Breath control exercises are for clients who are unable to phonate at all. They will help clients build their ability to produce speech sounds so that later they will be able to complete more advanced exercises.
Target Population: Patients who had a history of stroke, TBI, brainstem tumor and neurodegenrative diseases such as Amyotrophic Lateral Sclerosis (ALS) and Multiple Sclerosis (MS)
Impairment: Spastic Dysarthria is a motor control disorder characterized by "abnormalities in the strength, speed, range, steadiness, tone, or accuracy of movements required for breathing, phonatory, resonatory, articulatory, or prosodic aspects of speech production" (Duffy, 2013, p. 4).
Therapy goal: In six months, Mrs. Jones will be able to independently use abdominal breathing when producing sentences to support phonation in 8/10 trials across three consecutive sessions as measured by SLP data collection.
Have the client sit upright to improve breath support for speech
Have the client Inhale slowly for 3 seconds
Have the client hold their breath for 3 seconds
Have the client exhale slowly for 3 seconds
Have the client repeat this controlled breathing exercises for 5 min
Then have the client exhale and hold out the following sounds for as long as they can:
hhh
sss
thhh
fff
shhh
Now, have the client add vowels to the end of the sounds and extent them for as long as you can:
hhha, hhhoe, hhhi, hhhow, whho
sssah, ssso, ssseee, sssow, sssue
thhhaw, thhho, thhhee, thhhow, thhhew
fffa, fffoe, fffeee, fffow, fffoo
shhha, shhhow, shhhe, shhhaow, shhhoe
Independent: no help given
Gestural cue: with hands and facial expressions show the client what to do
Visual cue: with a picture show client what is the desired course of action
Verbal cue: tell the client what action to take
Modeling: show the client what action to take
Images of material:
Stopwatch/timer
Note book
Pen
EBP strategy:
"A standard course of LSVT resulted in some improvements in chest-wall biomechanics for breathing during oral reading, but these did not carry over to extemporaneous speech. After extended treatment including LSVT-type tasks, respiration treatment, and physical therapy (Combination Treatment), speech breathing improved for oral reading and monologues."
Reference:
Solomon, N. P., McKee, A. S., & Garcia-Barry, S. (2001). Intensive voice treatment and respiration treatment for hypokinetic-spastic dysarthria after traumatic brain injury. American Journal of Speech-Language Pathology, 10(1), 51–64. https://doi.org/10.1044/1058-0360(2001/008)
Data collection sheet