Assignment Task:
Please use Melissa Background, clinical observation and acoustic measures to answer the clinical questions.
Melissa
Background
Melissa is an 11-year-old girl with ataxic cerebral palsy. She is ambulatory but uses crutches to increase her sense of stability. Cognitively, Melissa is functioning within the normal range of intelligence and is attending a regular school, where she is performing at grade level. Even though Melissa does have a small group of good friends, she is frustrated because her friends and teachers often ask her to repeat herself. As Melissa will soon be entering middle school, she is concerned that the older children will make fun of her speech.
Clinical Observations
Upon reevaluation at the start of fifth grade, Melissa expressed her concerns to you, the school speech-language pathologist. Melissa has been receiving speech therapy services since kindergarten, and her speech intelligibility is fairly good. However, she still tends to slur some words due to vowel distortion and consonant imprecision, and her prosody in connected speech is noticeably monotone. Consequently, her speech sounds slow and labored. As part of a thorough diagnostic workup, you think it important to establish baselines for vowel duration, overall articulatory rate, and intonation as reflected by pitch variability. You will obtain these measures using the free downloadable acoustic program Praat.
Acoustic Measures
You tested Melissa's speech patterns in single words, sentences, and structured conversation. On the word level, spectrographic analysis showed that target formant frequencies were within the normal range. Vowel durations fell at the low end of the normal range. At the sentence level, distortions of all articulatory movements became more evident, with slow transitions between sounds and neutralized formant frequencies for all corner vowels. Consonant durations were also longer than normal, and stops were intermittently fricated. In addition, the pitch analysis program demonstrated that Melissa's average F0 in connected speech was 248 Hz, but her F0 range in sentences and in connected speech was limited to an average of 22 Hz, considerably lower than the expected range for her age.
Clinical Questions
1. Based on these findings, generate an age-appropriate F1/F2 plot for Melissa that will serve as a baseline against which to measure her progress.
2. Develop three goals related to Melissa's speech intelligibility/prosody and provide a rationale for each goal.
3. How might acoustic instrumentation be used to verify that Melissa is achieving the therapeutic objectives?
4. What other types of instrumentation could be helpful in establishing an intervention plan for Melissa?