1/23. Chronic cerebellar stimulation in cerebral palsy.Data are presented for the first 50 patients with cerebral palsy who underwent chronic cerebellar stimulation for symptom alleviation. We observed significant shorter and longer term improvement in spasticity as well as athetosis, speech, and functional status. Continuing increments in improvement were noted as a function of time on stimulation. In many instances, psychometric test scores and behavior also were improved. There was one death in this series. There were no neurologic complications due to cerebellar stimulation. The results of this study warrant the judicious use of cerebellar stimulation for symptomatic and functional relief in cerebral palsy.- - - - - - - - - - ranking = 1keywords = speech (Clic here for more details about this article) |
2/23. A child with spina bifida, cerebral palsy and juvenile rheumatoid arthritis: rehabilitation challenge.PURPOSE: A child with spina bifida, cerebral palsy and juvenile rheumatoid arthritis is presented, and strategies to approach a patient with multiple paediatric onset disabling conditions with possible overlaps are discussed. CONCLUSION: The value of multidisciplinary team approach including physiatrist, physical therapist, occupational therapist, rehabilitation nurse, prosthetist-orthotist, psychologist, speech-language pathologist, paediatric rheumatologist, social worker, kinesiotherapist, dietitian, recreation therapist, dentist and other disciplines as required is emphasized.- - - - - - - - - - ranking = 1keywords = speech (Clic here for more details about this article) |
3/23. Using electropalatography (EPG) to diagnose and treat articulation disorders associated with mild cerebral palsy: a case study.Some children with mild cerebral palsy have articulation disorders that are resistant to conventional speech therapy techniques. This preliminary study investigated the use of electropalatography (EPG) to diagnose and treat a long-standing articulation disorder that had not responded to conventional speech therapy techniques in an 8-year-old boy (D) with a congenital left hemiplegia. The targets for EPG therapy were speech errors affecting velar targets /k, g, eta/, which were consistently fronted to alveolar placement [t, d, n]. After 15 sessions of EPG therapy over a 4-month period, D's ability to produce velars improved significantly. The EPG data revealed two features of diagnostic importance. The first was an unusually asymmetrical pattern of tongue-palate contact and the second was unusually long stop closure durations. These features are interpreted as a subtle form of impaired speech motor control that could be related to a mild residual neurological deficit. The results suggest that EPG is of potential benefit for diagnosing and treating articulation disorders in individuals with mild cerebral palsy.- - - - - - - - - - ranking = 4keywords = speech (Clic here for more details about this article) |
4/23. Video-fluoroscopic study of swallowing in children with neurodevelopmental disorders.BACKGROUND: Children with neurodevelopmental disorders can have feeding problems. malnutrition and recurrent aspiration pneumonia can increase the risk of morbidity and mortality. Video-fluoroscopic study of swallowing (VFSS) is essential in understanding the pathological mechanisms involved during swallowing. methods: The aim of the present study was to assess the role of VFSS in assessment and management of four children with various neurodevelopmental disorders in a multidisciplinary feeding team. We describe the team approach, with the participation of child neurologist, radiologist with the rehabilitation team including the speech therapist, occupational therapist and dietician, in the assessment and plan of management. RESULTS: Video-fluoroscopic study of swallowing had been useful in assessing the type of swallowing problems with treatment goals targeted to the basic underlying pathophysiological mechanism. CONCLUSION: A child neurologist should be involved in the multidisciplinary oromotor rehabilitation program for neurologically impaired children with feeding problems.- - - - - - - - - - ranking = 1keywords = speech (Clic here for more details about this article) |
5/23. Modafinil for drooling in cerebral palsy.Two patients with spastic cerebral palsy recently treated with modafinil at the Walter Reed Army Medical Center child neurology clinic have stopped drooling. This occurred after starting modafinil for spasticity and without other changes in the patients' treatment programs. The decrease in drooling is to a remarkable degree. Both patients had a chronic problem with drooling. One patient has gone from wearing a bib or bandanna, which was constantly wet from drooling to being essentially dry. After starting modafinil, both patients stopped drooling. The parents initially observed decreased drooling at home. Clinic appointment examinations and evaluations at physical therapy confirmed these observations. Better coordination and speech have been noted in each patient. Modafinil improves drooling in at least some patients with spastic cerebral palsy. The decreased drooling is due to improvements noted in swallowing.- - - - - - - - - - ranking = 1keywords = speech (Clic here for more details about this article) |
6/23. Intrathecal baclofen therapy improves functional intelligibility of speech in cerebral palsy.OBJECTIVE: To assess the effect of intrathecal baclofen on spastic dysarthia in cerebral palsy. DESIGN: Single case study. methods: Functional outcome measures, including the Assessment of Intelligibility of Dysarthric Speech, were performed before and after a trial of intrathecal baclofen in an adult patient with spastic dysarthria due to cerebral palsy. The patient proceeded to intrathecal baclofen pump implantation and was reassessed after six months of continuous intrathecal baclofen therapy. RESULTS: Improvement in function including speech intelligibility was seen following the intrathecal baclofen trial. The improvement was sustained at six months post pump implantation. CONCLUSIONS: Intrathecal baclofen improved functional intelligibility of speech in a carefully selected subject. The Assessment of Intelligibility of Dysarthric Speech was found to be a useful quantitative tool to assess the effect of intrathecal baclofen on spastic dysarthria.- - - - - - - - - - ranking = 6keywords = speech (Clic here for more details about this article) |
7/23. Eco-cultural frameworks and childhood disability: a case study from puerto rico.Social and physical environments are powerful influences on disability status. The purpose of this case report is to consider the usefulness of scores on the Pediatric Evaluation of Disability Inventory (PEDI) of a child living in puerto rico for developing an intervention plan within the context of the child's eco-cultural niche. A 5 year-old boy with cerebral palsy, his family, therapists, and teacher are described by using ethnographic interviews and participant observation of the family, speech, occupational, and physical therapists, and teachers over a 9-month period. A physical therapy evaluation of the child, including administration of the PEDI and use of the eco-cultural niche concept to develop an intervention plans are described... The child's abilities and inabilities as measured by the PEDI were influenced by several aspects of the environment; family beliefs, values and resources; community resources; and personal characteristics of the child. An eco-cultural framework was useful for interpreting the scores of this standardized measure of disability.- - - - - - - - - - ranking = 1keywords = speech (Clic here for more details about this article) |
8/23. The effect of mouth closure on drooling and speech.The efficacy of a feeding program to decrease drooling and increase vocalizations by promoting mouth closure was explored in two boys with cerebral palsy through the use of oral facilitation techniques. A single-subject ABA design was repeated across subjects. Baseline 1 consisted of 5 (Subject 1) and 10 (Subject 2) half-hour sessions during which the subjects were fed applesauce and apple juice without treatment. A 1-hr play session followed, during which saliva was collected on an absorbent bib and weighted. Bilabial vocalizations produced by the subjects were recorded and counted. A 12-session intervention phase followed, which was identical to the baseline phase except that treatment was implemented. Treatment consisted of techniques to reduce tactile hypersensitivity before feeding and the application of jaw control during feeding. Baseline 2 consisted of 7 sessions identical to baseline 1. The results suggest that this intervention decreases drooling but does not increase bilabial vocalizations. Longer treatment and follow-up may be needed in future efficacy studies.- - - - - - - - - - ranking = 4keywords = speech (Clic here for more details about this article) |
9/23. Facilitating conversation through self-initiated augmentative communication treatment.We examined the conversational skills of 2 adult males with severe motor and speech deficits resulting from cerebral palsy. A multiple baseline design across subjects was used to determine the effectiveness of an intervention strategy designed to teach them to use an augmentative communication system (touch Talker) independently. The dependent measure was the number of conversation initiations relative to conversation reactions during spontaneous communication across baseline and treatment. The treatment included specific training on using the augmentative system to participate in communication. Once the intervention began, the production of conversation initiations accelerated at a rapid rate. The treatment program was effective in training the subjects to use the augmentative system to increase conversation participation. These results demonstrate that training on the operation of the device alone is not sufficient to ensure improvement in conversation performance, and that it is important to incorporate direct conversational treatment when providing instruction on the use of augmentative communication systems for severely speech-impaired individuals.- - - - - - - - - - ranking = 2keywords = speech (Clic here for more details about this article) |
10/23. On the use of hidden Markov modelling for recognition of dysarthric speech.Recognition of the speech of severely dysarthric individuals requires a technique which is robust to extraordinary conditions of high variability and very little training data. A hidden Markov model approach to isolated word recognition is used in an attempt to automatically model the enormous variability of the speech, while signal preprocessing measures and model modifications are employed to make better use of the existing data. Two findings are contrary to general experience with normal speech recognition. The first is that an ergodic model is found to outperform a standard left-to-right (Bakis) model structure. The second is that automated clipping of transitional acoustics in the speech is found to significantly enhance recognition. Experimental results using utterances of cerebral palsied persons with an array of articulatory abilities are presented.- - - - - - - - - - ranking = 8keywords = speech (Clic here for more details about this article) |
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