Dysarthria: Phonation; Loews Movie Theater at the Waterfront

This post will focus on how to manage phonation (the vibration of the vocal cords, also known as "voicing") in children with dysarthria.  Behavioral strategies for managing phonation are similar to strategies for respiration because better breath support leads to a stronger voice.  This is because when one takes a deeper breath, it creates more pressure underneath the vocal cords which makes them vibrate better, giving the speaker a louder and stronger voice; it also provides more air to speak on for longer sentences.  Thus, cueing for better phonation is often the same as cueing for better respiration.  Instruct your child to "Take a deep breath before each sentence."  This will allow her to speak louder, and to speak longer on one breath.  (See the previous post "Dysarthria: Respiration" for more detail.)

If your child still has deficits in phonation, there are other behavioral strategies.  The first is to known as a "vocal cord adduction" technique.  Have your child sit upright on a chair with armrests, and put her arms on the armrests.  Then, tell her to push down on the armrests with her hands while she is speaking (starting with a deep breath, of course).  This is known as "bearing down" and it will help push the vocal cords together in order to get better vibration.  To be on the safe side, I recommend speaking with your child's doctor before implementing this strategy.

Another behavioral strategy for improved phonation is to instruct your child to begin speaking at the beginning of the exhalation.   It is true that we speak during exhalation, but many of use exhale for a little bit before starting to speak.  This can be detrimental to children with dysarthria because it can lead to air wastage.

If behavioral interventions fail, you may wish to speak with your SLP about the appropriateness of a speech amplifier.  There are also medical interventions available.  I recommend consulting with a specialized voice team including an ENT and SLP.  Here is a link for the UPMC Voice Center: http://www.upmc.com/services/ear-nose-throat/services/voice/pages/default.aspx.

I think a great place to practice phonation is at the movie theater...don't worry because you can talk during the previews!  Loews Movie Theater at the Waterfront is a good one to stimulate speech because it is so interesting looking inside and out.

 

 Image retrieved from http://www.cbre.us/o/pittsburgh/properties/the-waterfront/Pages/tenants.aspx.

Plus, the movie seats have armrests which allow your child to practice "bearing down."

Image retrieved from http://pittsburgh.cbslocal.com/top-lists/free-and-affordable-pittsburgh-129-music-movies-and-family-fun/.

A good way for your child to practice is to start by imitating short sentences, then longer sentences.  Remember to cue her to "Take a deep breath before each sentence," and maintain upright positioning; instruct her to "bear down" or begin talking at the start of the exhalation as needed.  Finally, let her move onto making up her own sentences, then participating in conversation all while monitoring her own speech.

Short sentences for repetition may include:
"It smells like popcorn,"
"I like movies,"
"There is a line."

Long sentences for repetition may include:
"I like to get popcorn and a soda when I go to the movies,"
"I wish I had a big movie screen at home,"
"I like funny movies because I like to laugh."

To stimulate your child to make up her own sentences, ask her questions.  Some may include:
"What is your favorite movie?"
"What is your least favorite movie?"
"Who is your favorite actor?"

Some topics for conversation may include discussing your favorite snacks at the movies, comparing movies, and talking about other things to do at the Waterfront.