CASL
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Item Quantifying changes in ultrasound tongue-shape pre- and post-intervention in speakers with submucous cleft palate: An illustrative case study(Taylor & Francis, 2021-09-08) Roxburgh, Zoe; Cleland, Joanne; Scobbie, James M.; Wood, SaraUltrasound Tongue Imaging is increasingly used during assessment and treatment of speech sound disorders. Recent literature has shown that ultrasound is also useful for the quantitative analysis of a wide range of speech errors. So far, the compensatory articulations of speakers with cleft palate have only been analysed qualitatively. This study provides a pilot quantitative ultrasound analysis, drawing on longitudinal intervention data from a child with submucous cleft palate. Two key ultrasound metrics were used: 1. articulatory t-tests were used to compare tongue-shapes for perceptually collapsed phonemes on a radial measurement grid and 2. the Mean Radial Difference was reported to quantify the extent to which the two tongue shapes differ, overall. This articulatory analysis supplemented impressionistic phonetic transcriptions and identified covert contrasts. Articulatory errors identified in this study using ultrasound were in line with errors identified in the speech of children with cleft palate in previous literature. While compensatory error patterns commonly found in speakers with cleft palate have been argued to facilitate functional phonological development, the nature of our findings suggest that the compensatory articulations uncovered are articulatory in nature.Item 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, JoanneBackground: 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 therapyItem Changes in linguapalatal contact patterns during therapy for velar fronting in a 10-year-old with Down's syndrome.(2004) Gibbon, Fiona; McNeill, Alison M.; Wood, Sara; Watson, JocelynneBACKGROUND: Articulation errors in the speech of people with Down's syndrome are frequent and often resistant to speech therapy. This preliminary study investigates the use of electropalatography (EPG) to diagnose and treat abnormal articulation patterns associated with velar fronting in a 10-year-old girl. AIMS: The study measured changes in the accuracy and stability of linguapalatal (tongue-palate) contact patterns during a 14-week course of visual feedback therapy using EPG. Therapy aimed to resolve a pattern of velar fronting whereby targets /k, g, eta/ had alveolar placement [t, d, n]. METHODS & PROCEDURES: The participant was a girl (P) with Down's syndrome aged 10;11 years. P had a moderate-severe speech disorder, which included velar fronting. Her speech was recorded with EPG on three occasions during a 14-week course of therapy: first, before therapy; second, midway through therapy; and third, after therapy. Three analyses were conducted on the EPG data. The first used an EPG classification scheme that identified accuracy of placement for /t/ and /k/ targets. The second was a centre of gravity measure that detected whether P produced a significant difference between /t/ and /k/ targets. The third was a variability index that quantified the stability of contact patterns. OUTCOMES & RESULTS: The results of the EPG classification showed that before therapy, /t/ and /k/ targets had identical alveolar placement, reflecting the process of velar fronting. The results after therapy showed that 87% of /k/ targets had accurate velar placement. The centre of gravity measure showed no difference in contact patterns for /t/ and /k/ before therapy, but a statistically significant difference at the second and third recordings. The variability index showed stable contact patterns before therapy for /t/ and /k/ targets, but both became highly unstable midway through therapy, with a return to stability at the third recording. We embed a discussion of P's increased articulation instability during therapy in a recent theoretical framework--dynamic systems--that attempts to account for the emergence of new behavioural forms. CONCLUSIONS: These preliminary results suggest that EPG has potential as an effective diagnostic and therapy procedure for articulation errors in people with Down's syndrome. A major issue still to be addressed, however, is the extent to which others will benefit from this approach to intervention.Item Speech Production in Down Syndrome(2009) Timmins, Claire; Cleland, Joanne; Rodger, Rebecca; Wishart, Jennifer; Wood, Sara; Hardcastle, William J.Item Relationship between speech, oromotor, language and cognitive abilities in children with Down's syndrome(2010-01) Cleland, Joanne; Wood, Sara; Hardcastle, William J.; Wishart, Jennifer; Timmins, ClaireBackground: Children and young people with Down's syndrome present with deficits in expressive speech and language, accompanied by strengths in vocabulary comprehension compared with non-verbal mental age. Intelligibility is particularly low, but whether speech is delayed or disordered is a controversial topic. Most studies suggest a delay, but no studies explore the relationship between cognitive or language skills and intelligibility. Aims: This study sought to determine whether severity of speech disorder correlates with language and cognitive level and to classify the types of errors, developmental or non-developmental, that occur in the speech of children and adolescents with Down's syndrome. Methods & Procedures: Fifteen children and adolescents with Down's syndrome (aged 9-18 years) were recruited. Participants completed a battery of standardized speech, language and cognitive assessments. The phonology assessment was subject to phonological and phonetic analyses. Results from each test were correlated to determine relationships. Outcome & Results: Individuals with Down's syndrome present with deficits in receptive and expressive language that are not wholly accounted for by their cognitive delay. Receptive vocabulary is a strength in comparison with expressive and receptive language skills, but it was unclear from the findings whether it is more advanced compared with non-verbal cognitive skills. The majority of speech errors were developmental in nature, but all of the children with Down's syndrome showed at least one atypical or non-developmental speech error. Conclusions & Implications: Children with Down's syndrome present with speech disorders characterized by atypical, and often unusual, errors alongside many developmental errors. A lack of correlation between speech and cognition or language measures suggests that the speech disorder in Down's syndrome is not simply due to cognitive delay. Better differential diagnosis of speech disorders in Down's syndrome is required, allowing interventions to target the specific disorder in each individual.Item Variability in fricative production of young people with Down's syndrome : an EPG analysis(2007-08) Timmins, Claire; Hardcastle, William J.; Wood, Sara; McCann, Joanne; Wishart, Jennifer; Acknowledgements: MRC grant no. G0401388Speech production in Down's syndrome is highly variable, with particular problems arising from complex articulations such as fricatives. In this paper, EPG analysis is used to study the variation in the production of the fricatives /s/ and /sh/ in 6 young people with Down's syndrome. The variability of these productions is compared with information from the Robbins and Klee Oral/Speech Motor Control Protocol.Item Spatial & temporal variability of sibilants in children with down's syndrome(University of Glasgow: Glasgow, 2015-08-10) Timmins, Claire; Wood, SaraThis paper presents findings from EPG analysis of word initial /s/ and // in twenty five children with Down's syndrome (DS) and ten cognitively age-matched typically developing children (TD). Spatial and temporal variability measures show evidence of increased variability in all attempts of target /s/ and // for the speakers with DS. The findings also show evidence of high levels of spatial variability in children with DS and typically developing children in perceptually acceptable productions of the target sounds. These findings support previous research that links speech production difficulties in children with DS to impaired speech motor ability.Item The use of electropalatography (EPG) in the assessment and treatment of motor speech disorders in children with Down's syndrome: Evidence from two case studies(2009-04) Wood, Sara; Wishart, Jennifer; Hardcastle, William J.; Cleland, Joanne; Timmins, ClaireBackground: Many children experience significant difficulties in developing key aspects of speech. For some, these communication difficulties are compounded by co-occurring intellectual disabilities. Method: This paper presents two case studies from a larger on-going longitudinal study of the effectiveness of using electropalatography (EPG) to address the intelligibility problems experienced by many children and young people with Down's syndrome (DS). EPG, an innovative computer-based tool for assessing and treating speech motor difficulties, enables the speaker to 'see' the placement of his or her tongue during speech and to attempt to correct any lingual palatal errors. Results: This visual supplementation of auditory feedback offers potential therapeutic benefits for children with intellectual disabilities, many of whom show relative strengths in visual vs. auditory and simultaneous vs. sequential processing. EPG also provides therapists with an objective measure of articulatory ability. Conclusions: Findings from these two case studies demonstrate the potential utility of EPG in both the assessment and treatment of speech motor disorders in DS.Item Visual Feedback Therapy with Electropalatography(Paul H Brookes Pub Co., 2010-02-20) Gibbon, Fiona; Wood, SaraItem Electropalatography in the assessment and treatment of speech difficulties in children with Down syndrome(2010-01) Wood, SaraMany children with Down syndrome experience significant speech difficulties which in turn affects their speech intelligibility. This paper describes how electropalatography, a computer-based technique which uses visual feedback to alter speech production, is being used at Queen Margaret University, to assess and treat speech difficulties in a group of children and young people with Down syndrome. Encouraging results from a single case are reported.
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