Kinematic changes in jaw and lip control of children with cerebral palsy following participation in a motor-speech (PROMPT) intervention

Abstract

This study evaluates kinematic movements of the jaw and lips 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 (PROMPT) intervention program. An ABCA single subject research design was implemented. Subsequent to the baseline phase (A), phase B targeted each participant's first intervention priority on the PROMPT motor-speech hierarchy. Phase C then targeted one level higher. A reference group of 12 typically-developing peers, age- and sex-matched to each participant with CP, was recruited for comparison in the interpretation of the kinematic data. Jaw and lip measurements of distance, velocity, and duration, during the production of 11 untrained stimulus words, were obtained at the end of each study phase using 3D motion analysis (Vicon Motus 9.1). All participants showed significant changes in specific movement characteristics of the jaw and lips. Kinematic changes were associated with significant positive changes to speech intelligibility in five of the six participants. This study makes 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 intelligibility in children with cerebral palsy.

Keywords::

• Cerebral palsy
• effectiveness study
• motor speech disorders

Acknowledgements

The data reported in this paper is part of a larger data-set, collected in 2007, as part of a study aimed at evaluating the effectiveness of PROMPT therapy in children with cerebral palsy. This study is being completed as a doctoral thesis at Curtin University. 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, Meg Houghton (Senior PROMPT Instructor) for completing the fidelity to intervention measures, Paul Davey (Senior Research Officer, School of Physiotherapy) for creation of the custom programs and animations, and Peter McKinnon (Statistician, School of Physiotherapy) for support with the statistics.

Declaration of Interest: The authors report no conflicts of interest.

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.