Abstract
Background
Progressive ataxias frequently lead to speech disorders and consequently impact on communication participation and psychosocial wellbeing. Whilst recent studies demonstrate the potential for improvements in these areas, these treatments generally require intensive input which can reduce acceptability of the approach.
A new model of care—ClearSpeechTogether—is proposed which maximises treatment intensity whilst minimising demands on clinician. This study aimed to establish feasibility and accessibility of this approach and at the same time determine the potential benefits and adverse effects on people with progressive ataxias.
Method
This feasibility study targeted people with progressive ataxia and mild-moderate speech and gross motor impairment. ClearSpeechTogether consisted of four individual sessions over 2 weeks followed by 20 patient-led group sessions over 4 weeks. All sessions were provided online. Quantitative and qualitative data were collected for evaluation.
Results
Nine participants completed treatment. Feasibility and acceptability were high and no adverse effects were reported. Statistical tests found significantly reduced vocal strain, improved reading intelligibility and increased participation and confidence. Participant interviews highlighted the value of group support internalisation of speech strategies and psycho-social wellbeing.
Discussion
ClearSpeechTogether presented a feasible, acceptable intervention for a small cohort of people with progressive ataxia. It matched or exceeded the outcomes previously reported following individual therapy. Particularly notable was the fact that this could be achieved through patient led practice without the presence of a clinician. Pending confirmation of our results by larger, controlled trials, ClearSpeechTogether could represent an effective approach to manage speech problems in ataxia.
Progressive ataxias frequently lead to speech disorders and consequently impact on communication participation and psychosocial wellbeing. Whilst recent studies demonstrate the potential for improvements in these areas, these treatments generally require intensive input which can reduce acceptability of the approach.
A new model of care—ClearSpeechTogether—is proposed which maximises treatment intensity whilst minimising demands on clinician. This study aimed to establish feasibility and accessibility of this approach and at the same time determine the potential benefits and adverse effects on people with progressive ataxias.
Method
This feasibility study targeted people with progressive ataxia and mild-moderate speech and gross motor impairment. ClearSpeechTogether consisted of four individual sessions over 2 weeks followed by 20 patient-led group sessions over 4 weeks. All sessions were provided online. Quantitative and qualitative data were collected for evaluation.
Results
Nine participants completed treatment. Feasibility and acceptability were high and no adverse effects were reported. Statistical tests found significantly reduced vocal strain, improved reading intelligibility and increased participation and confidence. Participant interviews highlighted the value of group support internalisation of speech strategies and psycho-social wellbeing.
Discussion
ClearSpeechTogether presented a feasible, acceptable intervention for a small cohort of people with progressive ataxia. It matched or exceeded the outcomes previously reported following individual therapy. Particularly notable was the fact that this could be achieved through patient led practice without the presence of a clinician. Pending confirmation of our results by larger, controlled trials, ClearSpeechTogether could represent an effective approach to manage speech problems in ataxia.
| Original language | English |
|---|---|
| Pages (from-to) | 865–876 |
| Number of pages | 12 |
| Journal | Cerebellum |
| Volume | 22 |
| Issue number | 5 |
| Early online date | 24 Aug 2022 |
| DOIs | |
| Publication status | Published - Oct 2023 |
Bibliographical note
Publisher Copyright:© 2022, The Author(s).
Funding
We would like to thank all our participants for their valuable time. Many thanks also go to the Ataxia UK team, James Atkins and Anastasia Georgousis, who supported the group sessions. Finally, we are grateful to our expert SLT listeners, Rebecca Kimber, Caroline Waszkiewicz and Conor Brown for their time to evaluate the data. This study was funded by Ataxia UK, grant reference ZSTRATHC.
| Funders | Funder number |
|---|---|
| Ataxia UK team | |
| James Atkins and Anastasia Georgousis | |
| ZSTRATHC | |
| Ataxia UK |
Keywords
- Communication participation
- Dysarthria
- Group intervention
- Intelligibility
- Progressive ataxia
- Speech therapy