Treatment of Ataxic Dysarthria Using a Modified Be Clear Approach: A Pilot Study

Abstract

Ataxic dysarthria is a motor speech disorder characterized by irregular articulatory errors as well as changes to prosody, such as atypical variability in loudness, pitch and stress (Duffy, 2020). Like many other motor speech disorders, ataxic dysarthria can impact an individual's quality of life, affecting social participation, well-being, and mental health (Daker-White et al., 2015; Jacobi et al., 2018). To date, treatment studies specifically designed for speakers with ataxic dysarthria have been limited. The present study examined the viability of a tailored speech treatment that builds on the established Be Clear (Park et al., 2016) and ClearSpeechTogether (Lowit et al., 2023) approaches. In this pilot study, two speakers with ataxic dysarthria participated in an 8-week treatment administered remotely. Strategies focused on overenunciation and slowed rate via phrasing. Ten listeners conducted blinded perceptual ratings of articulation clarity and speech naturalness across three time points (pre-treatment, immediately post-treatment, and 1-month maintenance). Outcome measures of transcription intelligibility and psychosocial impact were also included. Results suggest improvements across perceptual ratings of intelligibility and naturalness, as well as pronounced increases to sentence-level intelligibility. Post-treatment changes to measures of dysarthria impact and communication participation were mixed. Additional research is required to establish efficacy with a larger and more diverse sample.