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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 Electropalatographic therapy for children and young people with Down's syndrome(2009-12) Cleland, JoanneArticulation disorders in Down's syndrome (DS) are prevalent and often intractable. Individuals with DS generally prefer visual to auditory methods of learning and may therefore find it beneficial to be given a visual model during speech intervention, such as that provided by electropalatography (EPG). In this study, participants with Down's syndrome, aged 10:1 to 18:9, received 24 individualized therapy sessions using EPG. Simultaneous acoustic and EPG recordings were made pre- and post-intervention during 10 repetitions of a word list containing lingua-palatal consonants. Participants also completed the DEAP phonology sub-test at both time points. Post-treatment, all participants showed qualitative and quantifiable differences in EPG patterns and improvements in DEAP percentage consonants correct. EPG assessment and therapy appears a positive approach for identifying and improving articulatory patterns in children with DS. © 2009 Informa UK, LtdItem 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 Tongue palate contact patterns of velar stops in normal adult English speakers(2008-02) Liker, Marko; Gibbon, FionaThis paper provides a more detailed description of normal tongue palate contact patterns for the occlusion phase of velar stops than currently exists. The study used electropalatography (EPG) to record seven normally speaking adults' contact patterns of voiceless velar stops in nine VkV contexts. A variety of EPG indices measured: per cent complete closures across the palate; place of articulation; articulatory distance between /k/ and /t/; and amount of contact. Complete EPG closure occurred in the majority (81%) of tokens. Some speakers almost always had complete closures regardless of context, whereas other speakers produced them only with high front vowels. As expected, place of articulation and amount of contact were heavily influenced by vowel context. The most fronted and most contact occurred in /i/ contexts and the most retracted and least contact in /a/ contexts. There was considerable interspeaker variability on all measures, particularly in the precise location of velar placement and articulatory distance between alveolar and velar placement. The implications for diagnosing and treating abnormal velar articulations are discussed.Item Advances in EPG for treatment and research: an illustrative case study(Taylor & Francis, 2004) Scobbie, James M.; Wood, Sara; Wrench, Alan A.Electropalatography (EPG), a technique which reveals tongue-palate contact patterns over time, is a highly effective tool for speech research. We report here on recent developments by Articulate Instruments Ltd. These include hardware for Windows-based computers, backwardly compatible (with Reading EPG3) software systems for clinical intervention and laboratory-based analysis for EPG and acoustic data, and an enhanced clinical interface with client and file management tools. We focus here on a single case study of a child aged 10 years who had been diagnosed with an intractable speech disorder possibly resulting ultimately from a complete cleft of hard and soft palate. We illustrate how assessment, diagnosis and treatment of the intractable speech disorder are undertaken using this new generation of instrumental phonetic support. We also look forward to future developments in articulatory phonetics that will link EPG with ultrasound for research and clinical communities. Keywords: Electropalatography, ultrasound, speech disorders, perceptual analysisItem A perceptual and electropalatographic study of /∫/ in young people with Down's syndrome(2009-12) Timmins, Claire; Cleland, Joanne; Wood, Sara; Hardcastle, William J.; Wishart, JenniferSpeech production in young people with Down's syndrome has been found to be variable and inconsistent. Errors tend to be more in the production of sounds that typically develop later, for example, fricatives and affricates, rather than stops and nasals. It has been suggested that inconsistency in production is a result of a motor speech deficit. Late acquired fricatives such as /s/ and /∫/ are complex articulations, which may require more precise motor programming and may therefore show highly inconsistent productions. Other factors potentially affecting speech production in this population are abnormal palatal structure, hearing loss, and hypotonia. A group of 20 young people with Down's syndrome were recorded using Electropalatography (EPG), reading a wordlist containing the phrase ‘a sheep’. The wordlist contained seven other phrases and was repeated 10 times. Eight typically developing, cognitively matched children and eight adults were also recorded producing the same data set. Articulatory (EPG pattern analysis) and perceptual analyses of the 10 productions of /∫/ were carried out. /∫/ production was found to be inconsistent in the young people with Down's syndrome, with more errors both in the auditory analysis and articulatory analysis than in the typical sample, which may be due to a motor programming or motor control problem. There were a greater number of errors in the EPG analysis than in the perceptual analysis. This suggests that some young people with DS were able to produce perceptually acceptable /∫/ with atypical EPG patterns. The use of typical, adult-modelled /∫/ EPG patterns in therapy may be inappropriate for some children with DS who present with atypical palatal structures.Item Investigating the asymmetry of English sibilant assimilation: Acoustic and EPG data(Walter de Gruyter, 2011-05-01) Pouplier, Marianne; Hoole, Philip; Scobbie, James M.We present tongue-palate contact (EPG) and acoustic data on English sibilant assimilation, with a particular focus on the asymmetry arising from the order of the sibilants. It is generally known that /s# / sequences may display varying degrees of regressive assimilation in fluent speech, yet for / #s/ it is widely assumed that no assimilation takes place, although the empirical content of this assumption has rarely been investigated nor a clear theoretical explanation proposed. We systematically compare the two sibilant orders in word-boundary clusters. Our data show that /s# / sequences assimilate frequently and this assimilation is strictly regressive. The assimilated sequence may be indistinguishable from a homorganic control sequence by our measures, or it can be characterized by measurement values intermediate to those typical for / / or /s/. / #s/ sequences may also show regressive assimilation, albeit less frequently and to a lesser degree. Assimilated / #s/ sequences are always distinguishable from /s#s/ sequences. In a few cases, we identify progressive assimilation for / #s/. We discuss how to account for the differences in degree of assimilation, and we propose that the order asymmetry may arise from the different articulatory control structures employed for the two sibilants in conjunction with phonotactic probability effects.Item Articulatory placement for /t/, /d/, /k/ and / / targets in school age children with speech disorders associated with cleft palate.(Taylor & Francis, 2004) Gibbon, Fiona; Ellis, Lucy; Crampin, LisaThis study used electropalatography (EPG) to identify place of articulation for lingual plosive targets /t/, /d/, /k/ and / / in the speech of 15 school age children with repaired cleft palate. Perceptual judgements indicated that all children had correct velar placement for /k/, / / targets, but /t/, /d/ targets were produced as errors involving palatalization or velar placement. An EPG classification scheme identified alveolar, palatal and velar placement. Articulations involving contact in alveolar and velar regions simultaneously were identified as alveolar velar double articulations (AVDAs). The classification revealed that AVDAs were relatively frequent, with 28% of alveolar and 12% of velar targets affected, and ten out of the 15 children produced one or more of these abnormal articulations. The majority of children had variable placements, with alveolar more variable than velar targets. The positive finding from the EPG data revealed that most children with perceptual errors for /t/, /d/ were able to make closure in the alveolar region during at least some of their attempts to articulate these targets. It is argued that appropriate analysis and interpretation of EPG data provide clinically relevant information about tongue placement in cleft palate speech.Item Abnormal patterns of tongue-palate contact in the speech of individuals with cleft palate.(Taylor & Francis, 2004) Gibbon, FionaIndividualswith cleft palate, even thosewith adequate velopharyngeal function, are at high risk for disordered lingual articulation. This article attempts to summarize current knowledge of abnormal tongue-palate contact patterns derived from electropalatographic (EPG) data in speakers with cleft palate. These data, which have been reported in 23 articles published over the past 20 years, have added significantly to our knowledge about cleft palate speech. Eight abnormal patterns of tongue-palate contact are described and illustratedwith data fromchildren and adults with repaired cleft palate. The paper also discusses some of the problems in interpreting EPG data from speakers with abnormal craniofacial anatomy and emphasizes the importance of quantifying relevant aspects of tongue-palate contact data. Areas of research requiring further investigation are outlined.Item Understanding speech production using electropalatography.(Taylor & Francis, 2007-03) Gibbon, Fiona; Lee, Alice; Yuen, IvanThe papers in this special issue of Advances in Speech- Language Pathology were originally delivered at the 4th International Electropalatography (EPG) Symposium, held in Edinburgh in September 2005.