The combination of accent method and phonemic contrast: an innovative strategy to improve speech production on post-stroke dysarthria

Introduction: Speech production includes segmental and suprasegmental features, which interact and cooperate with each other. Impaired speech production is common in individuals with post-stroke dysarthria. The commonly used phonemic contrast therapy and Accent Method in clinical practice can improve the segmental and suprasegmental aspects, respectively. This study aimed to explore the feasibility and immediate effectiveness of the combination of specific rhythm patterns of the Accent Method and phonemic contrast on speech production. Methods: Fifteen poststroke dysarthria patients (12 males and three females) first received accentuation task of three rhythm patterns (Largo-slow, Andante-medium, Allegro-fast) and later received speech task in appropriate rhythm patterns combined with phonemic contrast materials and non-phonemic contrast materials. Speech parameters were analyzed by considering speech clarity and prosody. Results: The results showed that the number of correct target syllables, sentence clarity, and standard deviation of intensity increased significantly, and the average length of pauses and abnormal pause times decreased significantly in Andante (medium) compared to other rhythms. The number of correct target syllables, sentence clarity, and standard deviation of intensity increased significantly compared with those in the non-phonemic contrast in Andante (medium). Conclusion: The combination of phonemic contrast and Accent Method was verified to have an immediate effect on speech production in Mandarin speakers with post-stroke dysarthria and could be further validated in other diseases with impaired speech production in the clinic in the future.