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ACQ Volume 12, Number 1 2010 9
Kleim, J. A., & Jones, T. A. (2008). Principles of
experience-dependent neural plasticity: Implications for
rehabilitation after brain damage. Journal of Speech,
Language and Hearing Research, 51, S225–S239.
Ludlow, C., Hoit, J., Kent, R., Ramig, L.O., Shrivastav,
R., Strand, E., Yorkston, K., & Sapienza, C.M. (2008).
Translating principles of neural plasticity into research on
speech motor control recovery and rehabilitation. Journal of
Speech, Language and Hearing Research, 51, S240–S258.
McCauley, R. J., & Strand, E. A. (2008). A review of
standardized tests of nonverbal oral and speech motor
performance in children. American Journal of Speech-
Language Pathology, 17, 81–91.
Miscimarra, L., Stein, C., Millard, C., Kluge, A., Cartier, K.,
Freebairn, L., Hansen, A., Shriberg, L., Taylor, H.G., Lewis,
B., & Iyengar, S.K. (2007). Further evidence of pleiotropy
influencing speech and language: Analysis of the DYX8
region. Human Heredity, 63, 47–58.
Morgan, A. T., Liegeois, F., & Occomore, L. (2007).
Electropalatography treatment for articulation impairment
in children with dysarthria post-traumatic brain injury. Brain
Injury, 21 (11), 1183–1193.
Morgan, A. T., & Skeat, J. (in press). Evaluating service
delivery for speech and swallowing problems following
paediatric brain injury: an international survey. Journal of
Evaluation in Clinical Practice.
Morgan, A. T., & Vogel, A. P. (2008). Intervention
for dysarthria associated with acquired brain injury
in children and adolescents. Cochrane Database of
Systematic Reviews, Issue 3. Art. No.: CD006279. DOI:
10.1002/14651858.CD006279, 2008.
Morgan, A. T., Ward, E. C., & Murdoch, B. E. (2004).
Clinical progression and outcome of pediatric dysphagia
following traumatic brain injury. Brain Injury, 18(4), 359–376.
Murdoch, B. E., Pitt, G., Theodoros, D. G., & Ward, E.
(1999). Real-time continuous visual biofeedback in the
treatment of speech breathing disorders following childhood
traumatic brain injury. Pediatric Rehabilitation, 3, 5–20.
Robbins, J., & Klee, T. (1987). Clinical assessment of
oropharyngeal motor development in young children. Journal
of Speech, Language and Hearing Disorders, 52, 271–277.
St Louis, K. O., & Ruscello, D. (2000). Oral speech mechanism
screening examination (3rd Ed.). Austin, TX: Pro-Ed.
Stein, C. M., Millard, C., Kluge, A., Miscimarra, L. E.,
Cartier, K. C., Freebairn, L. A., Hansen, A. J., Shriberg, L.
D., Gerry Taylor, H., Lewis, B. A., & Iyengar, S. K. (2006).
Speech sound disorder influenced by a Locus in 15q14
region. Behavioural Genetics, 36, 858–868.
Wilcox, K., & Morris, S. (1999). Children’s speech intelligibility
measure. San Antonio, TX: The Psychological Corporation.
Ziegler, W. (2003). Speech motor control is task
specific: Evidence from dysarthria and apraxia of speech.
Aphasiology, 17(1), 3–36.
1. Neural plasticity: “the ability of the central nervous system to
change and adapt in response to environmental cues, experience,
behaviour, injury, or disease” (Ludlow et al., 2008, p. S240).
a single session would be less complementary, and may
actually result in interference of motor skill learning in one or
the other domain.
In summary, there are too few studies, and no well-
controlled (i.e., quasi-randomised or RCT) studies, of
treatment for childhood-acquired dysarthria. At present,
clinicians are heavily reliant upon adapting adult-based
dysarthria treatments (e.g., see Academy of Neurologic
Communication Disorders and Sciences) for use with
children. Using the only available empirical data in the
paediatric field, the present overview was designed to
illustrate how we might consider recently outlined principles
of neural plasticity (Kleim & Jones, 2008; Ludlow et al., 2008)
when designing individual treatment programs for children
with acquired dysarthria.
Summary and conclusions
As for many fields within speech pathology, there is an
impoverished research evidence base underpinning clinical
management of children with acquired dysarthria. The
required future directions for research have been discussed
elsewhere (Morgan & Vogel, 2008) and are beyond the
scope of this clinically focused report. It was the aim of this
paper to provide an overview of recent evidence in childhood
acquired dysarthria, and its implications for guiding
assessment and treatment approaches in clinical practice.
The present review supports clinicians to consider the
application of a systematic and evidence based approach to
management of childhood dysarthria associated with ABI.
Acknowledgements
Thank you to clinical rehabilitation collaborators for ongoing
discussion (Louise Cahill, Queensland Paediatric
Rehabilitation Service; Turid Peters, Starship Hospital; Flora
Haritou, Maria Fassoulakis, Natalie Weekley, Victorian
Paediatric Rehabilitation Service; Candice Brady, Children’s
Hospital at Westmead).
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Correspondence to:
Angela Morgan PhD
Research Fellow, Murdoch Children’s Research Institute
Senior Speech Pathologist, Royal Children’s Hospital
Lecturer, Department of Paediatrics, University of Melbourne
50 Flemington Road, Parkville 3052
Victoria, Australia
phone: +61 (03) 9345 4215
email: