Retrospective examination of failed rate-control intervention

Individuals with motor-speech disorders are frequently admonished by clinicians to "slow down" to improve speech intelligibility and comprehensibility. Although most reports of rate-control therapy highlight the benefits of specific procedures, all patients are not candidates for these interventions. The subject of this clinical report is AC, a 40-year-old man who had spoken with an extremely rapid speech rate for 17 years following a traumatic brain injury but was never treated for the problem. Traditional rate-control interventions were not effective in slowing AC's speech rate nor in reducing its handicapping effects. In this report we supply background information on AC; initial assessment data from speech-language pathology, neurology, and neuropsychology; and describe rate-control interventions that were not effective with AC. A retrospective examination of this case was conducted to elucidate possible reasons why treatment was unsuccessful. This involved (a) an instrumental assessment of selected features of AC's speech rate (using equipment not available for the initial evaluation) and (b) a reinterpretation of other assessment information. Findings revealed how AC's speech differed from that of a normally speaking control subject and other normative data and provided insights on how he accomplished his rapid speech rate. This prompted us to consider (a) possible explanations for AC's fast rate, (b) reasons for failed rate-control intervention, and (c) what we learned from this case that would be useful to clinicians in management of similar patients.