ACQ Vol 12 no 1 2010

Gillam, S. L., & Gillam, R. B. (2006). Making evidence- based decisions about child language interventions in schools. Language, Speech & Hearing Services in Schools , 37 , 304–315. Greenhalgh, T. (2001). How to read a paper . 2nd ed. London: BMJ Publishing Group. Nelson, T. D., & Steele, R. G. (2006). Beyond efficacy and effectiveness: A multifaceted approach to treatment evaluation. Professional Psychology: Research and Practice , 37 , 389–397.

Sackett, D. L., Rosenberg, W. M. C., Muir J. A., Gray, R., Haynes, B., & Richardson, W. S. (1996). Evidence based medicine: What it is and what it isn’t. British Medical Journal , 312 , 71–72.

Correspondence to: Dr Jenny Harasty Speech Pathology Australia National Advisor Research and Evidence Based Practice email: jharasty@bigpond.net.au

Research update

Motor speech disorders research at UQ Deborah Theodoros

be due to the global effect of increased loudness and effort affecting other subsystems of the speech mechanism beyond the respiratory-laryngeal systems. This study in which people were treated with either LSVT ® or traditional dysarthria therapy revealed that both treatments, when delivered intensively (one hour per day, four days per week, for four weeks) resulted in significant improvements in certain aspects of speech production (Wenke, Theodoras, & Cornwell, 2008, 2009). Future research in motor speech disorders will continue to pursue the development of treatment protocols based on the principles of motor learning and neuroplasticity, and on technology-based methods of service delivery which will assist clinicians to meet the health challenges of the future. References Hill, A.J., Theodoros, D. G., Russell, T. & Ward, E. C. (in press). The re-design and re-evaluation of an Internet-based telerehabilitation system for the assessment of dysarthria in adults. Telemedicine and eHealth . Hill, A., Theodoros, D. G., Russell, T., & Ward, E. C. (2009). Using telerehabilitation to assess apraxia of speech in adults. International Journal of Language and Communication Disorders , 44 (5), 731–747. Wenke, R., Theodoros, D., & Cornwell, P. (2009). Effectiveness of the LSVT® on hypernasality in non- progressive dysarthria: The need for further research. International Journal of Language and Communication Disorders , iFirst, 1–23. Wenke, R., Theodoros, D., & Cornwell, P. (2008). The short and long term effectiveness of the LSVT® for dysarthria following TBI and stroke. Brain Injury , 22 , 339–352.

Historically, research in motor speech disorders at the University of Queensland has focused on the assessment of dysarthria and apraxia of speech utilising perceptual, acoustic, and instrumental techniques in order to investigate the underlying pathophysiology of these disorders. Such research continues to be conducted in various populations such as traumatic brain injury, Friedreich’s ataxia, stroke, and Parkinson’s disease (PD). More recently, however, research in motor speech disorders has involved the development of alternative service delivery models, and investigations of treatment efficacy. Over the last five years, researchers in the Telerehabilitation Research Unit (www.uq.edu.au/telerehabilitation) have developed and validated telerehabilitation applications to assess and treat people with motor speech disorders across the Internet. This mode of service delivery has the potential to overcome the difficulties encountered by many people living in rural and remote areas, and those with a disability, in accessing therapy services. One study in this area involved the assessment and treatment of hypokinetic dysarthria online using the Lee Silverman Treatment (LSVT ® ) program. Results from this randomised controlled trial revealed that significant improvements in speech and voice, comparable to those achieved face-to-face, can be achieved in people with PD when treated across the Internet (submitted for publication). In another study, the online assessment of dysarthria and apraxia of speech has been found to be comparable to results obtained face-to-face (Hill, Theodoras, Russell, & Ward, in press; Hill, Theodoras, Russell, & Ward, 2008). Research in telerehabilitation has led to the development of eHAB ® , a portable multi-media videoconferencing unit which connects to the Internet via the mobile telephone network. This system is designed to be placed in the person’s home. Treatment efficacy research in motor speech disorders has involved an investigation into the effectiveness of the LSVT ® in the management of dysarthric speakers with non- progressive dysarthria. Although originally developed for the treatment of hypokinetic dysarthria, the LSVT ® has been shown in single case studies to improve speech intelligibility in other types of dysarthria. These results are thought to

Deborah Theodoros

Correspondence to: Deborah Theodoros, PhD Professor and Head Division of Speech Pathology School of Health and Rehabilitation Sciences The University of Queensland, Brisbane email: d.theodorus@uq.edu.au

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ACQ Volume 12, Number 1 2010

ACQ uiring knowledge in speech, language and hearing