Exaggerated Consonants / Overarticulation

Over-emphasis of consonants at a greater intensity level than vowels can improve intelligibility and accuracy of speech production (“Handout-able: articulation strategies”,n.d.). Overarticulation or exaggeration of consonants helps a client to better articulate words, in particular those sounds that are in the middle or at the end of words.

Who benefits from exaggerated consonants / overaticulation therapy?

Individuals diagnosed with degenerative diseases such as autosomal dominant cerebellar ataxia of late onset, Freidrich's ataxia and olivopontocerebellar degeneration can benefit from therapy strategies incorporating the overarticulation of consonants. Individuals with these conditions may present inaccurate articulation of consonants, irregular articulatory breakdown, slow rate of speech, monopitch, monoloudness and overall poor coordination of speech (Duffy, 2013).

Motor Speech Impairment Target

Ataxic Dysarthria is characterized by the damage to the cerebellar control circuit (American Speech-Language-Hearing Association [ASHA], 2022). The clinical features of this motor speech impairment highlights the important role of the cerebellum and how it affects a person's speech motor control. A distinguishing characteristic of an individual with this disorder presents an activity which is poorly timed, controlled and coordinated (Duffy, 2013).

Therapy Goal: In 6 months, given 15 multisyllabic words including consonant clusters, the client will independently overarticulate the consonant sounds in 4 out of 5 trials at 80% accuracy as measured by SLP data collection.

Sample Video Demo

Activity Breakdown (45-minute session 2x a week)

Clinician will the start the session by having the client do an articulation warm-up by puckering the lips, puffing the cheeks, moving the jaw and tongue around and saying “aah” for a 5 seconds.
Clinician will present the list of 15 multisyllabic words with consonant clusters and will model how the consonant sounds are to be produced with exaggeration.
Clinician will inform the client will read the entire list in 5 trials that the session will be audio recorded for the purpose of data collection and client feedback.
Client will read through the list of words and required to exaggerate or overarticulate the consonant sounds (initial, medial and final positions) for each word.
Clinician will provide verbal prompts if the client is unable to produce the maximum exaggerated production of the consonant sound.
Once client has gone through the list in the first trial, the clinician will use the audio recording to review the task and provide feedback to the client.
The task will be repeat the cycle before the sessions ends.
Both clinician and client wil review audio recording of task for client feedback.
End of session.

Material for the Activity

Hierarchical Cueing

Modeling: Clinician will read the word list with overarticulation on the production of the consonant sounds.
Direct verbal prompt: Clinician will provide direct feedback to client when error is produced.
Fade verbal prompt: Client is able to read the word list with minimal to no verbal until client can perform task independently.

Data Collection Tool

An Evidence-based Approach

A meta-analysis study conducted by Mitchell et al. (2017) to identify the efficacy and lasting effects of interventions for dysarthria acknowledged how “over-articulation or slowing rate of speech” can be a compensatory strategy to increase intelligibility. Purposeful speech production implemented at an activity level can reinforce meaningful communication abilities (e.g. talking on the phone or distinguishing between statements and questions) for individuals with dysarthric speech caused by stroke, traumatic brain injury or other non-progressive brain damage. Although the results of the study indicated that over-articulation may have no long-term effect on everyday speech, the future for this intervention strategy is promising and should still be offered as part of the rehabilitation program when treating dysarthria (Mitchell et al., 2017).

References:

American Speech-Language-Hearing Association. (2022). Dysarthria in adults. ASHA. Retrieved from https://www.asha.org/practice-portal/clinical-topics/dysarthria-in-adults/#collapse_6

Day, Rebecca. (2016, June 14). Exaggerated Consonants Technique for Ataxic Dysarthria [Video File]. YouTube. https://www.youtube.com/watch?v=mH73FeFzXTM

Duffy, J. R. (2013). Motor speech disorders: Substrates , differential diagnosis, and management. St. Louis, MO: Elsevier.

Handout-able: Articulation strategies for improving dysarthria. (n.d.). Retrieved from https://nicespeechlady.com/wp-content/uploads/2019/11/HANDOUT-ABLE-Articulation-Strategies-for-improving-Dysarthria.pdf

Mitchell, C., Bowen, A., Tyson, S., Butterfint, Z., & Conroy, P. (2017). Interventions for dysarthria due to stroke and other adult-acquired, non-progressive brain injury. Cochrane Database Syst Rev., 1. doi: 10.1002/14651858.CD002088.pub3