Supporting Clinical Decision Making
Supporting Clinical Decision Making
We aim to produce research and frameworks that clinicians can use to:
- Strengthen diagnostic reasoning
- Interpret complex speech profiles
- Connect theory to real-world clinical decision making
Our work bridges research and practice, providing clinicians with tools and frameworks that support evidence-based assessment and intervention.
The Colorado Motor Speech Framework (CMSF)
The Colorado Motor Speech Framework (CMSF) is a core contribution of the lab and reflects our commitment to clinically meaningful theory. It is a conceptual framework that organizes motor speech disorders around underlying mechanisms of speech motor planning, subsystem coordination, and motor execution.
Clinicians may find the CMSF useful for:
- Teaching and supervising students
- Organizing differential diagnosis
- Interpreting mixed or atypical speech profiles
- Linking perceptual features to underlying motor mechanisms
CMSF in Practice
Using the Framework to Support Clinical Reasoning
The following examples demonstrate how clinicians can use the Colorado Motor Speech Framework to organize observations, explore underlying mechanisms, and support assessment and treatment planning.
Patient Background
A 62-year-old individual presents with reduced speech naturalness and inconsistent articulatory breakdowns.
Observed Characteristics
- Variable speech rate
- Irregular articulatory errors
- Reduced naturalness
- Fluctuating intelligibility
Using the CMSF
The clinician enters observations into the CMSF and reviews the resulting network of relationships.
The framework highlights potential contributions from:
✓ Coordination across speech subsystems
✓ Motor execution processes
while showing less support for speech motor planning involvement.
Clinical Reflection
The CMSF helps the clinician move beyond a broad diagnostic label and consider which underlying processes may be contributing most strongly to the observed speech characteristics.
Patient Background
A 58-year-old individual presents with inconsistent speech errors and difficulty producing complex words.
Observed Characteristics
- Inconsistent articulatory distortions
- Trial-and-error productions
- Difficulty sequencing speech movements
- Relatively preserved voice quality
Using the CMSF
After entering observations into the framework, the network demonstrates strong connections to characteristics associated with speech motor planning.
Clinical Reflection
The CMSF helps organize observations in a way that supports diagnostic reasoning and facilitates discussion of possible mechanisms underlying the speech presentation.
Patient Background
A 70-year-old individual reports that family members frequently ask them to repeat themselves.
Observed Characteristics
- Reduced loudness
- Monopitch
- Short rushes of speech
- Reduced speech intelligibility
Using the CMSF
The CMSF highlights several characteristics associated with motor execution and respiratory-laryngeal control.
Clinical Reflection
The framework supports the clinician in identifying speech characteristics that may warrant further assessment and may influence treatment planning.
Key Research Themes
Speech Naturalness and Intelligibility
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Respiratory-Laryngeal Coordination
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Motor Speech Variability
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Measurement approaches in Dysarthria and Apraxia of Speech
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Questions We Help Clinicians Answer
Our research examines how differences in speech motor planning, subsystem coordination, and motor execution contribute to variability in speech characteristics. The CMSF provides a framework for considering why individuals with the same diagnosis may present with different speech profiles.
The lab investigates how respiratory and laryngeal systems work together to support speech production. Our work explores how disruptions in coordination may contribute to reduced speech naturalness, intelligibility, and communicative effectiveness.
Clinicians often rely on perceptual observations during assessment. Our research seeks to better understand how those observations relate to measurable speech motor behaviors, helping bridge clinical judgment and objective measurement.
Traditional diagnostic labels do not always capture the complexity of speech presentations. Our work explores mechanism-based approaches that focus on observable speech characteristics and underlying motor processes rather than diagnosis alone.
Methods We Study
- Perceptual evaluation of speech features
- Acoustic measures
- Kinematic measures
- Repetitive and connected speech tasks
- Subsystem coordination
Why It Matters
- Helps clinicians understand what different measures reveal about speech performance
- Connects measurable speech behaviors to underlying motor control mechanisms
- Supports more informed interpretation of assessment findings
- Provides evidence that can strengthen clinical judgment and decision-making.
- Helps identify meaningful targets for intervention.