A Study On The Effect Of Dynamic Tactile Accent Method On Articulation Motor Ability In Children With Cerebral Palsy

Children with cerebral palsy have low articulatory motor ability,which is mainly manifested by decreased articulatory motor range,decreased articulatory motor flexibility and coordination.The dynamic tactile input of the lip and face can increase the peripheral sensory feedback of the lip and face and enhance the control ability of articulatory movement in the children with cerebral palsy.Accent Method can prolong the load-bearing time of articulatory muscles in children with cerebral palsy,activate the proprioceptors of speech motor muscles,increase the motor sensory feedback and enhance the control and coordination ability of articulatory movement.Dynamic tactile input during stress can comprehensively improve the articulatory motor ability of children with cerebral palsy.The purpose of this study was to develop a speech therapy technique,Dynamic Tactile Accent Method,and to verify its effect on improving articulatory motor ability in children with cerebral palsy.The first study was to explore the effects of rhythm stress combined with dynamic tactile input on articulatory motor ability in children with cerebral palsy.Seventeen children with cerebral palsy were selected and a two-factor repeated measurement experiment design was used to compare the changes of articulatory motor ability of children with cerebral palsy under different stress stimuli and with or without dynamic tactile input stimuli,so as to provide a basis for the formulation of follow-up treatment strategies.The results showed that the main effect of dynamic tactile input on F2 u,tongue distance,F2i/F2 u,VSA,VAI,FCR and ta accuracy was significant（p =0.023,p=0.005,p =0.006,p =0.014,p =0.006,p =0.006,p =0.009）.The dynamic tactile input was significantly better than the non-dynamic tactile input.The main effect of stress rhythm on F1 u,F2u,paka-DR（PCS /4s）was significant（p =0.003,p =0.000,p=0.014）.The ta accuracy,pata-DR accuracy,paka accuracy,taka accuracy and pataka accuracy of children with cerebral palsy had significant interaction effects（p =0.009,p=0.012,p =0.009,p =0.004,p =0.033）,the combination of adagio rhythm II and dynamic touch input was more obvious than that of other rhythmic types,suggesting that dynamic touch input and stress therapy could improve the articulation motor ability of children with cerebral palsy,and adagio rhythm II and dynamic touch input could improve the articulation motor ability of children with cerebral palsy.Based on the above results,the second study proposed a Dynamic Tactile Accent Method strategy（DT-AM）for children with cerebral palsy,which comprehensively considered the factors affecting the constructional motor ability of children with cerebral palsy,and designed targeted intervention strategies to improve the constructional motor ability of children with cerebral palsy on the basis of adagio rhythm type II combined with dynamic tactile input.Ten patients with cerebral palsy were selected for clinical verification through single group pre and post-test experiment.The results showed that the range of articulation motion in children with cerebral palsy was: F1 a,F2a,F2 i,△F1,△F2,F2i/F2 u,Vowel space area（VSA）,vowel articulation index（VAI）,formant centralization ratio（FCR）（p=0.007,p =0.007,p =0.038,p =0.005,p =0.013,p =0.013,p =0.005,p =0.005,p =0.005）;Articulation movement flexibility and coordination: pa-dr（PCS /4s）,ta-DR（PCS /4s）,ka-DR（PCS /4s）,pata-DR（PCS/4s）,paka-DR（PCS /4s）,taka-DR（PCS /4s）,pataka（PCS /4s）（p =0.005,p =0.005,p=0.008,p =0.007,p =0.011,p =0.012,p =0.012）and speech clarity（p =0.005）were significantly improved after the dynamic tactile accent method intervention.The innovation of this study is as follows: Based on the Dynamic System Theory,a Dynamic Tactile Accent Method strategy（DT-AM）was developed for the improvement of articulation motor ability in children with cerebral palsy.The main points of the strategy are:（1）the combination of adagio rhythm stress and dynamic tactile input;（2）Follow the logic of articulatory motor training from jaw to lip and then to tongue to comprehensively improve the articulatory motor ability of children with cerebral palsy.