Client background:

Oscar is a 12-year-old with a diagnosis of cerebral palsy movement disorder. Previous speech therapy priorities at Key to CP included improved breath support for speech and increasing the length and complexity of his sentences. Oscar returned to Key to CP this spring to focus on improving articulation skills and overall intelligibility.

Oscar’s journey

See how Oscar blossomed during a five-day speech therapy session at Key to CP in this case study, or continue reading below.

Goals before treatment:

Family goals centered around improving Oscar’s speech intelligibility and communication confidence with peers and unfamiliar adults.

Treatment:

Oscar attended a five-day speech therapy intensive at Key to CP with two 45-minute sessions per day. Full body strategies to improve positioning and attention for articulation tasks were utilized through collaboration with OT and PT. This was Oscar’s third speech intensive and his expressive language had improved steadily, but he had made little progress with the elimination of sound error patterns through limited and traditional speech therapy services at home.

Therapy initially focused on increasing awareness of targeted sounds, both through auditory discrimination and production tasks, with specific training on how to make the targeted sounds /s, f/ and “th”. 

Once Oscar began producing the target sounds accurately, we quickly moved through the articulation hierarchy using a combination of Knowledge of Performance (KP) and Knowledge of Results (KR) feedback. The majority of articulation tasks were based on simple verbal imitation of the therapist’s productions. Novel speech tasks to take advantage of neuroplasticity involved encouraging imitation of the targets using variations in loudness, rate, and prosody. Self-monitoring was encouraged through strategic use reinforcement schedules and elicited self-reflection during performance tasks. An articulation app was also used to allow Oscar to immediately listen to and rate his productions independently.

Results:

In just five days, the use of the motor speech approach resulted in significant improvement in articulation skills. Oscar demonstrated improved awareness through self-correction, achieved articulation objectives with all sounds at the sentence level and with multiple targets, and improved his overall intelligibility.

Oscar’s case illustrates that intensive speech therapy using a motor speech approach is effective for a child with a motor disorder who continues to struggle to make progress using a traditional articulation therapy. It is also an example of how a child can make significant gains using the Key to CP systematic approach in the area of speech/articulation skills.