A preliminary study on a speech improvement program through theater lessons for individuals with down syndrome: effects on speech fluency and clarity

Introduction
Recently, in Japan, there has been growing attention to casting individuals with disabilities, and the expressive abilities of those with down syndrome are highly valued. However, there is also the issue that casting individuals with unclear speech is difficult, which troubles directors. Therefore, the authors had the opportunity to participate in a speech improvement program in the context of theater lessons and examine the effects of this intervention. This paper reports on the content of this intervention.

Method
The study targeted 10 individuals (aged 7 to 22) diagnosed with Down syndrome and exhibiting moderate to severe intellectual disabilities. They reside in the Tokyo metropolitan area and regularly attend theater lessons. A total of six specialized lessons were conducted with the aim of improving speech abilities. These special theater lessons were designed to improve speech fluency and clarity and were led by a professional instructor who works as a director in television and theater. Pre- and post-intervention speech evaluations were conducted by a speech-language pathologist, and a questionnaire for parents was also administered.

Results
A comparison between pre- and post-intervention assessments showed improvements in diadochokinesis and speech motor control on word level. Additionally, fluency and clarity improved in reading the script aloud. While unintelligibility remained in some cases during free conversation, fluency had improved. According to the parents` responses to the questionnaire, both qualitative and quantitative improvements in general speech abilities were recognized.

Discussion
The improvement in diadochokinesis and speech programming tasks suggests that typical speech therapy could also be effective in these areas. However, it is speculated that the practice of speaking while performing slow, deliberate movements and acting, especially while watching videos, may have contributed to the improvement in speech clarity. This was a preliminary intervention, and the dependent variables were exploratory. Future research will aim to control for variables and clarify the specific training methods that most effectively influence skill improvement.

References
Kent, R. D., & Vorperian, H. K. (2013). Speech impairment in Down syndrome: A review. Journal of Speech, Language, and Hearing Research, 56(1), 178-210. doi: 10.1044/1092-4388(2012/12-0148).