Speech pacing is a common strategy used by speech therapists to treat many types of dysarthria.
Speech pacing can also be of benefit in the treatment of apraxia of speech, stuttering and cluttering.
The reason speech pacing is often used in dysarthria treatment is that in many dysarthria cases slowing rate of speech helps improve speech clarity and intelligibility.
Speech Pacing Activities
Traditionally paper-based pacing boards for speech and quarter boards have been used in dysarthria treatment. The user taps one circle or quarter for each syllable or word that they say.
This dysarthria treatment approach can certainly be effective for some but often the person with dysarthria will tap too quickly and then speak too quickly as a result. In other cases, the person may find it hard to tap as they talk and have difficulty correctly slowing their rate of speech.This problem is what inspired the making of the Conversation Paceboard, a pacing board app.
A Pacing Board App For Speech
Conversation Paceboard adds a high-tech feature to the traditional pacing board for speech – visual cues that prompt the user when to move to the next circle and say the next syllable or word.
Each circle on the pacing board fills with colour when touched. There is an adjustable time delay for when a slower rate is required. When a circle has filled with colour, a checkmark/tick appears to indicate that the user should move to the next circle, and say the next syllable or word. If the user goes too fast and doesn’t wait for each circle to fill with colour, “Too Quick!” flashes on screen.
On iPhone, there is also tactile feedback: each circle on the pacing board vibrates when filled with colour to help the person with dysarthria to know when they can move on and say the next syllable or word.
Watch Conversation Paceboard in action in this video.
Dysarthria Exercises: Conversation Questions
Conversation Paceboard as the name suggests also has conversation questions to get the conversation started. There is a broad range of questions to choose from simple ice-breakers to thought-provoking questions which are cognitively more challenging.
Speech Pacing Tips: Using Conversation Paceboard
Tip 1: Build self-awareness & give bio-feedback
Encourage the person with dysarthria to monitor their speech and give self-ratings. At the start of speech therapy, it’s a really good idea to record (with consent) the person with dysarthria answering a question without Conversation Paceboard and then answering the same question when using Conversation Paceboard. The aim is to contrast the person’s increased clarity of speech and intelligibility with how their speech is when it is not paced.
As Rosenbek (2017) notes, people with dysarthria often lack awareness of what makes their speech different and hard for others to understand. Building this self-awareness and giving bio-feedback is fundamental for change. See ‘Mind Over Matter’ article by Rosenbek (2017).
Tip 2: Give a continuous model
Give a model when using Conversation Paceboard with people with dysarthria by using it to slow your own rate of speech. Touch a button as you say the first syllable or word, wait for it to fill with colour and then say the next syllable or word as you touch the next button and so on. When the person with dysarthria sees you making the effort to slow your rate of speech and articulate each word carefully, they not only follow what you are asking them to do but they are also more motivated to do it.
Tip 3: Keep conversation natural
Keep the conversation with the person with dysarthria natural by asking more questions on the same topic or commenting on what they have said/giving your opinion. When there’s no more to say on that particular topic, move to a different conversation starter.
Tip 4: Train family members to take on speech therapist’s role at home
Family members are encouraged to use Conversation Paceboard with the person with dysarthria to practise slower and clearer conversations at home. Again, this motivates the individual with dysarthria to slow down their rate of speech and it becomes more of a shared and supported experience. Continued and regular practice at home also promotes carryover into everyday speech.