Spina bifida (SB) is a congenital condition that results from incomplete closure of the neural tube during embryonic development due to genetic and/or environmental factors. Structural anomalies of the base of the brain and accompanying hydrocephalus are highly likely to associate with SB; hence, children with SB often have lifelong problems in sensory and motor functions as well as difficulties in the cognitive domain and communication. Most previous research on communication skills in children with SB focused on their 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. Therefore, this study applied the Mayo clinic system of perceptual judgements of dysarthrias to establish a speech production profile for children with SB.
The participants were 18 children with SB (eight males and 10 females; aged 7-12 years with a mean of 9;02). All participants were monolingual Irish-English speakers except one child who was bilingual but spoke English as the primary language. A connected speech sample was elicited from each child using a wordless picture book and recorded using a digital recorder. Perceptual judgements of speech were carried out by two speech and language therapists who were 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 (VAS) on the 38 speech dimensions for each of the area of pitch (four dimensions), loudness (five), voice quality (nine), respiration (three), prosody (10), articulation (five) and overall impression (two: intelligibility and bizarreness). The VAS is a 100 mm straight line, where the left end represented “Normal” and right end represented “Deviation from normal”. Hence, the higher the rating, the more severe it deviated from normal for the speech dimension rated.
The results of the study showed that there were two-thirds of the children (12/18) who were judged as somehow unintelligible and bizarre. The 10 speech dimensions that showed the highest mean rating were ‘loudness level (overall)’, ‘short rushes of speech’, ‘phrases short’, ‘variable rate’, ‘phonemes prolonged’, ‘rate’, ‘audible inspiration’, ‘excess and equal stress’, ‘imprecise consonants’ and ‘pitch level’. Five of these dimensions were related to prosody, two to articulation, two to phonation and one to respiration. Four of these top 10 dimensions were also found to be prevalent in adults with ataxic dysarthria reported in a previous study and five of the 10 dimensions were also observed in the children and adults with SB reported in another study.