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Zhang S, Wang T, Tang L, Li X, Shang Z, Zhou T, Lan N, Yang L, Zhou H. Assessment Methods and Intervention Strategies for Cleft-Related Lateral Misarticulation in Chinese-Speaking Children. J Craniofac Surg 2024; 35:1523-1530. [PMID: 38830019 DOI: 10.1097/scs.0000000000010349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 05/03/2024] [Indexed: 06/05/2024] Open
Abstract
The aim of this study was to analyze the characteristics and error speech features of cleft-related lateral misarticulation and provide a basis for clinical evaluation and rational intervention. Participants who were diagnosed with lateral misarticulation after cleft palate repairment were 126 children aged 4, 6 to 16, and 11, and they had complete palatopharyngeal closure, no abnormalities in their speech organs and occlusion, and no hearing or intellectual impairments. The Chinese standard pronunciation clarity word list, the American KAY CSL4500, the Beijing Yangchen YF-16 computer speech analysis workstation, soundproof rooms, Wechsler scales of intelligence-fourth edition, and audiometers were used to evaluate the cleft-related lateral misarticulation. Statistical analysis was performed on the age, gender, error rate, corner of the mouth deviation direction, comorbidity, duration of intervention, period of treatment, and therapeutic effect of concentrated or normal intervention group in different patients. Our results showed that 2 to 3 straight stripes were visible at the onset of consonants /ti:/ /t'i:/, and 3 clear straight lines were visible in /tʂ/, indicating that the lateralized sound had 2 or 3 bursts and lasted for 1 to 2 ms. The onset age of lateralized sound was mostly below 12 years old. Chinese lateralized sound mainly occurred in vowel /i:/, and the occurrence rate of consonants with tongue surface /tɕ]/ /tɕ'/ /ɕ/ was the highest. In addition, the corner of the mouth deviation was also an indicator of lateralization sound, and other types of speech disorders mostly accompanied it. There was a significant difference in the improvement of speech clarity between the concentrated intervention group and the normal group before and after treatment. The 2 groups' average duration and course of treatment were not significantly different. Still, the period of concentrated intervention was shortened considerably, and the speech clarity of both groups of children after treatment exceeded 96%, reaching a normal level.
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Affiliation(s)
| | | | - Lihua Tang
- Medical Record Room, The Second Affiliated Hospital of Harbin Medical University
| | - Xiao Li
- Department of Cleft Palate Speech, Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Harbin Medical University, China
| | - Zibo Shang
- International Air Transport Association, Canada
| | - Tianyi Zhou
- Department of Orthopedics, The First Affiliated Hospital of Harbin Medical University
| | - Na Lan
- Department of Cleft Palate Speech, Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Harbin Medical University, China
| | - Lijun Yang
- Beijing Yangchen Electronic Technology Co., Ltd., China
| | - Haiyan Zhou
- Department of Cleft Palate Speech, Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Harbin Medical University, China
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Shields R, Hopf SC. Intervention for residual speech errors in adolescents and adults: A systematised review. CLINICAL LINGUISTICS & PHONETICS 2024; 38:203-226. [PMID: 36946222 DOI: 10.1080/02699206.2023.2186765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 02/23/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
When speech sound errors persist beyond childhood they are classified as residual speech errors (RSE) and may have detrimental impacts on an individual's social, educational and employment participation. Despite this, individuals who present with RSE are usually not prioritised on large caseloads. The aim of this literature review was to examine what intervention approaches are available in remediating RSE, and how effective are they for adolescents and adults? A systematised review was undertaken. Comprehensive and systematic searching included search of terms across seven databases, forward and reverse citation searching, and key author contact. Thirty articles underwent critical appraisal before data extraction. Inductive thematic analysis was done before completion of a narrative review. Twenty-three (76.6%) of the articles were from the US and most studies involved intervention for 'r' (90%). Intervention approaches for RSE involved traditional articulation therapy, auditory perceptual training, instrumental approaches, and approaches based on principles of motor learning. Twenty-one studies (70%) investigated the use of more than one intervention approach. Measures of intervention efficacy varied between studies; however, any intervention approach tended to be more successful if delivered in a more intensive schedule. A variety of approaches can be used for RSE, but a combination of high intensity, traditional therapy with adjunctive instrumental biofeedback may be most effective, especially with highly motivated individuals. Unfortunately, this usually requires costly equipment and training to implement. More information about the best dosage and intensity intervention for RSE, evaluated for a larger number of phonemes across other languages and dialects is required.
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Affiliation(s)
- Rebecca Shields
- Speech Pathology Department, School of Allied Health, Exercise and Sport Sciences, Charles Sturt University, Albury, Australia
| | - Suzanne C Hopf
- Speech Pathology Department, School of Allied Health, Exercise and Sport Sciences, Charles Sturt University, Albury, Australia
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Overby MS, Mazeika S, DiFazio M, Ioli J, Birch K, Devorace L. Clinicians' Perspectives of Treatment for Lateralization Errors: A Quantitative and Qualitative Study. Lang Speech Hear Serv Sch 2022; 53:749-767. [PMID: 35679621 DOI: 10.1044/2022_lshss-21-00109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE This mixed-methods study aimed to obtain information regarding speech-language pathologists' (SLPs) perspectives about treatment of lateralization errors (LEs), challenges to implementing evidence-based LE treatment practice, and the sources SLPs' use to find evidence to treat LEs. This information can assist our understanding of ways to facilitate the uptake of evidence-based practice into the everyday treatment of clients with this disorder. METHOD A convergent parallel mixed-methods design was used to collect data from SLPs (N = 214) using 24 questions from an online survey distributed through electronic mailing lists and Speech and Hearing State Associations. Quantitative data were analyzed using frequencies and averages; themes and subthemes of qualitative data were analyzed using a content analysis approach with no a priori codes. Quantitative and qualitative results were compared and integrated. RESULTS Participants believed that LEs required individualized treatment before the age of 5 years, were largely caused by structural and neuromuscular factors, and required an understanding of orofacial and dental structure and function. Challenges to implementing LE treatment included a lack of skills and knowledge specific to LEs, competing demands on clinicians' time and resources, and a research-practice gap. Sources of evidence frequently used to obtain information about LE treatment were colleagues, trainings, workshops, and American Speech-Language-Hearing Association journals. CONCLUSIONS Clinicians believe that LE treatment is challenging and requires skill training. Future research in LEs will need to consider the real-world decisions clinicians must make when treating this disorder as well as clinicians' everyday constraints and challenges.
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Affiliation(s)
- Megan S Overby
- Department of Speech-Language Pathology, Duquesne University, Pittsburgh, PA
| | - Sarah Mazeika
- Department of Speech-Language Pathology, Duquesne University, Pittsburgh, PA
| | - Magdalena DiFazio
- Department of Speech-Language Pathology, Duquesne University, Pittsburgh, PA
| | - Julianna Ioli
- Department of Speech-Language Pathology, Duquesne University, Pittsburgh, PA
| | - Katherine Birch
- Department of Speech-Language Pathology, Duquesne University, Pittsburgh, PA
| | - Lauren Devorace
- Department of Speech-Language Pathology, Duquesne University, Pittsburgh, PA
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Barbier G, Merzouki R, Bal M, Baum SR, Shiller DM. Visual feedback of the tongue influences speech adaptation to a physical modification of the oral cavity. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2021; 150:718. [PMID: 34470311 DOI: 10.1121/10.0005520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 06/15/2021] [Indexed: 06/13/2023]
Abstract
Studies examining sensorimotor adaptation of speech to changing sensory conditions have demonstrated a central role for both auditory and somatosensory feedback in speech motor learning. The potential influence of visual feedback of oral articulators, which is not typically available during speech production but may nonetheless enhance oral motor control, remains poorly understood. The present study explores the influence of ultrasound visual feedback of the tongue on adaptation of speech production (focusing on the sound /s/) to a physical perturbation of the oral articulators (prosthesis altering the shape of the hard palate). Two visual feedback groups were tested that differed in the two-dimensional plane being imaged (coronal or sagittal) during practice producing /s/ words, along with a no-visual-feedback control group. Participants in the coronal condition were found to adapt their speech production across a broader range of acoustic spectral moments and syllable contexts than the no-feedback controls. In contrast, the sagittal group showed reduced adaptation compared to no-feedback controls. The results indicate that real-time visual feedback of the tongue is spontaneously integrated during speech motor adaptation, with effects that can enhance or interfere with oral motor learning depending on compatibility of the visual articulatory information with requirements of the speaking task.
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Affiliation(s)
- Guillaume Barbier
- École d'Orthophonie et d'Audiologie, Université de Montréal, Case Postale 6128, Succursale Centre-Ville, Montréal, Québec H3C 3J7, Canada
| | - Ryme Merzouki
- École d'Orthophonie et d'Audiologie, Université de Montréal, Case Postale 6128, Succursale Centre-Ville, Montréal, Québec H3C 3J7, Canada
| | - Mathilde Bal
- École d'Orthophonie et d'Audiologie, Université de Montréal, Case Postale 6128, Succursale Centre-Ville, Montréal, Québec H3C 3J7, Canada
| | - Shari R Baum
- School of Communication Sciences and Disorders, McGill University, 2001 McGill College Avenue, Suite 800, Montréal, Québec H3A 1G1, Canada
| | - Douglas M Shiller
- École d'Orthophonie et d'Audiologie, Université de Montréal, Case Postale 6128, Succursale Centre-Ville, Montréal, Québec H3C 3J7, Canada
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Mat Zin S, Md Rasib SZ, Suhaimi FM, Mariatti M. The technology of tongue and hard palate contact detection: a review. Biomed Eng Online 2021; 20:17. [PMID: 33549118 PMCID: PMC7866712 DOI: 10.1186/s12938-021-00854-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 01/23/2021] [Indexed: 11/10/2022] Open
Abstract
The tongue and hard palate play an essential role in the production of sound during continuous speech. Appropriate tongue and hard palate contacts will ensure proper sound production. Electropalatography, also known as EPG, is a device that can be used to identify the location of the tongue and hard palate contact. It can also be used by a speech therapist to help patients who have a speech disorder. Among the group with the disease are cleft palate, Down syndrome, glossectomy, and autism patients. Besides identifying the contact location, EPG is a useful medical device that has been continuously developed based on the patient's needs and treatment advancement. This article reviews the technology of electropalatography since the early introduction of the device. It also discusses the development process and the drawbacks of the previous EPG systems, resulting in the EPG's upgraded system and technology. This review suggests additional features that can be useful for the future development of the EPG. The latest technology can be incorporated into the EPG system to provide a more convenient method. There are some elements to be considered in the development of EPG's new technology that were discussed in this study. The elements are essential to provide more convenience for the patient during speech therapy. New technology can accelerate the growth of medical devices, particularly on the development of speech therapy equipment that should be based on the latest technological advancements available. Thus, the advanced EPG system suggested in this article may expand the usage of the EPG and serve as a tool to provide speech therapy treatment services and not limited to monitoring only.
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Affiliation(s)
- Syatirah Mat Zin
- Craniofacial and Biomaterial Sciences Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, 13200, Kepala Batas, Penang, Malaysia
| | - S Z Md Rasib
- School of Materials and Mineral Resources Engineering, Universiti Sains Malaysia, Engineering Campus, 14300, Nibong Tebal, Penang, Malaysia
| | - Fatanah M Suhaimi
- Craniofacial and Biomaterial Sciences Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, 13200, Kepala Batas, Penang, Malaysia.
| | - M Mariatti
- School of Materials and Mineral Resources Engineering, Universiti Sains Malaysia, Engineering Campus, 14300, Nibong Tebal, Penang, Malaysia
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Overby MS, Moorer LL, Belardi K, Schreiber J. Retrospective video analysis of the early speech sound development of infants and toddlers later diagnosed with lateralisation errors. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 22:196-205. [PMID: 31382784 DOI: 10.1080/17549507.2019.1645884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose: Although lateralisation errors (LEs) are a common speech sound disorder, no studies have examined their early development. The purpose of this exploratory small-scale investigation was to compare the early (birth-24 months) speech sound development between children later diagnosed with LEs and typically developing children.Method: This was a between-group case-controlled design with six monolingual English-speaking participants. Participants were White, non-Hispanic girls with at least one college-educated parent. As children, three had been diagnosed with lateralisation speech sound errors and three demonstrated typical speech sound development. Participants' parents provided home video-recordings of the participants as infants/toddlers between birth and age 2. These videos were then analysed for the amount, type and diversity of sounds, and canonical babbling onset.Result: There was no statistically significant between-group difference in the volubility (i.e. combined frequency of non-resonant and resonant utterances) or in the age at which [s] or [z] emerged. However, infants/toddlers who were later diagnosed with LEs showed reduced frequency/minute in production of resonant utterances and consonants (including [s, z]), used fewer different consonants/minute, and used fewer syllable shapes/minute compared to typically developing infants/toddlers. At 7-12 months, none of the infants/toddlers later diagnosed with LEs, but all participants in the comparison group had reached the canonical babbling stage.Conclusion: Children who have LEs may have had a less robust speech sound system as infants/toddlers than their typically developing peers. However, these findings must be considered with caution due to the significant limitations of this investigation.
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Affiliation(s)
- Megan S Overby
- Department of Speech-Language Pathology, Duquesne University, Pittsburgh, PA, USA
| | - Laura L Moorer
- Department of Communication Sciences and Disorders, Texas Woman's University, Denton, TX, USA
| | - Katie Belardi
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, PA, USA
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Mauszycki SC, Wambaugh JL. Acquired Apraxia of Speech: Comparison of Electropalatography Treatment and Sound Production Treatment. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:511-529. [PMID: 31693389 DOI: 10.1044/2019_ajslp-cac48-18-0223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose This investigation compared 2 treatment approaches for acquired apraxia of speech. The effects of a treatment that uses an articulatory-kinematic approach in conjunction with visual biofeedback (VBFB) via electropalatography (EPG) were compared to Sound Production Treatment (SPT), an established behavioral treatment that is also an articulatory-kinematic approach. Method A multiple baseline design across behaviors and participants was used with 2 participants with chronic apraxia of speech and aphasia. Accuracy of target speech sounds in treated and untreated words or phrases in probe sessions served as the dependent variable. The effects of 2 treatments based on an articulatory-kinematic approach were compared: (a) VBFB via EPG and (b) SPT. The order of treatments was counterbalanced across participants. Results Positive changes in articulatory accuracy were observed for SPT and VBFB treatment via EPG. Generalization to untreated stimulus items composed of treated speech sounds was also positive for both treatments. However, participants achieved greater articulatory accuracy with SPT during treatment and better long-term maintenance. Discussion Both treatment approaches resulted in improved speech production accuracy, but gains were greater for SPT. However, further research with additional participants is needed due to the small sample size included in this investigation.
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Affiliation(s)
- Shannon C Mauszycki
- Aphasia/Apraxia of Speech Research Program, VA Salt Lake City Health Care System, UT
- Department of Communication Sciences and Disorders, University of Utah, Salt Lake City
| | - Julie L Wambaugh
- Aphasia/Apraxia of Speech Research Program, VA Salt Lake City Health Care System, UT
- Department of Communication Sciences and Disorders, University of Utah, Salt Lake City
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Namasivayam AK, Coleman D, O’Dwyer A, van Lieshout P. Speech Sound Disorders in Children: An Articulatory Phonology Perspective. Front Psychol 2020; 10:2998. [PMID: 32047453 PMCID: PMC6997346 DOI: 10.3389/fpsyg.2019.02998] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Accepted: 12/18/2019] [Indexed: 01/20/2023] Open
Abstract
Speech Sound Disorders (SSDs) is a generic term used to describe a range of difficulties producing speech sounds in children (McLeod and Baker, 2017). The foundations of clinical assessment, classification and intervention for children with SSD have been heavily influenced by psycholinguistic theory and procedures, which largely posit a firm boundary between phonological processes and phonetics/articulation (Shriberg, 2010). Thus, in many current SSD classification systems the complex relationships between the etiology (distal), processing deficits (proximal) and the behavioral levels (speech symptoms) is under-specified (Terband et al., 2019a). It is critical to understand the complex interactions between these levels as they have implications for differential diagnosis and treatment planning (Terband et al., 2019a). There have been some theoretical attempts made towards understanding these interactions (e.g., McAllister Byun and Tessier, 2016) and characterizing speech patterns in children either solely as the product of speech motor performance limitations or purely as a consequence of phonological/grammatical competence has been challenged (Inkelas and Rose, 2007; McAllister Byun, 2012). In the present paper, we intend to reconcile the phonetic-phonology dichotomy and discuss the interconnectedness between these levels and the nature of SSDs using an alternative perspective based on the notion of an articulatory "gesture" within the broader concepts of the Articulatory Phonology model (AP; Browman and Goldstein, 1992). The articulatory "gesture" serves as a unit of phonological contrast and characterization of the resulting articulatory movements (Browman and Goldstein, 1992; van Lieshout and Goldstein, 2008). We present evidence supporting the notion of articulatory gestures at the level of speech production and as reflected in control processes in the brain and discuss how an articulatory "gesture"-based approach can account for articulatory behaviors in typical and disordered speech production (van Lieshout, 2004; Pouplier and van Lieshout, 2016). Specifically, we discuss how the AP model can provide an explanatory framework for understanding SSDs in children. Although other theories may be able to provide alternate explanations for some of the issues we will discuss, the AP framework in our view generates a unique scope that covers linguistic (phonology) and motor processes in a unified manner.
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Affiliation(s)
- Aravind Kumar Namasivayam
- Oral Dynamics Laboratory, Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Deirdre Coleman
- Oral Dynamics Laboratory, Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada
- Independent Researcher, Surrey, BC, Canada
| | - Aisling O’Dwyer
- Oral Dynamics Laboratory, Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada
- St. James’s Hospital, Dublin, Ireland
| | - Pascal van Lieshout
- Oral Dynamics Laboratory, Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
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Abstract
Purpose
Speech production is a complex 3-dimensional (3D) process, and yet most of what is known about it is derived from 2D midsagittal data. The relatively recent development of safe 3D imaging technologies (including magnetic resonance imaging and ultrasound) provide new opportunities to revisit and reformulate what is already known and to push the boundaries of current knowledge still further. A particularly useful imaging modality for this purpose is 3D/4D ultrasound, which until very recently was not well suited for studies in speech research. This technical report presents an overview of what 3D/4D ultrasound can contribute to speech research, with a focus on 2 demonstrations.
Conclusion
The 1st demonstration illustrates how 3D/4D ultrasound makes it possible to image certain vocal tract anatomical structures and planes that conventional 2D ultrasound is not capable of imaging. The 2nd demonstration illustrates how 3D/4D ultrasound can be combined with static 3D magnetic resonance imaging to provide new insight into the temporal pervasiveness and spatial extensiveness of lateral contact between the tongue and palate–teeth during speech production.
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Affiliation(s)
- Steven M. Lulich
- Department of Speech & Hearing Sciences, Indiana University, Bloomington
| | - William G. Pearson
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta
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Hitchcock ER, Byun TM, Swartz M, Lazarus R. Efficacy of Electropalatography for Treating Misarticulation of /r/. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2017; 26:1141-1158. [PMID: 28834534 DOI: 10.1044/2017_ajslp-16-0122] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 05/10/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE The purpose of the present study was to document the efficacy of electropalatography (EPG) for the treatment of rhotic errors in school-age children. Despite a growing body of literature using EPG for the treatment of speech sound errors, there is little systematic evidence about the relative efficacy of EPG for rhotic errors. METHOD Participants were 5 English-speaking children aged 6;10 to 9;10, who produced /r/ at the word level with < 30% accuracy but otherwise showed typical speech, language, and hearing abilities. Therapy was delivered in twice-weekly 30-min sessions for 8 weeks. RESULTS Four out of 5 participants were successful in achieving perceptually and acoustically accurate /r/ productions during within-treatment trials. Two participants demonstrated generalization of /r/ productions to nontreated targets, per blinded listener ratings. CONCLUSIONS The present findings support the hypothesis that EPG can improve production accuracy in some children with rhotic errors. However, the utility of EPG is likely to remain variable across individuals. For rhotics, EPG training emphasizes one possible tongue configuration consistent with accurate rhotic production (lateral tongue contact). Although some speakers respond well to this cue, the narrow focus may limit lingual exploration of other acceptable tongue shapes known to facilitate rhotic productions.
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Icht M, Ben-David BM. Sibilant production in Hebrew-speaking adults: Apical versus laminal. CLINICAL LINGUISTICS & PHONETICS 2017; 32:193-212. [PMID: 28727493 DOI: 10.1080/02699206.2017.1335780] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 05/24/2017] [Indexed: 06/07/2023]
Abstract
The Hebrew IPA charts describe the sibilants /s, z/ as 'alveolar fricatives', where the place of articulation on the palate is the alveolar ridge. The point of constriction on the tongue is not defined - apical (tip) or laminal (blade). Usually, speech and language pathologists (SLPs) use the apical placement in Hebrew articulation therapy. Some researchers and SLPs suggested that acceptable /s, z/ could be also produced with the laminal placement (i.e. the tip of the tongue approximating the lower incisors). The present study focused at the clinical level, attempting to determine the prevalence of these alternative points of constriction on the tongue for /s/ and /z/ in three different samples of Hebrew-speaking young adults (total n = 242), with typical articulation. Around 60% of the participants reported using the laminal position, regardless of several speaker-related variables (e.g. tongue-thrust swallowing, gender). Laminal production was more common in /s/ (than /z/), coda (than onset) position of the sibilant, mono- (than di-) syllabic words, and with non-alveolar (than alveolar) adjacent consonants. Experiment 3 revealed no acoustical differences between apical and laminal productions of /s/ and of /z/. From a clinical perspective, we wish to raise the awareness of SLPs to the prevalence of the two placements when treating Hebrew speakers, noting that tongue placements were highly correlated across sibilants. Finally, we recommend adopting a client-centred practice, where tongue placement is matched to the client. We further recommend selecting targets for intervention based on our findings, and separating between different prosodic positions in treatment.
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Affiliation(s)
- Michal Icht
- a Communication Disorders Department, Ariel University, Ariel, Israel
| | - Boaz M Ben-David
- b Communication, Aging and Neuropsychology Lab (CANlab) , Baruch Ivcher School of Psychology, Interdisciplinary Center (IDC) Herzliya , Herzliya , Israel
- c Department of Speech-Language Pathology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- d Toronto Rehabilitation Institute , University Health Network , Toronto, Ontario , Canada
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Mauszycki SC, Wright S, Dingus N, Wambaugh JL. The Use of Electropalatography in the Treatment of Acquired Apraxia of Speech. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2016; 25:S697-S715. [PMID: 27997947 DOI: 10.1044/2016_ajslp-15-0144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 03/28/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE This investigation was designed to examine the effects of an articulatory-kinematic treatment in conjunction with visual biofeedback (VBFB) via electropalatography (EPG) on the accuracy of articulation for acquired apraxia of speech (AOS). METHOD A multiple-baseline design across participants and behaviors was used with 4 individuals with chronic AOS and aphasia. Accuracy of target speech sounds in treated and untreated phrases in probe sessions served as the dependent variable. Participants received an articulatory-kinematic treatment in combination with VBFB, which was sequentially applied to 3 stimulus sets composed of 2-word phrases with a target speech sound for each set. RESULTS Positive changes in articulatory accuracy were observed for participants for the majority of treated speech sounds. Also, there was generalization to untreated phrases for most trained speech sounds. Two participants had better long-term maintenance of treated speech sounds in both trained and untrained stimuli. CONCLUSIONS Findings indicate EPG may be a potential treatment tool for AOS. It appears that individuals with AOS can benefit from VBFB via EPG in improving articulatory accuracy. However, further research is needed to determine if VBFB is more advantageous than behavioral treatments that have been proven effective in improving speech production for speakers with AOS.
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Affiliation(s)
- Shannon C Mauszycki
- VA Salt Lake City Healthcare System, Salt Lake City, UTUniversity of Utah, Salt Lake City
| | - Sandra Wright
- VA Salt Lake City Healthcare System, Salt Lake City, UT
| | - Nicole Dingus
- VA Salt Lake City Healthcare System, Salt Lake City, UT
| | - Julie L Wambaugh
- VA Salt Lake City Healthcare System, Salt Lake City, UTUniversity of Utah, Salt Lake City
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Heng Q, McCabe P, Clarke J, Preston JL. Using ultrasound visual feedback to remediate velar fronting in preschool children: A pilot study. CLINICAL LINGUISTICS & PHONETICS 2016; 30:382-397. [PMID: 26810299 PMCID: PMC4826297 DOI: 10.3109/02699206.2015.1120345] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Anecdotally, velar fronting can be difficult to remediate in some children. This pilot study examined the use of ultrasound visual feedback in remediating velar fronting in typically developing children. A single-case, multiple-baseline across-subjects experimental design was used to examine acquisition, retention and generalisation of velar treatment targets. Two otherwise typically developing children (P1, aged 4;0; P3, aged 4;11) completed the study. The productions of /k/ and /ɡ/ at syllable level were targeted during treatment. P1 improved her productions of /k/ and /ɡ/ at syllable level during the treatment period and achieved correct production at word level during follow-up. P3 made no improvements in his productions of velar targets. This study suggests that ultrasound visual feedback may be an option for remediating velar fronting in some preschoolers. Further study is required.
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Affiliation(s)
- Qiwen Heng
- University of Sydney, Australia
- KK Women’s and Children’s Hospital, Singapore
| | - Patricia McCabe
- University of Sydney, Australia
- Murdoch Children’s Research Institute, Australia
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Kearney E, Granata F, Yunusova Y, van Lieshout P, Hayden D, Namasivayam A. Outcome Measures in Developmental Speech Sound Disorders with a Motor Basis. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2015. [DOI: 10.1007/s40474-015-0058-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Liker M, Horga D, Mildner V. Electropalatographic specification of Croatian fricatives /s/ and /z/. CLINICAL LINGUISTICS & PHONETICS 2012; 26:199-215. [PMID: 21967279 DOI: 10.3109/02699206.2011.602460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Electropalatographic specification of alveolar fricatives in Croatian is aimed at providing speech therapists with normative data about the range of acceptable productions of /s/ and /z/ in adult speakers of Croatian. Four variables were analysed: place of articulation, total contact, groove width and hold phase duration. Intra- and inter-speaker variability for each variable was analysed. Lingual palatal cues for voicing difference were also quantified and discussed. Results show that Croatian /s/ and /z/ are alveolar and not dental as previously reported. The comparison between the voiced and the voiceless fricative shows that durational measures provide the best differentiation. The voiceless counterpart is significantly longer. The difference between voiced and voiceless is also found in the total contact, with /z/ having more contact in the anterior four rows of electrodes, while /s/ has more contact in the posterior four rows of electrodes. This difference is also reflected in the anterior and the posterior groove widths. Possibilities of using these results as normative data for the diagnosis and treatment of atypical articulation of /s/ and /z/ are discussed.
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Affiliation(s)
- Marko Liker
- Department of Phonetics, University of Zagreb, Zagreb, Croatia.
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Baker E, McLeod S. Evidence-Based Practice for Children With Speech Sound Disorders: Part 1 Narrative Review. Lang Speech Hear Serv Sch 2011; 42:102-39. [PMID: 20844274 DOI: 10.1044/0161-1461(2010/09-0075)] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose
This article provides a comprehensive narrative review of intervention studies for children with speech sound disorders (SSD). Its companion paper (Baker & McLeod, 2011) provides a tutorial and clinical example of how speech-language pathologists (SLPs) can engage in evidence-based practice (EBP) for this clinical population.
Method
Studies reporting speech sound intervention for children with SSDs published from 1979 to 2009 were identified and coded.
Results
One hundred thirty-four intervention studies were identified. Intervention typically was conducted by an SLP in a one-to-one individual format for 30- to 60-min sessions 2 to 3 times per week. Total duration of intervention (from assessment to discharge) was reported for 10 studies and ranged from 3 to 46 months. Most studies were either Level IIb (quasi-experimental studies, 41.5%) or Level III (nonexperimental case studies, 32.6%). Single-case experimental design (29.6%) was the most frequently used experimental research design. There were 7 distinct approaches to target selection and 46 distinct intervention approaches, with 23 described in more than 1 publication. Each approach was associated with varying quantities and levels of evidence, according to research design.
Conclusion
Collaborative research reflecting higher levels of evidence using rigorous experimental designs is needed to compare the relative benefits of different intervention approaches.
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Lohmander A, Henriksson C, Havstam C. Electropalatography in home training of retracted articulation in a Swedish child with cleft palate: effect on articulation pattern and speech. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2010; 12:483-496. [PMID: 20602582 DOI: 10.3109/17549501003782397] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The aim was to evaluate the effectiveness of electropalatography (EPG) in home training of persistent articulation errors in an 11-year-old Swedish girl born with isolated cleft palate. The /t/ and /s/ sounds were trained in a single subject design across behaviours during an eight month period using a portable training unit (PTU). Both EPG analysis and perceptual analysis showed an improvement in the production of /t/ and /s/ in words and sentences after therapy. Analysis of tongue-contact patterns showed that the participant had more normal articulatory patterns of /t/ and /s/ after just 2 months (after approximately 8 hours of training) respectively. No statistically significant transfer by means of intelligibility in connected speech was found. The present results show that EPG home training can be a sufficient method for treating persistent speech disorders associated with cleft palate. Methods for transfer from function (articulation) to activity (intelligibility) need to be explored.
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Affiliation(s)
- Anette Lohmander
- Department of Clinical Science, Intervention and Technique, Division of Speech and Language Pathology, Karolinska University Hospital, Karolinska Institute, Huddinge, Stockholm, Sweden.
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