Residual speech impairment in patients with traumatic brain injury

Abstract

Rehabilitation of patients with traumatic brain injury is a challenge for whole rehabilitation team (especially for speech and language pathologist). There is a general agreement that individual who suffer head injury may exhibit communication deficit either in the form of speech disorders (dysarthria) or language disorders (subclinical aphasia). Although head injured patients recover basic language skill within the first six months post-injury, they continue to show deficits in the analysis and synthesis of expressive and receptive language. Acoustical correlates of speech in patients with traumatic brain injury have received minimal attention in research literature. We examined the residual speech impairment in patients with traumatic brain injury even after 3 yrs post trauma, using ten simple sentences in Marathi. Subjects were asked to read the sentences, which were recorded digitally. Acoustical as well as perceptual analysis was carried out. The scores were compared with healthy controls. Patients showed deviated results compared to healthy controls except intensity parameters. Duration of word was lengthened in the patients with traumatic brain injury. Vowel quadrangle was shrunken as compared to healthy controls. Though the difference was not statistically significant, the milder deviations in speech of patients with TBI were affecting the results in perceptual evaluation. Patient with traumatic brain injury need long term therapy in terms of their speech and language is concerned. The study concludes that TBI patients continued to have prosodic as well as articulatory deviations (compared to healthy controls) even after 3 years after trauma.

Keywords

frequency - intensity - duration - traumatic brain injury (TBI) - vowel quadrangle

• References

• 1 Murdoch B.E.. Speech and language disorder associated with traumatic brain injury. In: Murdoch B.E.. 1^st Ed Acquired speech and language disorders. Paul H. Brooke’s publishing co; North America: 1990: 120-141
• 2 Groher. Speech and language disorder associated with traumatic brain injury. In: Murdoch B.E.. 1^st Ed Acquired speech and language disorders. Paul h. Brooke’s publishing co; North America: 1983: 139
• 3 Holland. Speech and language disorder associated with traumatic brain injury. In: Murdoch B.E.. 1^st Ed Acquired speech and language disorders. Paul H. Brooke’s publishing co.; North America: 1982: 133
• 4 Sarno MT, Buonaguro A, Levita E. Characteristics of verbal impairment in closed head injured patients. Arch Phys Med Rehabil 1986; 67: 400-405
• 5 Samuel C, Louis-Dreyfus A, Couillet J. et al Dysprosody after severe closed head injury an acoustic analysis. J Neurol Neurosurg Psychiat 1998; 64: 482-485
• 6 Lubinski R, Moskato BS, Willer BS. Prevalence of speaking and hearing disabilities among adults with traumatic brain injury from a household survey. Brain Inj 1997; 11: 103-114
• 7 Groher. Speech and language disorder associated with traumatic brain injury. In: Murdoch B.E.. 1^st Ed Acquired speech and language disorders. Paul H. Brooke’s publishing co.; North America: 1977: 137
• 8 Theodoros DG, Murdoch BE, Chenery HJ. Perceptual speech characteristics of dysarthric speakers following severe closed head injury. Brain Inj 1994; 08: 101-124
• 9 Theodoros DG, Murdoch BE. differential patterns of hyperfunctional laryngeal impairment in dysarthric speakers following severe closed head injury. In: Robin D.A., Yorkston K.M., Beukelman D.R.. 1^st Ed. Disorders of motor speech assessment, treatment and clinical characterization. Paul H. Brookes Publishing Co.; Maryland: 1989: 219
• 10 Cahill LM, Murdoch BE, Theodoros DG. Perceptual and instrumental analysis of speech following traumatic brain injury in childhood. J Head Trauma Rehabil 2003; 18: 268-283
• 11 Cahill LM, Murdoch BE, Theodoros DG. Perceptual analysis of speech following traumatic brain injury in childhood. Brain Inj 2002; 16: 415-446