Doctor of Philosophy (PhD)


Communication Sciences and Disorders

Document Type



ABSTRACT Objective – The present study aimed to determine if a treatment effect is present on speech outcomes in children with spastic cerebral palsy (CP) given 5 sessions of a manual therapy treatment protocol. Methods – A single-subject experimental design (ABAB) study was devised to establish the treatment efficacy of a manual therapy protocol on speech outcomes in children with spastic CP. The protocol was administered to 5 participants, 4-6 years old. It included five intercostal stretches administered in 15-minute sessions for five sessions. During the withdrawal phase, a sham treatment was administered that included an equal dosage of treatment. Measurements of sound pressure level (SPL) and Maximum Phonation Duration (MPD) of /a/ served as the primary outcomes. Secondary outcome measures included speech intelligibility, syllables per breath unit (SBU), and chest structure measurements. Results – Trend, level, variability, effect sizes, % of Non-Overlapping Data, and immediacy of effect were combined to support or refute each effect. 15 of 15 demonstrations of effect for SPL, and 9 of 15 demonstrations of effect for MPD were located. This data demonstrate a positive effect on SPL and minimal support for an effect on MPD. Secondary outcome measures of SBU and chest mobility showed a positive treatment effect, while speech intelligibility and abdominal protrusion did not. Conclusions – This is the first known study to demonstrate a treatment effect in SPL and SBU using a manual therapy protocol, which provide evidence of a likely treatment effect in speech outcomes in children with spastic CP.



Document Availability at the Time of Submission

Release the entire work immediately for access worldwide.

Committee Chair

Donovan, Neila