Introduction: Most previous research on communication skills in children with spina bifida (SB) focused on language abilities and related cognitive skills, with very little attention on their speech deficits. Nonetheless, the few previous studies on speech production in children with SB showed that they did have apparent problems in prosody, phonation and articulation but how well or poorly these children perform in other aspects of speech production is unknown.
Research Aims: To establish a speech production profile for children with SB
Methods: The participants were 18 children with SB aged 7-12 years (mean = 9;02 years). A connected speech sample was elicited from each child using a wordless picture book. Perceptual judgements of speech were carried out by two speech and language therapists experienced in motor speech disorders in children, using the general procedure of the Mayo clinic system of perceptual judgements of dysarthrias. Each speech sample was judged using a visual analogue scale on 38 speech dimensions, across seven speech categories- pitch, loudness, voice quality, respiration, prosody, articulation and overall impression (including intelligibility and bizarreness).
Results: The five speech dimensions that showed the highest mean rating were ‘overall loudness level’, ‘short rushes of speech’, ‘phrases short’, ‘variable rate’, and ‘phonemes prolonged’. Three of these dimensions were related to prosody; no child was perceived as “normal” on all prosody dimensions. Moreover, 83% of children were perceived as unintelligible or bizarre.
Discussion: It is likely that the speech difficulties shown in the participants in the current study were related to structural or motor deficits (e.g. small stature, wheelchair bound) or pragmatic difficulties (awareness of loudness level and rate) rather solely motor speech disorders.
Conclusion: Children with SB present with atypical speech characteristics across several aspects of speech (primarily prosody, articulation and phonation), and these deficits may be overlooked in this population, both in research and in clinical practice.