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Online Speech Therapy program helps improve speech in ataxia

Written by Caroline Spencer, PhD
Edited by Celeste Suart, PhD

ClearSpeechTogether is a virtual group-based speech therapy program for people with speech problems due to progressive ataxia.

In this article, researchers studied whether an online, group speech therapy program was helpful for people with ataxia. The study tested the hypothesis that a patient-led group therapy session could be as effective as individual speech therapy with a clinician. The speech therapy program focused on improving functional outcomes like speech intelligibility.

How was the research done?

This study included 9 participants (ages 16 and up) who had mild to moderate progressive ataxia and ataxic dysarthria. Dysarthria, or slurred speech, is a common symptom in people with ataxia.

Participants first completed a two-week pre-treatment baseline assessment. During these two weeks, participants recorded themselves speaking during various tasks, such as reading words, sentences, and paragraphs. They also rated their communication abilities, participation in communication-related activities of daily living, and communication confidence. The study also assessed the participants’ general fatigue.

After the pre-treatment assessment period, participants received individual therapy (via Zoom) with a speech therapist for the next two weeks. These individual sessions were held twice a week for about 20-30 minutes per week, and participants completed twice-daily homework tasks. Over the two weeks, participants had a total of four individual speech therapy sessions.

Participants focused on speaking with a loud voice and clear speech in the sessions. The loud voice focused on using an effective voice without straining or putting forth too much effort. The clear speech involved over-enunciating words.

For the next four weeks, participants met with each other in a group (also via Zoom) for five sessions per week to practice their speech together. Speech exercises were designed to last 20 to 30 minutes. However, many sessions lasted longer, depending on how much the participants socialized with each other. During this phase, a speech therapist joined their group session once per week.

In the group sessions, participants continued to focus on speaking with a loud voice and clear speech. They used a handbook of speech exercises to practice saying single words, phrases, sentences, reading passages, and free speech. Participants were encouraged to also incorporate their own personalized materials as the group sessions went on. During the group sessions, participants gave feedback and comments on each other’s performance.

After the conclusion of the treatment program, participants’ speech and self-ratings were re-assessed. They were assessed one last time eight weeks after the end of group therapy

What were the research results?

Adherence to the treatment protocol was generally good. All participants showed improvement in reading intelligibility immediately after the conclusion of the therapy program. After the eight week follow up, five of eight participants showed a decline in reading intelligibility from the assessment immediately after treatment. Still, the average intelligibility rating at the eight week follow up was higher than pre-treatment.

All participants reported improvements in self-perception of their communication abilities, voice, and articulation after the program. Participants were positive about their experience with the therapy program. They reported a good balance between clinician and group elements.

The speech therapists’ ratings of vocal strain were reduced after treatment. This means that participants seemed to require less effort to use their voice. However, participants’ self-ratings of overall fatigue were similar before and after treatment. This means that they felt a similar level of fatigue before and after the treatment.

What does this mean for people with ataxia?

The researchers conclude that the study adds evidence that people with progressive ataxia can benefit from group speech therapy. They note that this study included only a small number of participants, so future research might assess the effectiveness of group speech therapy with more participants.

Conflict of Interest Statement

The author and editor have no conflicts of interest to declare.

Citation of Article Reviewed

Lowit A, Cox J, Loucas M, Grassly J, Egan A, van Brenk F, Hadjivassiliou M. ClearSpeechTogether: a rater blinded, single, controlled feasibility study of speech intervention for people with progressive ataxia. The Cerebellum. 2023 Oct;22(5):865-76.