A Modified “Be Clear” Treatment for Ataxic Dysarthria: Targeting Cognitive Load and Generalization

Abstract

Ataxic dysarthria is a motor speech disorder that often leads to reduced speech intelligibilityand naturalness, which can negatively impact communication participation and quality of life. The present study is a partial replication of the Olegario and Spencer (2025a,b) treatment approach based on previous Clear Speech-based interventions, which emphasized overarticulation and slowed rate of speech (see Lowit et al., 2023; Park et al., 2016; Whelan et al., 2022). Modifications to the original protocol were made to intentionally target cognitive load, generalization, and communicative participation (Gartner-Schmidt et al., 2016; Rosenbek, 2017; Yorkston et al., 1996). The eight-week remote treatment program consisted of individual and joint group sessions for two speakers with mild-moderate ataxic dysarthria. Blinded perceptual ratings of articulatory precision and speech naturalness were collected from ten listeners across three time points (pre-treatment, post-treatment, one-month maintenance). Additional outcome measures included transcription intelligibility and measures of communication participation and psychosocial impact. Findings were partially consistent with those reported by Olegario and Spencer (2025a,b) and suggested improvements in perceptual ratings of precision but not naturalness. Improvements in transcription intelligibility were present but less pronounced, while improvements in participant-reported communicative participation and psychosocial impact were more consistent and greater in magnitude. Further research is necessary to assess generalizability of the findings in the broader population of individuals with ataxic dysarthria.