Current research exploring treatment of dysarthria in children with diagnoses of cerebral palsy (CP) suggests the importance of prioritizing the respiratory system, rather than isolating treatment to the oral motor or articulatory system alone. The purpose of this investigation was to attempt replication of previous intervention targeting specific respiratory tasks (Speech Subsystems Treatment – SST) in intervention, followed by examination of the effectiveness in use of a more direct respiratory treatment in the use of a specifically developed Neuro-Developmental Treatment (NDT) protocol combined with the respiratory tasks of the SST protocol. Two five-year old participants with diagnoses of spastic/dystonic CP and associated dysarthria completed an intensive course of speech therapy in an investigation structured using single case research design (A1-B-A2-BC). Seven sessions of SST were presented, followed by a two-week no treatment period, and then combined SST/NDT for six therapy sessions. Data were collected regarding performance on respiratory/speech tasks, as well as intermittent measures of single word and connected speech intelligibility. A rating of postural control was also included in this investigation. Each participant responded positively to both the SST and NDT/SST combined treatment, with improved performance on the respiratory/speech tasks of coordination of respiration with phonation, duration of phonation, slowed rate of speech and appropriate pausing for breath. While variable changes in speech intelligibility were identified at the single word level, intelligibility of connected speech improved 15.5-20% over the course of the investigation. Following the combined NDT/SST phase, increased postural control in a seated position was also documented. Short intensive cycles of SST and NDT/SST combined were effective in improving respiratory control and coordination in children with CP/dysarthria, with functional improvement in speech intelligibility achieved.
