CSDS 213: Treatments for Prosody Deficits - Stress/Intonation

Pitch Range Exercises

Begin by assessing the pt’s ability to perceive pitch changes in the SLPs voice. If pt isunable to do so, prognosis is poor for improving pitch control. If pt is able to perceive pitch changes, proceed with the following:

Prolong /a/ on lowest pitch possible

Prolong /a/ on highest pitch possible

Sing up and down the pitch range (8 notes), “stepping” and “gliding” can be used

Pt. reads printed sentences that have arrows written above and below key words indicating the pitch changes for those words (e.g., an up arrow on the final word might indicate pitch elevation used in a question)

Intonation Profiles

Pt. reads printed sentences containing lines to show intonation changes

Lines drawn immediately below words = flat intonation

Lines farther below = drop in pitch

Lines above the words = rise in pitch

These lines can easily be added to any written material

Start with short, simple sentences, then progress to longer sentences

Ultimately, you want pt. to use these same types of pitch changes in conversational speech

Contrastive Stress Drills

Place a picture between the pt. and the SLP

The clinician asks questions about the picture and the pt. answers by adding stress on the key word(s) that convey the intended meaning of the answer.

Vary the length and complexity of the pictures and sentences, as appropriate.

Chunking Utterances into Syntactic Units

If the pt’s dysarthria limits the number of words produced on a single inhalation, they may need to learn how to take replenishing breaths at natural pause points

Begin by marking written phrases and sentences to indicate where, syntactically, natural pause points would occur, often where comma or period might occur (e.g.’ “In the morning,/ I went shopping at the mall”)

Practice these patterns to establish a more natural rhythm

Ultimately work on carry-over to conversational speech (structured conversation activities – to – conversation)