1 THE TREATMENT OF A SEVERE ATAXIC DYSARTHRIA, USING ELECTROPALATOGRAPHY. Single case study Alison Main, Steve Kelly and Graham Manley Electropalatography has been used successfully with several client groups (Hardcastle et al 1991). Intelligibility has been improved in children with articulation difficulties as a result of cleft palate, or with dyspraxia, or long standing phonological difficulties. There has been less work with adults and a very limited amount with acquired dysarthrics (Gibbon 1997). In the majority of cases reported, there has been a degree of improvement in intelligibility (eg Goldstein et al 1994). This is not a miraculous return to “normal speech”, but an improvement, often where conventional speech therapy has failed. The Canterbury and Thanet Speech and Language Therapy Department, together with the local Community Dental Department and the University of Kent Medical Electronics Research Team, have undertaken a clinical trial. The intention was to have a subject group of at least 24 adult, acquired dysarthrics, and to compare the effects of electropalatography with conventional speech and language therapy in each case. Dr Rosemarie MorganBarry acted as a Speech and Language Therapy adviser and the research was funded by SE Thames Regional Health Authority. The results of this clinical trial will be fully reported in a separate paper. This paper reports on a single case history from within the trial. LINGUAGRAPH The electropalatography system used was the Kent Linguagraph (Kelly & Main 1997). This system has been devised by the above team specifically for clinical use. It works with a PC fitted with a standard interface card. Features include: a large, bright display (which can be single, two channel or full screen), and the facility to record and replay data. The system is easy to use for both therapy and assessment. CASE HISTORY CB was referred to the trial by his Speech and Language Therapist in October 1995, approximately 6 months post onset. He was a 48 year old male, living at home with his wife and two teenage children. He had taken early retirement, due to mobility problems caused by ankylosing spondylitis. In February 1995, he had large, bilateral cerebellar infarcts, and infarcts in the posterior fossa, as a result of vasculitis. As well as compounding mobility difficulties, this affected swallowing and speech. CB was dysphagic: his swallow was poorly coordinated, and following videofluoroscopy, a PEG was inserted, in May 1995. This provided the bulk of his nutrition, and only very small amounts of purees and thickened fluids were taken for pleasure. Additionally, CB was left with a severe ataxic dysarthria. Speech was “rarely intelligible”, and he was provided with a Lightwriter SL 35, to aid communication. CB was reluctant to use this, and very keen to work on his speech. THE TRIAL All potential subjects for this trial were screened. This assessment specifically checked tongue movement and sensitivity, visual acuity and perception, the ability to follow instructions, and to interpret what can be seen on the computer screen. In CB’s case, tongue mobility and sensitivity were greatly reduced. He was easily able to interpret the data on a small computer screen, and to follow instructions. He was keen to take part, and was considered suitable, but CB was very anxious about the palate. He did not feel he would be able to open his mouth sufficiently for an impression to be made and, due to his dysphagia, was concerned that he might inhale some of the impression material. brought to you by CORE View metadata, citation and similar papers at core.ac.uk provided by Kent Academic Repository