Pacing is a common strategy used by Speech Therapists to treat many types of dysarthria, apraxia of speech, stuttering and cluttering. Traditionally paper pacing boards and quarter boards have been used. The user taps one circle or quarter for each syllable or word that they say. This treatment approach can certainly be effective for some but often the person 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 pacing their speech.
This problem is what inspired the making of the Conversation Paceboard app. It adds a high-tech feature to the traditional pacing board – visual cues that prompt the user when to move to the next circle and say the next syllable or word. Each button fills with colour when touched. There is an adjustable time delay for when a slower rate is required. When the button has filled with colour, a checkmark/tick appears to indicate that the user should move to the next button and say the next syllable or word. If the user goes too fast and doesn’t wait for each button to fill with colour, the word “Too Quick!” flashes on screen.
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.
Pacing Therapy Tip 1: Build self-awareness & give bio-feedback
Encourage clients to monitor their speech and give self-ratings. At the start of the therapy, it’s a really good idea to record (with consent) the client answering a question without Conversation Paceboard and then answering the same question when using Conversation Paceboard. The aim is to contrast the client’s increased clarity of speech and intelligibility with how their speech is when it is not paced.
As Rosenbek (2017) notes, clients 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).
Pacing Therapy Tip 2: Give a continuous model
Give a model when using Conversation Paceboard with clients 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 user 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.
Pacing Therapy Tip 3: Keep conversation natural
Keep the conversation natural by asking more questions on the same topic or commenting on what the client has said/giving your opinion. When there’s no more to say on that particular topic, move to a different conversation starter.
Pacing Therapy Tip 4: Train family members to take on therapist’s role at home
Family members are encouraged to use Conversation Paceboard with the client to practice slower and clearer conversations at home. Again, this motivates the client to pace their speech and it becomes more of a shared and supported experience. Continued and regular practice at home also promotes carryover into everyday speech.