Pacing boards are simple yet versatile tool in speech therapy that can be used for a variety of speech and language disorders including articulation and phonological disorders, fluency, dysarthria and apraxia of speech (Vollmer, 2020). This can be conveniently used by the client in the speech clinic or at home.
Who benefits from using a Pacing Board?
Individuals diagnosed with Parkinson's disease which is characterized by limited range of motion and rigidity of speech structures (Duffy, 2013). Many people with Parkinson's disease speak in a soft voice without presenting any change in intonation. Their speech may also sound breathy and hoarse with slurring or mumbling of words. Some will either speak slowly or rapidly with evidence of stuttering ("Speech and Swallowing Problems", n.d.).
Motor Speech Impairment Target
Hypokinetic Dysarthria is associated with the damages to the basal ganglia control circuit (American Speech-Language-Hearing Association [ASHA], 2022). Prominent effects of this deficit include rigidity and decreased range of movement. Areas of speech motor control such as the preparation, maintenance and switiching of motor programs are significantly impacted with the damage (Duffy, 2013).
Therapy Goals: In 6 months, the client will independently slow down the rate of speech by using a pacing board in 8/10 trials with 80% accuracy as measured by SLP data collection.
Sample Demo Videos
Activity breakdown (45-minute session 2x a week)
Select conversation starter questions
The clinician will model how to tap on the pacing board while matching each tap to each word in the sentence. The clinician will instruct the client to answer the question by tapping on the pacing board for every word that will be said.
If the client speech rate increases, the clinician will provide a feedback,"that was too fast, please use your pacing board".
The clinician will demonstrate how to slow the rate of speech and will model the taping on the pacing board while repeating the client's answer.
Both the clinician and the client will say the sentence together will while tapping on the pacing board.
The sequence of activities will be repeated 6 using a variety of questions.
End of session.
Hierarchical Cueing
Modeling: The clinician will read sentences while tapping on the pacing board in a slow rate.
Direct verbal prompt: The clinician will provide direct feedback, reminding the client to coincide his/her pace with the tapping on the pacing board.
Scaffolding with the use of non-verbal prompt: The clinician will tap on the table to indicate a slow rate.
Fade verbal prompt: The client is able to answer questions without the use of a pacing board.
Materials for the Activity
Conversation Paceboard: Pacing Board App (Aptus Speech Therapy)
An Evidence-based Approach
A study on the effect of rate control methods on running speech intelligibility, speech rate, articulation rate and pause characteristics in a sample of clients with dysarthria revealed that hand tapping with the use of a pacing board or an alphabet board was an effective strategy in improving intelligibility of clients (Van Nuffelen et al., 2010).
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
Aptus Speech Therapy. (2020, July 27). Conversation Paceboard - Pacing Board for Speech by Aptus Speech Therapy [Video File]. YouTube. https://www.youtube.com/watch?v=qKDLVFPRvzY
Duffy, J. R. (2013). Motor speech disorders: Substrates , differential diagnosis, and management. St. Louis, MO: Elsevier.
Sierra Speech. (2018, March 24). Better Speech with Parkinson’s Using Pacing Board [Video file]. YouTube. https://www.youtube.com/watch?v=zO3odDn1y6Q.
Speech and Swallowing Problems. (n.d.). Retrieved from https://www.michaeljfox.org/news/speech-swallowing-problems
Van Nuffelen, G., De Bodt, M., Vanderwegen, J., Van de Heyning, P., & Wuyts, F. (2010). Effect of rate control on speech production and intelligibility in dysarthria. Folia Phoniatrica Et Logopaedica, 62(3), 110–119. https://doi.org/10.1159/000287209
Vollmer, E. (2020). Prompt speech therapy for kids. Therapyworks. Retrieved from https://therapyworks.com/blog/language-development/what-is-prompt-method/
