The efficacy of speech intervention using electropalatography with an 18-year-old deaf client: A single case study

Clinical application of usage-based phonology: Treatment of cleft palate speech using usage-based electropalotography

PURPOSE

To investigate whether a novel electropalatography (EPG) therapy, underpinned by usage-based phonology theory, can improve the accuracy of target speech sounds for school-aged children and adults with persistent speech sound disorder (SSD) secondary to cleft palate +/- lip.

METHOD

Six consecutively treated participants (7-27 years) with long-standing speech disorders associated with cleft palate enrolled in a multiple baseline (ABA) within-participant case series. The usage-based EPG therapy technique involved high-volume production of words. Speech was assessed on three baselines prior to therapy, during weekly therapy, at completion of therapy, and 3 months post-therapy. Percent correct of target phonemes in untreated words and continuously connected speech were assessed through acoustic phonetic transcription. Intra- and inter-transcriber agreement was determined.

RESULT

Large to medium treatment effect sizes were shown for all participants following therapy (15-33 sessions). Percentage of targets correct for untreated words improved from near 0% pre-therapy, to near 100% for most target sounds post-therapy. Generalisation of target sounds to spontaneous connected speech occurred for all participants and ranged from 78.95-100% (M = 90.66; SD = 10.14) 3 months post-therapy.

CONCLUSION

Clinically significant speech change occurred for all participants following therapy. Response to the novel therapeutic technique is encouraging and further research is indicated.

Investigation into the effectiveness of electropalatography in treating persisting speech sound disorders in adolescents with co-occurring developmental language disorder

This study aimed to assess the effectiveness of electropalatography (EPG) intervention in targeting specific phonemes/words in seven adolescents aged 14:10-18:06 with co-occurring speech sound and language disorders. Progress on individualised targets versus controls was evaluated following intervention undertaken as part of the participants' usual speech and language therapy provision. As a group, the participants showed significantly greater progress on their targets than controls, indicating that the EPG intervention was effective. However, performance varied between participants, targets and school terms. Factors that may have influenced the effectiveness of intervention include spending more time on targets and focusing on a specific phoneme. Overall, the results suggest EPG should be considered as an intervention approach for this client group, even in the late teenage years.

Efficacy of Electropalatography for Treating Misarticulation of /r/

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.

Generalised EPG treatment effect in a cochlear implant user maintained after 2 years

PURPOSE

The aim of this study was to evaluate speech therapy using electropalatography (EPG) in home training of persistent articulation errors in a cochlear implant user with hearing impairment. There was a particular focus on aspects of maintenance of training effects and possible transfer to connected speech.

METHOD

The participant was a young woman, deaf from early childhood and a cochlear implant user from pre-school age. Treatment effects were evaluated using a single-subject design with multiple measures.

RESULT

Instrumental and perceptual outcome measures showed a clear improvement in the production of the treatment target /ɡ/ in single words and sentences after 4 months of therapy (17 hours). The results were maintained at 3, 6 and 24 months after intervention. Also, /ɡ/ in connected speech, consisting of text reading and spontaneous speech, showed a significant difference between before and after treatment and at long-term follow-up.

CONCLUSION

The results show that EPG used in home training can be an efficient method for treating persistent speech disorders associated with hearing impairment and that the treatment effect appears to maintain.

Long-term outcomes of speech therapy for seven adolescents with visual feedback technologies: ultrasound and electropalatography

This follow-up study investigated the speech production of seven adolescents and young adults with hearing impairment 2-4 years after speech intervention with ultrasound and electropalatography. Perceptual judgments by seven expert listeners revealed that five out of seven speakers either continued to generalize post-treatment or maintained their level of performance post-treatment. Targets included fricatives, vowels and the rhotic /ɹ/. Speakers ranged in age from 14 to 19 years. Listeners were considered to be expert listeners. All listeners had extensive backgrounds in phonetics and phonology and were speech-language pathologists. This long-term investigation revealed that speech habilitation with visual feedback tools as adjuncts to therapy appeared to have lasting effects. The implications for habilitation include reduced therapy times and outcomes not previously possible.

Physiological investigation of dysarthria: recent advances

Recent years have seen the development and introduction of a range of new physiological instruments for investigating various aspects of articulatory function in persons with dysarthria. Included among these techniques are electromagnetic articulography (EMA), electropalatography (EPG), and pressure-sensing EPG. The aim of this paper is to describe and evaluate these techniques, highlighting their relative advantages, disadvantages, and specific applications in assessing articulation in speakers with dysarthria associated with a variety of neurological disorders. Emphasis will be given to those instruments that enable researchers and clinicians to examine articulatory functions in 3-dimensions, such as 3D-EMA (AG500) and 3D-EPG. In addition the application of pressure-sensing EPG and ultrasonography will be outlined. Each of these physiological techniques will be fully described in terms of their component hardware and underlying principles of operation. The use of each technique in the assessment of dysarthria will be illustrated wherever possible by reference to specific case examples, and especially cases drawn from various neuropathological groups. Research findings reported to date based on each of the above physiological instruments will be reviewed and the research summarized.