Using Ultrasound to Quantify Tongue Shape and Movement Characteristics

The feasibility of visualizing and quantifying muscle changes in postoperative oral cancer patients using Quantitative Muscle Ultrasound (QMUS)

PURPOSE

Quantitative muscle ultrasound (QMUS) is a patient friendly tool for examining orofacial muscles. Resection of tissue can have an effect on the architecture and function of these muscles. The aim of this study is to investigate the feasibility of visualizing and quantifying muscle changes in postoperative oral cancer patients and to relate the findings to tumor and patient characteristics.

METHODS

Adult patients with a resected first primary pT1 or T2 oral squamous cell carcinoma, at least one year post operatively, where included. Ultrasound data were collected of the geniohyoid muscle, digastric muscles, masseter muscle, transverse muscle and genioglossus muscle. Ultrasound images were labeled as clearly visible, questionable or unclear. Of the clear muscles, echogenicity and muscle thickness were measured.

RESULTS

37 patients were included. The masseter muscle was clearly visible in all ultrasound images, both intrinsic tongue muscles had the lowest visibility (45.9%). There was a significant correlation between visibility and tumor localization for the genioglossus (p = 0.029). Age correlated with the visibility of the genioglossus muscle, BMI with the genioglossus and transverse muscles. Echogenicity and muscle thickness of the clearly identified muscles did not differ from normative values.

CONCLUSION

QMUS of orofacial muscles is feasible in postoperative oral cancer patients with relatively small tumor sizes. Tongue resections negatively affected the visibility of the two intrinsic tongue muscles. These preliminary results for particular muscles indicate that the use of ultrasound might be promising in oral cancer patients to help determine targeted goals in post-operative rehabilitation.

The Articulatory and Acoustic Representation of Second-Language French Vowels

This study examines how L1 English-L2 French learners use L1 articulatory and acoustic categories to produce L2 vowels that are both similar to and different from their L1 vowels. Previous studies examining the relationship between L1 and L2 sound inventories have found that learners reuse L1 phone categories to produce L2 phones that are perceived as similar, but importantly, there is a lack of articulatory data included in these types of studies, which has reinforced the assumption that vowel categories can be solely represented by their acoustic properties. The present study uses ultrasound tongue imaging data and videos of lip rounding in addition to acoustic data to examine how L1 English-L2 French learners produce the French vowels /i y u e ø o/ compared with their English vowels /i u e o/. The results focus on individual paths to category formation to show how learners articulate L2 vowels, and reveal that they tend to reuse L1 tongue body gestures to produce the French vowels /i u e o/, and lip rounding gestures to produce the round vowels /y u o/. This study demonstrates that transfer of articulatory gestures depends on vowel quality and emphasizes the importance of using articulatory data to inform theories of L2 category formation.

An Ultrasound Investigation of Tongue Dorsum Raising in Children with Cleft Palate +/- Cleft Lip

OBJECTIVE

This study aimed to determine whether increased raising of the back of the tongue is evident in children with repaired cleft palate with or without cleft lip (CP+/-CL). We hypothesized that children with CP+/-CL would show increased raising of the tongue dorsum, a compensatory pattern.

METHOD

Secondary data analysis of mid-sagittal ultrasound tongue imaging data from 31 children with CP+/-CL and 29 typically developing children were used. We annotated the consonants /ʃ, t, s, k/ at the point of maximum constriction in an /aCa/ environment. Children with CP+/-CL said the tokens 10 times, typically developing children said them once. We automatically fitted splines to the tongue contour and extracted the Dorsum Excursion Index (DEI) for each consonant. This metric measures the relative use of the tongue dorsum, with more posterior consonants having higher values. We compared DEI values across groups and consonants using a linear mixed effects model. DEI was predicted by the interaction of consonant (baseline: /ʃ/) and speaker type (baseline: TD), including by-speaker random slopes for consonant and random intercepts for speaker.

RESULTS

Overall DEI was not higher in children with CP+/-CL compared to typically developing children. Between groups the only significant difference was the position of /k/ relative to /ʃ/, where the difference between these two consonants was smaller in the children with CP+/-CL.

CONCLUSIONS

There was no support for the hypothesis that increased raising of the tongue dorsum is a common characteristic in children with repaired CP+/-CL. However, individual children may present with this pattern.

Ultrasound Tongue Imaging in Research and Practice with People with Cleft Palate ± Cleft Lip

Ultrasound tongue imaging is becoming popular as a tool for both phonetic research and biofeedback for treating speech sound disorders. Despite this, it has not yet been adopted into cleft palate ± cleft lip care. This paper explores why this might be the case by highlighting recent research in this area and exploring the advantages and disadvantages of using ultrasound in cleft palate ± cleft lip care. Research suggests that technological advances have largely overcome some of the difficulties of employing ultrasound with this population and we predict a future increase in the clinical application of the tool.

Tongue Shape Complexity in Children With and Without Speech Sound Disorders

PURPOSE

This study investigates the hypothesis that younger speakers and speakers with more severe speech sound disorders are more likely to use simpler (undifferentiated) tongue gestures due to difficulties with, or immaturity of, lingual motor control.

METHOD

The hypothesis is tested using cross-sectional secondary data analysis of synchronous audio and high-speed ultrasound recordings from children with idiopathic speech sound disorders (n = 30, aged 5;0-12;11 [years;months]) and typically developing children (n = 29, aged 5;8-12;10), producing /a/, /t/, /ɹ/, /l/, /s/, and /ʃ/ in an intervocalic /aCa/ environment. Tongue shape complexity is measured using NINFL (Number of INFLections) and modified curvature index (MCI) from splines fitted to ultrasound images at the point of maximal lingual gesture. Age, perceived accuracy, and consonant are used as predictors.

RESULTS

The results suggest that as age increases, children with speech sound disorders have lower MCI compared to typically developing children. Increase in age also led to decrease of MCI for the typically developing group. In the group of children with speech sound disorders, perceptually incorrect /ɹ/ productions have lower MCI than correct productions, relative to /a/.

CONCLUSIONS

There is some evidence of systematic tongue shape complexity differences between typically developing children and children with speech sound disorders when accounting for increase in age. Among children with speech sound disorders, increase in age and perceptually incorrect consonant realizations are associated with decreasing tongue shape complexity.

Speech assessment tool methods for speech impaired children: a systematic literature review on the state-of-the-art in Speech impairment analysis

Speech is a powerful, natural mode of communication that facilitates effective interactions in human societies. However, when fluency or flow of speech is affected or interrupted, it leads to speech impairment. There are several types of speech impairment depending on the speech pattern and range from mild to severe. Childhood apraxia of speech (CAS) is the most common speech disorder in children, with 1 out of 12 children diagnosed globally. Significant advancements in speech assessment tools have been reported to assist speech-language pathologists diagnosis speech impairment. In recent years, speech assessment tools have also gained popularity among pediatricians and teachers who work with preschoolers. Automatic speech tools can be more accurate for detecting speech sound disorders (SSD) than human-based speech assessment methods. This systematic literature review covers 88 studies, including more than 500 children, infants, toddlers, and a few adolescents, (both male and female) (age = 0-17) representing speech impairment from more than 10 countries. It discusses the state-of-the-art speech assessment methods, including tools, techniques, and protocols for speech-impaired children. Additionally, this review summarizes notable outcomes in detecting speech impairments using said assessment methods and discusses various limitations such as universality, reliability, and validity. Finally, we consider the challenges and future directions for speech impairment assessment tool research.

Comparison of auto-contouring and hand-contouring of ultrasound images of the tongue surface

Contours traced by trained phoneticians have been considered to be the most accurate way to identify the midsagittal tongue surface from ultrasound video frames. In this study, inter-measurer reliability was evaluated using measures that quantified both how closely human-placed contours approximated each other as well as how consistent measurers were in defining the start and end points of contours. High reliability across three measurers was found for all measures, consistent with treating contours placed by trained phoneticians as the 'gold standard.' However, due to the labour-intensive nature of hand-placing contours, automatic algorithms that detect the tongue surface are increasingly being used to extract tongue-surface data from ultrasound videos. Contours placed by six automatic algorithms (SLURP, EdgeTrak, EPCS, and three different configurations of the algorithm provided in Articulate Assistant Advanced) were compared to human-placed contours, with the same measures used to evaluate the consistency of the trained phoneticians. We found that contours defined by SLURP, EdgeTrak, and two of the AAA configurations closely matched the hand-placed contours along sections of the image where the algorithms and humans agreed that there was a discernible contour. All of the algorithms were much less reliable than humans in determining the anterior (tongue-tip) edge of tongue contours. Overall, the contours produced by SLURP, EdgeTrak, and AAA should be useable in a variety of clinical applications, subject to spot-checking. Additional practical considerations of these algorithms are also discussed.

Clinical Linguistics: Analysis of Mapping Knowledge Domains in Past, Present and Future

Across the world, many infants, children, adults, and elderly people are reported with many types of disorders and disabilities that damage, delay, or impede typical language development and/or use. Speech-language pathologists and other relevant clinicians are responsible for diagnosing, assessing, and rehabilitating these conditions. In nearly all types of disorders or disabilities that affect language, clinical linguistics plays a significant role in their study, diagnosis, and evaluation. This study provides a thorough analysis of the field of clinical linguistics. Data from Scopus, WOS, and Lens were used between 1981 and 2022. The documents included in the analysis were 1685, 1628, and 2677 articles published between 1981 and 2022 in clinical linguistics in Scopus, WOS, and Lens, respectively. For the purpose of assessing the development and impacts of the field of clinical linguistics, we used eight bibliometric and eight scientometric indicators. As part of the study, the results summarized the top contributors to clinical linguistics in terms of production size by year, country, university/research centre, journal, publisher, and author. The impact of the examined evidence on clinical linguistics was visualized and tabulated in the form of visual networks, citation counts, burst, cooccurrence, centrality, and sigma factors that are helpful in identifying the main influencers in clinical linguistics. A few examples of clinical linguistics patterns that are being explored extensively by researchers include cleft palate speech with model theories, visual feedback, motor speech disorders with instrumental analysis, acoustic analysis to understand conversational breakdown, nonlinear phonological theory, aphasic conversation in atypical interaction, and diagnostic markers in functional segments. There are also phonological disorders, William Syndrome, and the use of ultrasound, which may be considered potential clusters of clinical linguistics. A key contribution of this paper is highlighting the importance of clinical linguistics as well as its integration with linguistics, speech-language pathology, neurolinguistics, psycholinguistics, neuroscience, cognitive sciences, psychology, and psychometrics.

The Dorsal Differentiation of Velar From Alveolar Stops in Typically Developing Children and Children With Persistent Velar Fronting

Purpose This study has two key aims: first, to provide developmental articulatory norms for the alveolar-velar distinction in 30 English-speaking typically developing (TD) children; second, to illustrate the utility of the reported measures for classifying and quantifying the speech of children with a history of persistent velar fronting as they develop the contrast longitudinally. Method This study involved secondary data analysis of the UltraSuite corpus comprising ultrasound tongue imaging recordings of speech materials from 30 typical children and longitudinal data from five children with persistent velar fronting undergoing ultrasound visual biofeedback intervention. We present two new measures of coronal dorsal differentiation: KTMax and KT crescent area. These measures distinguish /k/ and /t/ by quantifying the magnitude of this distinction in absolute spatial terms (mm of linear dorsal difference). For the typical children, we report these measures in corner vowel contexts. We then compare these to dorsal productions by the children with speech disorders, before, during, and after intervention. Results Both measures reliably distinguished /k/ and /t/ in TD children. There was an effect of vowel, with larger KTmax and KT crescent area in /a/ and /o/ vowel contexts than in an /i/ context. The children with persistent velar fronting showed KTmax values near zero before intervention, showing a complete merger between /k/ and /t/. During intervention, they showed variable KTmax values. Post intervention, they showed values within the range of typical children. Conclusions This study provides articulatory norms derived from ultrasound tongue imaging for the dorsal differentiation in alveolar and velar stops in TD children. By applying these norms to children with persistent velar fronting as they acquire this contrast, we see that /k/ is acquired in an articulatorily gradient manner.

Ultrasonography applied to the description of voice quality settings in adult speakers of Brazilian Portuguese

ABSTRACT Purpose: to relate ultrasound images with auditory-perceptual data on vocal quality settings in adult speakers of Brazilian Portuguese. Methods: the corpus consisted of speech samples (sentences contained in the instructional material of the Vocal Profile Analysis Scheme - VPAS-PB) from seven adult subjects of both genders, recorded simultaneously by acoustic and ultrasonographic means. Data analysis was based on auditory-perceptual judgments of vocal quality and ultrasound images generated by the AAA software. Results: vocal quality settings related to the position of the tongue body and the extension of the tongue and jaw found correspondences to the contours of ultrasound images of the tongue in selected key segments (oral vowels), especially those with greater degrees of manifestation. Conclusion: there were correspondences between vocal quality settings detected in the perceptual sphere and their respective tongue body and jaw ultrasound images.

The quantitative ultrasound study of tongue shape and movement in normal Persian speaking children

OBJECTIVES

Ultrasound research on speech production in normal speakers has long used quantitative measurements in different languages. However, no studies in this area have been conducted in the Persian language. This study investigated Persian speaking children scores on two single curve measures of tongue shape, based on midsagittal tongue shape data from ultrasound imaging.

METHODS

This is a cross-sectional study conducted on four 7-8 years old Persian speaking children. The data for analysis was collected using an ultrasound machine in 2018-2019. The stimuli included a range of consonants including/p/,/t/,/f/,/k/and/s/in consonant-vowel sequences, with the vowels/a/and/i/. The measures do not require head stabilization. Statistical analyses were done using Linear mixed models in lmer software package of R version 3.6.2. The results were performed by Chi-squared and Tukey post hoc tests in R.

RESULTS

In all of the consonants, the mean of two single curve measures in the context of/i/was greater than the context of/a/. However, there was no significant effect of the vowel context on one measure for the/k/. Also, these measures were significantly different in each of the Persian consonants and they showed consistent patterns across all of the participants (P<0.001).

CONCLUSION

It seems the single curve measures are the valid value of tongue dorsum excursion for Persian speaking children. This study showed that measures of single curves are reliable for distinguish between consonants in vowel contexts and created robust results on lingual coarticulation of the consonants without the use of head stabilization.

Native Language Influence on Brass Instrument Performance: An Application of Generalized Additive Mixed Models (GAMMs) to Midsagittal Ultrasound Images of the Tongue

This paper presents the findings of an ultrasound study of 10 New Zealand English and 10 Tongan-speaking trombone players, to determine whether there is an influence of native language speech production on trombone performance. Trombone players' midsagittal tongue shapes were recorded while reading wordlists and during sustained note productions, and tongue surface contours traced. After normalizing to account for differences in vocal tract shape and ultrasound transducer orientation, we used generalized additive mixed models (GAMMs) to estimate average tongue surface shapes used by the players from the two language groups when producing notes at different pitches and intensities, and during the production of the monophthongs in their native languages. The average midsagittal tongue contours predicted by our models show a statistically robust difference at the back of the tongue distinguishing the two groups, where the New Zealand English players display an overall more retracted tongue position; however, tongue shape during playing does not directly map onto vowel tongue shapes as prescribed by the pedagogical literature. While the New Zealand English-speaking participants employed a playing tongue shape approximating schwa and the vowel used in the word 'lot,' the Tongan participants used a tongue shape loosely patterning with the back vowels /o/ and /u/. We argue that these findings represent evidence for native language influence on brass instrument performance; however, this influence seems to be secondary to more basic constraints of brass playing related to airflow requirements and acoustical considerations, with the vocal tract configurations observed across both groups satisfying these conditions in different ways. Our findings furthermore provide evidence for the functional independence of various sections of the tongue and indicate that speech production, itself an acquired motor skill, can influence another skilled behavior via motor memory of vocal tract gestures forming the basis of local optimization processes to arrive at a suitable tongue shape for sustained note production.

Assessment of Childhood Apraxia of Speech: A Review/Tutorial of Objective Measurement Techniques

Background With respect to the clinical criteria for diagnosing childhood apraxia of speech (commonly defined as a disorder of speech motor planning and/or programming), research has made important progress in recent years. Three segmental and suprasegmental speech characteristics-error inconsistency, lengthened and disrupted coarticulation, and inappropriate prosody-have gained wide acceptance in the literature for purposes of participant selection. However, little research has sought to empirically test the diagnostic validity of these features. One major obstacle to such empirical study is the fact that none of these features is stated in operationalized terms. Purpose This tutorial provides a structured overview of perceptual, acoustic, and articulatory measurement procedures that have been used or could be used to operationalize and assess these 3 core characteristics. Methodological details are reviewed for each procedure, along with a short overview of research results reported in the literature. Conclusion The 3 types of measurement procedures should be seen as complementary. Some characteristics are better suited to be described at the perceptual level (especially phonemic errors and prosody), others at the acoustic level (especially phonetic distortions, coarticulation, and prosody), and still others at the kinematic level (especially coarticulation, stability, and gestural coordination). The type of data collected determines, to a large extent, the interpretation that can be given regarding the underlying deficit. Comprehensive studies are needed that include more than 1 diagnostic feature and more than 1 type of measurement procedure.

Visualization and quantification of tongue movement during articulation: Is ultrasound a valid alternative to magnetic resonance imaging?

BACKGROUND

Quality of life in tumour patients following combined ablative and reconstructive head and neck surgery varies significantly. This is at least partially due to differences in speech and swallowing function. A tool to objectively evaluate articulation by magnetic resonance imaging (MRI) has now been tested alongside ultrasound examination.

PATIENTS AND METHODS

A standardized sequence of phonemes from the German language was established in 20 healthy volunteers and recorded in different planes by MRI and ultrasound. Phonemes were identified through recognition of typical tongue configurations by two different observers. An algorithm for metric analysis of articulation in terms of distances and angles for five extreme points on the tongue (anterior, posterior, cranial and two basal corners) was designed. The findings in these volunteers were subsequently compared with the results of an examination of a tumour patient.

RESULTS

Physiological articulation was visualized and evaluated both by MRI and ultrasound. There was a high intra-class correlation coefficient for measurements between independent observers. Tongue position for certain phonemes was mostly constant in healthy patients of different age groups, with gender-specific differences. In a first comparison, tongue position in a patient with tongue cancer differed significantly from this position, both pre- and postoperatively. In agreement with clinical articulation quality, the tongue position of the patient returned to almost normal within 12 months postoperatively.

CONCLUSION

Both ultrasound and MRI are appropriate instruments for visualization of articulation and objective measurements to evaluate speech in tumour patients. Whilst MRI is more precise and can identify more subtle differences, ultrasound is a valid alternative due to its wider availability and broader applicability.

Preparation of a Protocol for Instrumental Assessment of Speech (PRAINF) based on psychometric and linguistic criteria

OBJECTIVE

Propose a protocol for instrumental assessment of adult speech considering psychometric and linguistic criteria.

METHODS

The choice of words was based on previously defined Brazilian Portuguese linguistic criteria after a search on the "Portal da Língua Portuguesa" database using the Portuguese Orthographic Vocabulary (VOP). The defined linguistic criteria considered grammatical class, vowel context, number of syllables, stress, and presence of words in the daily life of Brazilian adults. The choice of the images to represent the words considered the criteria of imageability, clearness, and cultural aspects. The words and images were rigorously evaluated by 13 non-specialist judges and six specialist judges. After being examined by the judges, the words were tested in adults through instrumental assessment.

RESULTS

The protocol was composed of 19 words and images, with prevalence of nouns over adjectives. Each word included one target sound in Onset Medial position, in the context precedent and following the vowel [a], trisyllabic and paroxytone words. The adults that attended the instrumental assessments succeeded in producing the list of words spontaneously. The data obtained through the assessments provided adequate analysis.

CONCLUSION

This study provided additional information on psychometric and linguistic criteria in addition to providing a protocol for instrumental assessment of adult speech.

The contrast between alveolar and velar stops with typical speech data: acoustic and articulatory analyses

Purpose

This study used acoustic and articulatory analyses to characterize the contrast between alveolar and velar stops with typical speech data, comparing the parameters (acoustic and articulatory) of adults and children with typical speech development.

Methods

The sample consisted of 20 adults and 15 children with typical speech development. The analyzed corpus was organized through five repetitions of each target-word (/'kap ə/, /'tapə/, /'galo/ e /'daɾə/). These words were inserted into a carrier phrase and the participant was asked to name them spontaneously. Simultaneous audio and video data were recorded (tongue ultrasound images). The data was submitted to acoustic analyses (voice onset time; spectral peak and burst spectral moments; vowel/consonant transition and relative duration measures) and articulatory analyses (proportion of significant axes of the anterior and posterior tongue regions and description of tongue curves).

Results

Acoustic and articulatory parameters were effective to indicate the contrast between alveolar and velar stops, mainly in the adult group. Both speech analyses showed statistically significant differences between the two groups.

Conclusion

The acoustic and articulatory parameters provided signals to characterize the phonic contrast of speech. One of the main findings in the comparison between adult and child speech was evidence of articulatory refinement/maturation even after the period of segment acquisition.

Electropalatography and its correlation to tongue movement ultrasonography in speech analysis

Purpose

To analyze the use of electropalatography and ultrasonography regarding speech therapy through literature narrative review.

Research strategies

A literature review was conducted at PubMed and Scielo databases, using descriptors as electropalatography, electropalatography AND evaluation, electropalatography AND therapy, electropalatography AND ultrasonography, electropalatography AND speech.

Selection criteria

The research criteria selected in the database were: studies in the past five years and studies in humans. In the pre-selection, studies that were duplicate, not fully available, and have shown no direct relation with electropalatography in speech-language therapy were discarded.

Data analysis

Data analysis was performed descriptively, following subdivisions: title, area, year, subject, implementation, and conclusion of the study.

Results

Twenty one papers were selected, eight of them using the term electropalatography, two with the keywords electropalatography AND evaluation, six with the keywords electropalatography AND therapy, three of them with the keywords electropalatography AND ultrasonography, and two papers with the keywords electropalatography AND speech.

Conclusion

Different types of research involving the use of electropalatography in the field of speech-language therapy were found and analyzed. Few researches have concomitantly used electropalatography and ultrasonography.

Voiceless alveolar stop coarticulation in typically developing 5-year-olds and 13-year-olds

In this study, vowel-on-consonant lingual coarticulation at [t] closure offset was compared in 5-year-old children and 13-year-old adolescents. The study aimed to establish whether, by the end of the closure, children from the younger age group adjust the tongue shape to the following vowels to the same extent as adolescents. Ten 5-year-olds and ten 13-year-olds, all speakers of Scottish Standard English, produced [t]-vowel syllables with the vowels [i] and [a], in a carrier phrase. Measures of tongue shape based on midsagittal ultrasound imaging data were used to compare anticipatory coarticulation and within-speaker variability across groups. Both age groups changed the extent of tongue dorsum bunching in order to coarticulate the consonant with the following vowels. The 5-year-old children, unlike the adolescents, did not consistently modify the bunching location within the tongue curve to accommodate the tongue shape to that of the upcoming vowel. Token-to-token variability was significantly greater in the younger age group. The results suggest that vowel-on-[t] coarticulatory patterns produced by typically developing children are affected by the development of motor control, with articulatory constraints on the tongue limiting the extent of lingual coarticulation in 5-year-old children. The findings on typical coarticulation development are relevant for clinical practice, and they highlight the need for more detailed descriptions of how phonetic characteristics of speech sounds affect coarticulation throughout childhood.

Covert contrast and covert errors in persistent velar fronting

Acoustic and articulatory studies demonstrate covert contrast in perceptually neutralised phonemic contrasts in both typical children and children with speech disorders. These covert contrasts are thought to be relatively common and symptomatic of phonetic speech disorders. However, clinicians in the speech therapy clinic have had no easy way of identifying this covertness. This study uses ultrasound tongue imaging to compare tongue contours for /t/and /k/in seven children with persistent velar fronting. We present a method of overlaying tongue contours to identify covert contrast at the articulatory level. Results show that all seven children, contrary to expectations, produced both /t/and /k/with near-identical tongue shapes showing no evidence of covert contrast. However, further analysis of one of the participants showed highly variable tongue shapes for /t/and /k/, including retroflex productions of both. Although not phonologically conditioned, this covert error is evidence of speech disorder at the phonetic level.

Using ultrasound tongue imaging to identify covert contrasts in children's speech

Ultrasound tongue imaging has become a promising technique for detecting covert contrasts, due to the developments in data analysis methods that allow for processing information on tongue shape from young children. An important feature concerning analyses of ultrasound data from children who are likely to produce covert contrasts is that the data are likely to be collected without head-to-transducer stabilisation, due to the speakers' age. This article is a review of the existing methods applicable in analysing data from non-stabilised recordings. The article describes some of the challenges of ultrasound data collection from children, and analysing these data, as well as possible ways to address those challenges. Additionally, there are examples from typical and disordered productions featuring covert contrasts, with illustrations of quantifying differences in tongue shape between target speech sounds.

Ultrasound and acoustic analysis of sibilant fricatives in preadolescents and adults

This study describes the production of sibilant fricatives /s/ and /∫/, comparing Scottish English speaking preadolescent children with adults. The materials were the sequences /əCa/ and /əCi/ produced by 15 adults and 15 children aged between 10 and 12 years old. Quantitative analyses were carried out on both spectral information and on ultrasound imaging data on tongue shape, taken from nine successive time points during the fricative. The two groups of speakers were very similar to each other in the articulatory and acoustic characteristics distinguishing the two fricatives. Age-related differences in the fricative centroid measure occurred at consonant-vowel boundaries, with lower values in the preadolescents. Within-speaker variability was mostly similar across age groups, with the exception of the fricative centroid for /∫/, which was significantly more variable in preadolescents than in adults. Throughout the consonant duration, both groups consistently differentiated between the two consonants in both the fricative centroid and in one measure of tongue shape.

Ultrasound visual feedback in articulation therapy following partial glossectomy

Disordered speech is common following treatment for tongue cancer, however there is insufficient high quality evidence to guide clinical decision making about treatment. This study investigated use of ultrasound tongue imaging as a visual feedback tool to guide tongue placement during articulation therapy with two participants following partial glossectomy. A Phase I multiple baseline design across behaviors was used to investigate therapeutic effect of ultrasound visual feedback during speech rehabilitation. Percent consonants correct and speech intelligibility at sentence level were used to measure acquisition, generalization and maintenance of speech skills for treated and untreated related phonemes, while unrelated phonemes were tested to demonstrate experimental control. Swallowing and oromotor measures were also taken to monitor change. Sentence intelligibility was not a sensitive measure of speech change, but both participants demonstrated significant change in percent consonants correct for treated phonemes. One participant also demonstrated generalization to non-treated phonemes. Control phonemes along with swallow and oromotor measures remained stable throughout the study. This study establishes therapeutic benefit of ultrasound visual feedback in speech rehabilitation following partial glossectomy.

LEARNING OUTCOMES

Readers will be able to explain why and how tongue cancer surgery impacts on articulation precision. Readers will also be able to explain the acquisition, generalization and maintenance effects in the study.

Perceptual, durational and tongue displacement measures following articulation therapy for rhotic sound errors

Outcomes of articulation therapy for rhotic errors are usually assessed perceptually. However, our understanding of associated changes of tongue movement is limited. This study described perceptual, durational and tongue displacement changes over 10 sessions of articulation therapy for /ɹ/ in six children. Four of the participants also received ultrasound biofeedback of their tongue shape. Speech and tongue movement were recorded pre-therapy, after 5 sessions, in the final session and at a one month follow-up. Perceptually, listeners perceived improvement and classified more productions as /ɹ/ in the final and follow-up assessments. The durations of VɹV syllables at the midway point of the therapy were longer. Cumulative tongue displacement increased in the final session. The average standard deviation was significantly higher in the middle and final assessments. The duration and tongue displacement measures illustrated how articulation therapy affected tongue movement and may be useful for outcomes research about articulation therapy.

Multiple phonetically trained-listener comparisons of speech before and after articulatory intervention in two children with repaired submucous cleft palate

Cleft Palate (CP) assessments based on phonetic transcription are the "gold standard" therapy outcome measure, despite reliability difficulties. Here we propose a novel perceptual evaluation, applied to ultrasound-visual biofeedback (U-VBF) therapy and therapy using visual articulatory models (VAMs) for two children with repaired submucous CP. Three comparisons were made: post VAM, post U-VBF and overall pre- and post-therapy. Twenty-two phonetically-trained listeners were asked to determine whether pre- or post-therapy recordings sounded "closer to the English target", using their own implicit phonological knowledge (prompted via orthographic representation). Results are compared with segment-oriented percent target consonant correct (PTCC) derived from phonetic transcriptions. Listener judgements and PTCC suggest that both children made improvements using both VAM and U-VBF. Statistical analysis showed listener agreement in each comparison, though agreement was weak. However, perceptual evaluation offers a straightforward method of evaluating the effectiveness of interventions and can be used by phonetically trained or lay listeners.

Covert contrast in velar fronting: An acoustic and ultrasound study

There is growing evidence that speech sound acquisition is a gradual process, with instrumental measures frequently revealing covert contrast in errors perceived to involve phonemic substitution. Ultrasound imaging has the potential to expand our understanding of covert contrast by showing whether a child uses different tongue shapes while producing sounds that are perceived as neutralised. This study used an ultrasound measure (Dorsum Excursion Index) and acoustic measures (VOT and spectral moments of the burst) to investigate overt and covert contrast between velar and alveolar stops in child speech. Participants were two children who produced a perceptually overt velar-alveolar contrast and two children who neutralised the contrast via velar fronting. Both acoustic and ultrasound measures revealed significant differences between perceptually distinct velar and alveolar targets. One child with velar fronting demonstrated covert contrast in one acoustic and one ultrasound measure; the other showed no evidence of contrast. Clinical implications are discussed in this article.

Methods for quantifying tongue shape and complexity using ultrasound imaging

Quantification of tongue shape is potentially useful for indexing articulatory strategies arising from intervention, therapy and development. Tongue shape complexity is a parameter that can be used to reflect regional functional independence of the tongue musculature. This paper considers three different shape quantification methods - based on Procrustes analysis, curvature inflections and Fourier coefficients - and uses a linear discriminant analysis to test how well each method is able to classify tongue shapes from different phonemes. Test data are taken from six native speakers of American English producing 15 phoneme types. Results classify tongue shapes accurately when combined across quantification methods. These methods hold promise for extending the use of ultrasound in clinical assessments of speech deficits.

Quantifying lingual coarticulation using ultrasound imaging data collected with and without head stabilisation

Previous studies reporting the use of ultrasound tongue imaging with clinical populations have generally provided qualitative information on tongue movement. Meaningful quantitative measures for use in the clinic typically require the speaker's head to be stabilised in relation to a transducer, which may be uncomfortable, and unsuitable for young children. The objective of this study was to explore the applicability of quantitative measurements of stabilisation-free tongue movement data, by comparing ultrasound data collected from 10 adolescents, with and without head stabilisation. Several measures of tongue shape were used to quantify coarticulatory influence from two contrasting vowels on four different consonants. Only one of the measures was completely unaffected by the stabilisation condition for all the consonants. The study also reported cross-consonant differences in vowel-related coarticulatory effects. The implications of the findings for the theory of coarticulation and for potential applications of stabilisation-free tongue curve measurements in clinical studies are discussed.

Ultrasound applicability in Speech Language Pathology and Audiology

PURPOSE: To present recent studies that used the ultrasound in the fields of Speech Language Pathology and Audiology, which evidence possibilities of the applicability of this technique in different subareas. RESEARCH STRATEGY: A bibliographic research was carried out in the PubMed database, using the keywords "ultrasonic," "speech," "phonetics," "Speech, Language and Hearing Sciences," "voice," "deglutition," and "myofunctional therapy," comprising some areas of Speech Language Pathology and Audiology Sciences. The keywords "ultrasound," "ultrasonography," "swallow," "orofacial myofunctional therapy," and "orofacial myology" were also used in the search. SELECTION CRITERIA: Studies in humans from the past 5 years were selected. In the preselection, duplicated studies, articles not fully available, and those that did not present direct relation between ultrasound and Speech Language Pathology and Audiology Sciences were discarded. DATA ANALYSIS: The data were analyzed descriptively and classified subareas of Speech Language Pathology and Audiology Sciences. The following items were considered: purposes, participants, procedures, and results. RESULTS: We selected 12 articles for ultrasound versus speech/phonetics subarea, 5 for ultrasound versus voice, 1 for ultrasound versus muscles of mastication, and 10 for ultrasound versus swallow. Studies relating "ultrasound" and "Speech Language Pathology and Audiology Sciences" in the past 5 years were not found. CONCLUSION: Different studies on the use of ultrasound in Speech Language Pathology and Audiology Sciences were found. Each of them, according to its purpose, confirms new possibilities of the use of this instrument in the several subareas, aiming at a more accurate diagnosis and new evaluative and therapeutic possibilities.

Tongue contour for /s/ and /?/ in children with speech sound disorder

PURPOSE: To describe the tongue shape for /s/ and /∫/ sounds in three different groups of children with and without speech sound disorder. METHODS: The six participants were divided into three groups: Group 1 - two typically developing children, Group 2 - two children with speech sound disorder presenting any other phonological processes but not the ones involving the production of the /∫/ and Group 3 - two children with speech sound disorder presenting any phonological processes associated to the presence of the phonological process of palatal fronting (these two children produced /∫/ as /s/) aged between 5 and 8 years old, all speakers of Brazilian Portuguese. The data were the words /'∫avi/ (key) and /'sapu/ (frog). Tongue contour was individually traced for the five productions of each target word. RESULTS: The analysis of the tongue contour pointed to evidences that both /s/ and /∫/ were produced using distinct tongue contours for G1 and G2. The production of these two groups was more stable than G3. The tongue contour for /s/ and /∫/ from the children in G3 was similar, indicating that their production was undifferentiated. CONCLUSION: The use of the ultrasound applied to the speech analysis was effective to confirm the perceptual analysis of the sound made by the speech-language pathologist.

Cleft Palate-Craniofacial Journal 50th anniversary editorial board commentary: anatomy, basic sciences, and genetics--then and now

To celebrate the 50th year of the Cleft Palate-Craniofacial Journal we look back to where we started in 1964 and where we are now, and we speculate about directions for the future in a "Then and Now" editorial series. This editorial examines changing trends and perspectives in anatomical, basic science, and genetic studies published in this 50-year interval. In volume 1 there were 45 total papers, seven (16%) of which were peer-reviewed basic science and genetic articles published: four in anatomy, three in craniofacial biology, and none in genetics. In contrast, in volume 50, of 113 articles there were 47 (42%) peer-reviewed basic science and genetic articles published: 30 in anatomy, five in craniofacial biology, and 12 in genetics. Topical analysis of published manuscripts then and now reveal that similar topics in anatomy and craniofacial biology are still being researched today (e.g., phenotypic variability, optimal timing of surgery, presurgical orthopedics, bone grafting); whereas, most of the more recent papers use advanced technology to address old questions. In contrast, genetic publications have clearly increased in frequency during the last 50 years, which parallels advances in the field during this time. However, all of us have noticed that the more "cutting-edge" papers in these areas are not being submitted for publication to the journal, but instead to discipline-specific journals. Concerted efforts are therefore indicated to attract and publish these cutting-edge papers in order to keep the Cleft Palate-Craniofacial Journal in the forefront of orofacial cleft and craniofacial anomaly research and to provide a valuable service to American Cleft Palate-Craniofacial Association members.

A normative-speaker validation study of two indices developed to quantify tongue dorsum activity from midsagittal tongue shapes

This study reported adult scores on two measures of tongue shape, based on midsagittal tongue shape data from ultrasound imaging. One of the measures quantified the extent of tongue dorsum excursion, and the other measure represented the place of maximal excursion. Data from six adult speakers of Scottish Standard English without speech disorders were analyzed. The stimuli included a range of consonants in consonant-vowel sequences, with the vowels /a/ and /i/. The measures reliably distinguished between articulations with and without tongue dorsum excursion, and produced robust results on lingual coarticulation of the consonants. The reported data can be used as a starting point for collecting more typical data and for analyzing disordered speech. The measurements do not require head-to-transducer stabilization. Possible applications of the measures include studying tongue dorsum overuse in people with cleft palate, and typical and disordered development of coarticulation.