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    The use of electropalatography in the treatment of speech disorders in children with Down Syndrome: a randomised controlled trial
    (2018-07-24) Wood, Sara; Timmins, Claire; Wishart, Jennifer; Hardcastle, William J.; Cleland, Joanne
    Background: Electropalatography (EPG) records details of the location and timing of tongue contacts with the hard palate during speech. It has been effective in treating articulation disorders that have failed to respond to conventional therapy approaches but, until now, its use with children and adolescents with intellectual/learning disabilities and speech disorders has been limited. Aims: This study aimed to evaluate the usefulness of EPG in the treatment of speech production difficulties in children and adolescents with Down syndrome (DS) aged 8-18 years. Methods: Twenty-seven children with DS were assessed on a range of cognitive and speech and language measures and underwent additional EPG assessment. Participants were randomly allocated to one of three age-matched groups receiving either EPG therapy, EPG-informed conventional therapy or ‘treatment as usual’ over a 12 week period. The speech of all children was assessed before therapy using the Diagnostic Evaluation of Articulation and Phonology (DEAP: Dodd et al. 2002) and re-assessed immediately post- and 3- and 6-month post-intervention to measure percent consonants correct (PCC). EPG recordings were made of the DEAP assessment items at all time-points. Percent intelligibility was also calculated using the Children’s Speech Intelligibility Measure (CSIM: Wilcox and Morris 1999). Results: Gains in accuracy of production immediately post-therapy, as measured by PCC, were seen for all groups. Reassessment at 3- and 6-month post-therapy revealed that those who had received therapy based directly on EPG visual feedback were more likely to maintain and improve on these gains compared to the other groups. Statistical testing showed significant differences between groups in DEAP scores across time-points although the majority did not survive post hoc evaluation. Intelligibility across time-points, as measured by CSIM, was also highly variable within and between the three groups, but despite significant correlations between DEAP and CSIM at all time-points, no statistically significant group differences emerged. Conclusions and implications: EPG was an effective intervention tool for improving speech production in many participants. This may be because it capitalizes on the relative strength of visual over auditory processing in this client group. The findings would seem to warrant an increased focus on addressing speech production difficulties in current therapy
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    Widening access to electropalatography for children with persistent sound system disorders.
    (American Speech-Language-Hearing Association, 1999-11) Gibbon, Fiona; Stewart, Fiona; Hardcastle, William J.
    Previous studies have demonstrated the value of using electropalatography (EPG) to assess, diagnose, and treat persistent sound system disorders in children. However, the application of EPG research has been limited in clinical contexts because most speech-language pathologists do not have access to the technique. This article provides an overview of recent EPG research on persistent sound system disorders and describes a network that has been established to widen access to EPG. The use of EPG via the network is illustrated in the case description of an 8-year-old boy, Robbie, who presented with a persisting speech disorder. The network was used because the clinician treating Robbie did not have an EPG. The main perceptual feature of Robbie's speech before EPG treatment was the deviant phonological process of backing /t/ and /d/ targets to velar place of articulation. EPG was used to assess articulatory patterns before treatment, to provide visual feedback as part of a treatment program, and to record changes in tongue-palate contact patterns as treatment progressed. Robbie achieved normal /t/ and /d/ articulatory patterns after treatment and was subsequently discharged. Factors that could have contributed to the successful outcome in this case are discussed, and areas requiring further research are identified.