Rate of Production of Individual Phonemes of the Diadochokinetic Rate in Pwms Both with and without Complaints of Speech Production or Swallowing Difficulty

Background:

Persons with Multiple Sclerosis (pwMS) present for evaluation by skilled Speech –Language Pathologists with complaints of difficulty producing speech and with difficulty swallowing.  With variability of symptoms characteristic of the MS disease process, it is difficult to assess and plan a course of care based on patient report only. An objective measure to support patient complaints was sought.

Objectives:

To determine if production rate of each individual component of the diadochokinetic rate differs between pwMS who have complaints of difficulty with speech production or swallow function and pwMS who do not report such difficulties.

Methods:

A one year medical record review of 232 evaluations completed between the dates between November 1^st, 2013 and October 31^st2014 was conducted by the Primary Investigator.  Of these evaluations, 161 included objective measurement of the individual components of the diadochokinetic rate through use of the KatPENTAX Visi Pitch IV 3950B. The data were organized into four groups: those pwMS both with and without complaints of difficulty with speech production, and pwMS both with and without complaints of difficulty swallowing.  A production rate of 4.5 phonemes per second was set as the cut-off, as 5.0 phonemes per second is the lowest rate within the “typical” range of production for an adult (male or female).  Percentages of the pwMS who could not produce the phonemes at the minimum rate were then calculated for all four groups for comparison.

Results:

Of the pwMS with complaints of difficulty with swallow function, a higher percentage could not produce the individual components of the diadochokinetic rate to the minimal acceptable rate than those pwMS who did not have complaints of difficulty with swallowing.  Similarly, a higher percentage of pwMS with complaints of difficulty producing speech could not produce the individual components of the diadochokinetic rate to the minimal acceptable rate than those pwMS with no complaints of difficulty with speech production.  The velar phoneme /k/ showed the greatest difference in percent accurate for both speech and swallow function.

Conclusions:

1.  PwMS with complaints of speech or swallowing difficulty do not produce components of the diadochokinetic rate at the same rate as those pwMS who do not have those complaints.

2. The velar phoneme /k/ shows the largest difference between the two groups with complaints and the two groups without complaints of difficulty.

3. Future directions include first, increasing the sample size, and second, determine if the differences between the groups is significant.