ICF.

ICF dimension	Techniques
Impairment	Normalization of muscle tone and/or increasing strength of movement precision and co-ordination (Pinto, Ozsancak, Tripoliti, Thobois, Limousin-Dowsey, & Auzou, 2004; Schmidt & Fitzpatrick, 1996; Joffe & Reilly 2004). Prosthetic methods for controlling some of the symptoms associated with dysarthria, e.g., palatal lifts (Enderby, Hawthorn, & Servant, 1984). A speech systems approach to control breath support, phonation, and speech rate (Pennington & Noble, 2010; Pennington, Roelant, Thompson, Robson, Steen, & Miller, 2013). Behavioural techniques (Deane, Whurr, Clarke, Playford, & Ben-Shlomo, 2001). Examples include: The Lee Silverman Voice Technique (Fox & Boliek, 2012); Dysarthria Treatment Programmes (Drummond, Worley, & Watson, 2003).
Activity	Facilitating a communicative environment (Pennington & Noble, 2010; Pennington, Thomson, James, Martin, & McNally, 2009b). The use of devices and biofeedback giving feedback to enable individuals to monitor and modify speech characteristics (Pinto et al., 2004; Schmidt & Fitzpatrick, 1996). Assistive devices, ranging from the low-tech such as an alphabet board, to a high-tech computerized Augmentative and Alternation Communication system. Voice amplifiers used to increase effectiveness of communication (Enderby, Judge, Creer, & John, 2013). Altering the environment can improve function (Sellars, Hughes, & Langhorne, 2005), e.g., ensuring that the listener has full view of the dysarthric speakers face (Palmer & Enderby, 2007).
Participation	Providing education about dysarthria to child, family, and/or school, and advice on promoting self-esteem, to increase social interaction and participation in society, facilitate interaction in school, and communication on social settings. This will lead to increased autonomy, which is associated with general well-being and quality-of-life (Pennington & Noble, 2010; Pennington et al., 2009b).

Table II. Brendan pre-treatment using the TOMS-DYS.

Impairment (4 scores)		Activity/communication (2 scores)		Participation (1 score)	Wellbeing (1 score)	Carer wellbeing (1 score optional)
Physical	1	Without augmentation	1	2	4	2
Cognitive	3	With augmentation	NA
Sensory	5
Speech	2
Language	2.5

Table III. Brendan post-treatment.

Impairment (4 scores)		Activity/communication (2 scores)		Participation (1 score)	Wellbeing (1 score)	Carer wellbeing (1 score optional)
Physical	1	Without augmentation	1	3.5	4	4
Cognitive	3	With augmentation	3
Sensory	5
Speech	3
Language	4

Table IV. Amelia pre-treatment.

Impairment (4 scores)		Activity/communication (2 scores)		Participation (1 score)	Wellbeing (1 score)	Carer wellbeing (1 score optional)
Physical	3.5	Without augmentation	3	3	2	4
Cognitive	4	With augmentation	NA
Sensory	5
Speech	3
Language	5

Table V. Amelia post-treatment.

Impairment (4 scores)		Activity/communication (2 scores)		Participation (1 score)	Wellbeing (1 score)	Carer wellbeing (1 score optional)
Physical	3.5	Without augmentation	4	4	3.5	4
Cognitive	4	With augmentation	4.5
Sensory	5
Speech	4
Language	5

Table VI. Robin pre-treatment.

Impairment (4 scores)		Activity/communication (2 scores)		Participation (1 score)	Wellbeing (1 score)	Carer wellbeing (1 score optional)
Physical	0	Without augmentation	0	1	4	3
Cognitive	1	With augmentation	0
Sensory	2
Speech	0
Language	.5

Table VII. Robin post-treatment.

Impairment (4 scores)		Activity/communication (2 scores)		Participation (1 score)	Wellbeing (1 score)	Carer wellbeing (1 score optional)
Physical	0	Without augmentation	2	2	4	3.5
Cognitive	3	With augmentation	2.5
Sensory	2
Speech	2
Language	2

Figure 1. Comparison of the Therapy Outcome Measure for children with dysarthria (TOM-DYS) scores for Impairment (a), Activity/Communication (b), and Participation (c) across four trusts providing speech and language intervention for children with dysarthria.

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