MSc in Speech and Language Therapy

Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/7221

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Testing the reliability and validity of the Cluttering Severity Instrument
(Queen Margaret University, 2015)
Background Cluttering is a rather poorly defined fluency disorder, thought to be characterised by an accelerated and/or irregular speech rate with a large amount of disfluencies. As there is not yet a universally agreed upon definition of cluttering, clinicians have faced challenges identifying reliable and efficient assessment tools for the diagnosis of cluttered speech. A lack of diagnostics has also impacted upon the ability to develop treatment strategies and to monitor their success. A recently developed software programme called the Cluttering Severity Instrument (CSI; Bakker and Myers 2011) is anticipated to be the first acceptable, reliable and valid diagnostic tool for identifying cluttered speech. The CSI requires clinicians to provide perceptual ratings for eight speech characteristics, and to complete a task estimating the percentage of the sample that is cluttered. The CSI programme uses these two factors to calculate an overall CSI score. Aims The principle aim of the present study is to investigate whether the CSI programme can be regarded as a reliable and valid method of diagnosing cluttered speech. To achieve this, interrater and intra-rater reliabilities were determined. A second aim was to establish whether the CSI provides raters with the means to discriminate between impaired and unimpaired speech. A final aim is to identify whether raters' familiarity with speech analysis impacted upon rater reliability. Methodology Twelve raters provided perceptual ratings of eight speech characteristics and indicated the duration of the speech sample that they perceived to be cluttered. Raters recorded their judgements using the CSI programme and an overall cluttering percentage was calculated. Raters completed the experiment for five separate speech samples. Results Overall, inter-rater reliability was poor. The combined ratings of speakers and subtests found a high percentage of correlations, but not many with a strong coefficient value. Additionally, many of these correlations were determined to have significantly different means. Separate analysis of subtests indicated that although scores correlated, they often differed in range, with some raters giving consistently lower scores than others. These correlation analyses indicate that the CSI does not have strong inter-rater reliability. Intra-rater reliability was examined by re-testing four participants. Of these four, three had a strong correlation between their score sets, which provided some evidence of intra-rater reliability. When speakers were analysed separately, results indicated that raters were successfully discriminating between impaired and unimpaired speech. Correlation analysis of speech and language therapists (SLT) and laypersons groups did not determine a familiarity of speech analysis to have an influencing factor on perceptual judgements. Conclusions Based on the results of this study, we cannot conclude that the CSI programme is a reliable or valid diagnostic tool. Ratings provided by the SLT group were not found to be more reliable or less variable than the laypersons group. This indicated that a familiarity with speech analyses did not impact upon perceptual judgements of speech. Although the present study did not find significant evidence to support the CSI programme as a reliable and valid assessment tool, it did indicate that it provides raters with the means to successfully discriminate between impaired and unimpaired speech.
Do vowel error patterns distinguish the speech of typically developing children to children with a phonological disorder or children with suspected Childhood Apraxia of Speech? A comparison of vowel errors produced by typically developing children, children with a phonological disorder and children with suspected apraxia of speech
(Queen Margaret University, 2016)
This research project takes the format of an extended research proposal designed to examine the validity of using vowel error patterns to support a differential diagnosis between typically developing children (TD), children with a phonological disorder (PD) and children with suspected Childhood Apraxia of Speech (sCAS). It proposes a cross-sectional empirical study comparing the vowel errors produced by two client groups: (i) children with a phonological disorder and (ii) children with suspected Childhood Apraxia of speech and compares them to the control group of typically developing children. Both the type and extent of error patterns and the consistency of production will be examined. Previous studies have examined the vowel errors of typical and clinical children and employed a range of methods of data collection, analysis and study designs, including single case studies, case series or single case groups. Despite this, there is, to the author's knowledge, no other study which directly compares the vowel productions of TD children to these two client groups using the same methodology. Given the claims in the literature that vowel errors might be a useful diagnostic feature - with more extensive errors, 'vowel distortions' and variable vowel patterns associated with sCAS - it is clear that the literature, and hence clinical diagnosis and decision making, would benefit from an empirical account of the extent and universality of any distinction between the groups.
Is working memory span linked to recall of disfluencies in spontaneous speech?
(Queen Margaret University, 2016)
The regularity with which speech disfluencies are produced in spontaneous speech has led researchers to examine their effect on listener comprehension. Bard and Lickley (1998) and Young (2013) propose that listeners have trouble recalling repetition and deletion disfluencies in spontaneous speech due to the influence of processes in the working memory, and a lack of context to support word recognition. Following a similar rationale to that of Bard and Lickley (1998) and Young (2013), this study aims to discover the extent to which listeners recall repetition and deletion disfluencies in spontaneous speech. Furthermore, the influence of working memory span on the recall of these types of disfluencies will be explored. Working memory span has been implicated in the performance of a number of language-based tasks (Daneman and Carpenter 1980). Therefore, it is pertinent to discover its influence in this subject area. Spontaneous speech utterances were carefully edited to create four different types of stimuli: onset, fluent, repetition and deletion. Participants listened to and transcribed six of each type of stimulus, and twenty-four fluent distractor stimuli. A battery of working memory tasks were also carried out. The results showed that listener recall of repetition and deletion disfluencies was significantly lower than recall of fluent sections of speech. Additionally, it was found that reparanda ending in fragment words led to lower rates of recall in deletion disfluencies when compared with whole words in the same position. Finally, a positive correlation was discovered between working memory span and listener recall of deletion disfluencies. The findings of this study suggest that listeners have difficulty recalling sections of speech containing repetition and deletion disfluencies. This is attributed to the absence of context to support word recognition and the influence of the Phonological Similarity Effect and the Irrelevant Speech Effect in working memory. Furthermore, the results suggest that working memory span influences listeners' ability to recall deletion disfluencies in spontaneous speech.
Electropalatography: Can it lead to long-term improvements in the speech of children with Down's syndrome?
(Queen Margaret University, 2016)
Children with Down's syndrome tend to produce a high number of speech sound errors (Stoel-Gammon, 2001), which can lead to frustration, behaviour difficulties, academic failure and social exclusion. Their speech tends to be resistant to traditional methods of speech therapy (Gibbon, McNeill, Wood & Watson, 2003), therefore, the use of electropalatography (EPG) is emerging. EPG allows clients to see their tongue-palate contact patterns on a computer screen during an articulation. It is a form of visual feedback and is expected to be beneficial for those with Down's syndrome due to this population having a preference for visual learning. However, it is an expensive tool and requires sufficient evidence to confirm its efficacy. This study attempts to explore the long-term benefits of EPG. It looked at nine children with Down's syndrome, age nine to eighteen years, who had been randomly allocated into three groups. One group received 24 sessions of EPG therapy, another received 24 sessions of traditional therapy, and the final group received no therapy. All children had been identified as having difficulty with sibilants at the start of the study. Perceptual and EPG measures were taken pre-therapy, post-therapy, and at two long-term time points: three months post-therapy and six months post-therapy. All three groups showed improvements immediately post-therapy. The EPG group continued to make gains in percentage consonants correct (PCC) and accuracy of /s/ in the six months post-therapy, but lost the original gains in accuracy of /ʃ/. The traditional group showed the reverse results. It therefore seems that EPG can lead to long-term improvements in certain phonemes, but /ʃ/ may require more input for EPG therapy to be effective. Further research is required, however, this study provides preliminary data suggesting that EPG may be beneficial for certain children with Down's syndrome over a long-term period.
An extended research proposal for the validation of the adapted Paediatric Voice-Related Quality of Life Questionnaire for use as an outcome measures tool
(Queen Margaret University, 2016)
The multidimensional assessment of voice disorder in adults includes the client's subjective evaluation of the dysphonia's impact on their daily life. Multiple instruments have been developed to assess voice-related quality of life in adult clients. In the paediatric voice disorder population, voice-related quality of life is typically evaluated using parent proxy questionnaires derived from adult measures. Recent studies have shown children's ability to express their own thoughts and concerns regarding their voice disorder and how their perception of the dysphonia's impact on their life can differ from the perception of their parents. Cohen and McGregor Wynne (2015) adapted the existing parent proxy Paediatric Voice-Related Quality of Life Questionnaire (PVRQoL) into a version for the direct administration to children. Their study found that the use of the parent proxy questionnaire alongside the adapted child-direct questionnaire provided the clinician with two unique and valid perceptions on the child's dysphonia. This research proposal presents a project to expand upon the results of Cohen and McGregor Wynne (2015) by examining if the parallel use of the parent proxy PVRQoL and adapted PVRQoL for children contribute to treatment outcome measures and provide clinically useful information by evaluating their responsiveness to change after voice therapy and their relationship to a clinician-based assessment of vocal severity. Expected results from the proposed study will contribute to the evidence base supporting the use of the child-direct subjective evaluation of vocal impact in the assessment of paediatric dysphonia. Results will also provide evidence for the utility of the parallel parent and child PVRQoL questionnaires to measure therapy outcomes and their ability to provide independent and clinically valid information. This study will benefit the wider paediatric voice disorder community by increasing children's contributions to the evaluation process and the development of more child-centred approaches to intervention.
Evaluating Ultrasound Visual Biofeedback Therapy in Treating Residual Speech Sound Disorder
(Queen Margaret University, 2016)
Ultrasound imaging is used to investigate typical lingual articulation and to assist articulation therapy. Studies have investigated ultrasound visual biofeedback therapy (U-VBF) therapy's efficacy when instructing second language learners and treating client groups with hearing impairment, Down's syndrome, childhood apraxia of speech (CAS), acquired apraxia and residual speech sound disorder (rSSD), mainly through a number of single-subject and small n studies. These studies provided preliminary information on the feasibility and implementation of U-VBF therapy but due to the limitations of their research designs, were not able to provide definitive conclusions regarding U-VBF therapy's efficacy in comparison to traditional treatment, which can be addressed via a randomised control trial. This thesis reviews the relevant studies up to January 31, 2015 and provides a critical analysis of their structure and findings. A randomised controlled trial is proposed, and its design set out. It seeks to compare the changes in articulation and speech perception seen in children with rSSD receiving up to 12 sessions of U-VBF therapy against traditional motor-based therapy. The therapy will target a range of phonemes and their specific disorders. Quantitative outcome measures will investigate articulatory and auditorily-evaluated measures. Trained listeners will evaluate intelligibility to determine if there are differences in post-therapy target productions. We would hypothesise improvements will be found, the extent reflecting improvements in the speech of the client. Results plus qualitative evaluation of the therapeutic process could guide future research and SLT services in deciding on evidence based treatment for this population.
A Comparison of Outcome Measures Following Electropalatography (EPG) Therapy in Children with Down's Syndrome
(Queen Margaret University, 2016)
Background Electropalatography (EPG) therapy has shown to remediate speech sound errors that have been intractable through traditional speech therapy. In more recent years, EPG therapy has been explored as an intervention technique for children with Down's syndrome. There are a variety of ways to measure progress following EPG therapy. However, at present, too much reliance is placed on subjective measures to analyse EPG patterns and this does not promote consistency within research addressing the clinical effectiveness of EPG therapy. Aims The principle aim of this project is to compare outcome measures post EPG therapy and identify if a change seen in one outcome measure is also reflected in other outcome measures, and if not then why not? A secondary aim of this project is to explore the possibility of quantifying EPG patterns by developing a classification scheme that provides a set of criteria associated with a target phoneme's idealized articulatory pattern. Methodology Three children with DS were selected from a larger study. Each child received EPG therapy from the school learning assistant with the aim for therapy to be carried out daily in schools over the course of twelve weeks. Each child had an individualized word list which contained phonemes considered most problematic at pre-therapy recordings. The word lists presented target phonemes in word initial and word final position. Four analyses were carried out; a percent consonant correct analysis, an EPG pattern analysis, a property analysis and analysis of intelligibility measures. A classification scheme designed by the author was implemented to enable quantitative results from the EPG pattern analysis. Results from these outcome measures were compared. Results Participants showed variability between different outcome measures and within the results from the same outcome measure, suggesting that the clinical effectiveness of EPG therapy was reflected differently depending on the outcome measure that was used. Intelligibility measures did not provide enough evidence to capture progress about therapy goals and inform intervention. Conclusions This project highlighted questions surrounding the ability of EPG patterns to be quantified and demonstrated how sensitive these patterns can be when analysed in a quantitative manner. The devised classification scheme was binary (tongue palate contact patterns were measured as acceptable or unacceptable) and was therefore unable to measure and recognize incremental change within EPG patterns from pre to post-therapy. Speech and language therapists should give closer consideration to well written therapy goals with carefully designed outcome measures that reflect those therapy goals.
The Vocal Acoustic Correlates of Stress and the Interactional Effects of Personality: An Extended Research Proposal
(Queen Margaret University, 2016)
Psychological stress influences the way people speak, more specifically the acoustic parameters of voice. These changes in acoustic parameters may have a detrimental effect on the voice, increasing the risk of the development of voice disorders. Previous studies have provided evidence of vocal acoustic correlates of stress. However, most of these fail to take into consideration personality type, despite evidence that personality is an important factor in determining the effects of stress in an individual. Additionally, those studies that consider personality have only examined a small number of acoustic parameters. This proposal aims to take into consideration personality type, by examining neuroticism and conscientiousness, within a wider range of acoustic parameters, namely mean F0, maximum F0, F0 floor, SDF0, jitter and shimmer. A field study approach will be proposed making use of the Smartphone application Voicecheck in order to collect data of naturally occurring stress. Three stress levels will be analysed, baseline, mild stress and high stress, to examine any vocal acoustic correlates within both personality types. Results from this study will provide better knowledge of the vocal acoustic correlates of stress. Having better knowledge of these correlates will aid in the prevention of voice disorders. Prevention will not only be cost effective but will increase productivity within workplaces, increase health and reduce the secondary effects of voice disorders. This study could contribute to improvements in health and wellbeing and within health and safety policies in the workplace, particularly in professional voice users. Investigating personality will also add to the evidence base for clinicians working within voice clinics. Results will allow clinicians to consider vulnerability to stress dependent on the individual's personality type and how this may increase their risk of psychogenic voice disorders as well as contributing towards reoccurrence.
Distribution of intermittent episodes of creaky voice in relation to prosodic constituents
(Queen Margaret University, 2016)
The aims of this study were to investigate the use of creak in relation to prosodic constituents. Creak is a phonation type (Laver, 1980) that is easily perceived by listeners (Blomgren et al, 1998). Para linguistically, creak signifies mood, emotions and attitude (Gobl and Ní Chasaide, 2003), extra linguistically, it is a social identifier (Wolk et al, 2012; Stuart-Smith, 1999). Linguistically it is phonemic in some languages (Gordon and Ladefoged, 2001) but also manifests at points of prosodic significance such as utterancefinal position (Redi and Shattuck Hufnagel, 2001). In addition to this, creak may indicate unhealthy vocal habits or an early-stage voice problem (Colton et al, 2011; Mathieson, 2001). The rationale for the study, therefore, was to provide normative information regarding the occurrence of this complex set of phenomena, which may be of use in the decision-making process of speech and language therapists. A pre-existing corpus of 15 female, south-east English speakers was prosodically annotated using the ToBI framework (Beckman and Ayers Elam, 1997; Silverman et al, 1992; Beckman and Pierrehumbert, 1986). The data comprised a reading passage of approximately one minute in length. The speakers were between the ages of 19 and 38 years; English was their native language. Tonal categories were established, based on the tones perceived in each word, its divisibility within the speech signal, and their overall frequency. The data were perceptually analysed for creak. The main findings suggest that creak occurs most often in tonal categories containing boundary tones, particularly when low, and in phrase-initial position. A wide range of speaker variation was also attested in the data. Findings support current literature suggesting that creak occurs in a non random distribution.
Cochlea-spectral entropy and intelligibility in spastic dysarthria associated with cerebral palsy
(Queen Margaret University, 2016)
The cochlea-scaled entropy (CSE) measure has been suggested as a measure of speech intelligibility in healthy speakers and speakers with hypokinetic dysarthria associated with Parkinson's disease (PD). However, the reliability of CSE measure use in speakers with spastic dysarthria associated with cerebral palsy (CP) is unknown. The aims of this study were to discover whether the CSE measure is a reliable measure for assessing speech intelligibility in people with spastic dysarthria associated with CP and whether the CSE measure is able to differentiate between healthy speakers and speakers with spastic dysarthria associated with CP. The performances of CSE parameters in the study are also discussed. Data from 25 speakers (12 in the CP group and 13 in the control group) was taken from the UA-Speech Database (Kim et al. 2008). The CP speakers were divided into groups according to their level of speech intelligibility: levels 4 (high), 3 (medium), 2 (low) and 1 (very low). Twenty-four single-word speech samples with three recording repetitions were analysed and were then divided into easy phoneme and difficult phoneme group for the investigation of the CSE performance between the groups. A Pearson correlation coefficient test was carried out to examine the correlation between the CSE measure and speech intelligibility in the CP group. Boxplots and t-tests were carried out to investigate the performance of the CSE values between the control and the CP groups as well as the CP subgroups. The CSE performances in the easy and difficult phoneme groups between the control and the CP groups were also examined using t-tests. The correlation between the CSE measure and the speech intelligibility in the CP group was not significant (p>.05). The CSE values between the control group and the CP group were significant different (p<.05) and the CSE values were higher in the control group (mean=13.01; SD=4.73; minimum=5.21 and maximum=48.12) than in the CP group (mean=12.42; SD=3.92; minimum=3.99 and maximum=41.53) as well as than other CP subgroups. The CSE standard deviation in the 12 words in the easy phoneme group and 10 out of 12 words in the difficult phoneme group showed significant differences (p<.05) between the control and the CP group. These findings suggest that CSE does not correlate with ratings of speech intelligibility in the CP group but the CSE measure was able to differentiate the control and the CP group. Moreover, the CSE SD may be the most sensitive parameter to differentiate healthy speakers and speakers with spastic dysarthria associated with CP when single word speech samples contain easy phonemes and one syllable.
Grammaticality judgments in linguistic and musical structures: is there behavioural evidence for a common processing system?
(Queen Margaret University, 2016)
A connection between language and music has been a matter of debate both in theory and empirical research. In theory, generativist approaches have posited common syntactic rules for music and language. In empirical research, efforts have been made to localize musical and linguistic syntactic processing in the brain, while others have suggested a common processing system. An online, graded grammaticality judgment task was administered to typical adults with and without music education. The stimuli contained structural deviances both in language and music: for linguistic syntax, deviant stimuli with adjective-noun disagreement were read, whereas for musical syntax, deviant stimuli with cadence violation were heard. These regular and irregular stimuli were judged alongside semantically regular and irregular sentences. For semantics, deviant sentences contained reversed thematic roles of nonreversible verbs, that is verbs that demand a [+animate] agent and a [-animate] theme. The participants read or heard the sequences and had to decide on a scale of 1-5 how acceptable the presented stimulus was. Reaction times were also recorded. It was hypothesized that stimuli with structural deviations would yield stricter judgments, whereas semantically deviant stimuli would yield milder judgments. No specific hypothesis was made on reaction times, although it was hypothesized that the group that had reported some years of music education would be quicker to decide on deviant music stimuli. However, it was observed that linguistic stimuli as a whole caused a binary judgment, whereas deviant music stimuli were more evenly distributed. No effect of music education was observed on the participants' performance. Optimality Theory suggests that constraint rules are hierarchically organized for each language, resulting in hard and soft constraints. A similar approach is observed in Generative Theory of Tonal Music and there have been some efforts to align these theories in a common framework for some levels of linguistic and music analysis. It is suggested that the constraints used for linguistic stimuli are hard, whereas the constraint used for music stimuli is soft. However, these two theoretical approaches have not been aligned in terms of syntactic analysis; thus further theoretical and empirical research is needed.
Make your memory work for it: The effect of increased speech rate and disfluencies on accuracy of story recall
(Queen Margaret University, 2017)
Cluttering is an under-investigated fluency disorder characterized by excessive disfluencies and rapid speech rate. Most research examines these features from a production or low-level contextual perception viewpoint, rather than investigating their effects on more complex discourse comprehension. Models of discourse comprehension emphasize the involvement of working memory in recall, but it is unknown how these factors interact with characteristics of cluttering. This study therefore aimed to fill the literature gap with regards to repetition disfluencies and rapid speech rate at the discourse recall level and investigate their relationship with individual working memory span. The study replicated the methodology from Fraundorf and Watson [2011, The disfluent discourse: Effects of filled pauses on recall. Journal of Memory and Language. vol. 65, no. 2, pp. 161-175]. Forty participants listened to 4 recordings of passages paraphrased from Alice's Adventures in Wonderland in one of the four conditions (Control, Speed, Disfluent, and Combined) and were asked to recall the story and complete a rating of the speed, fluency, and comprehensibility. Results suggest that excessive disfluencies and increased speech rate significantly reduce a listener's recall of information from discourse. This supports the prioritisation of speech rate in intervention goal setting. No relationship between working memory spans and recall were observed.
AN INVESTIGATION INTO THE EFFECT OF CARBONATED THIN AND THICKENED LIQUIDS ON THE DURATION OF SWALLOWING IN NORMAL HEALTHY INDIVIDUALS.
(Queen Margaret University, 2017)
Carbonic acid is believed to heighten sensory input to the nervous system and trigger a faster or more effective swallow. (Logemann 1996, 1998) Previous research into the effect of carbonic acid on measures of pharyngeal transit time, pharyngeal retention of residue, and penetration/aspiration have highlighted its potential as an effective sensory stimulant. Further investigation into how the normal swallowing process responds to oropharyngeal sensory input is required before diet plans that include trigeminal irritants may be used in dysphagia management. Using a swallowing reaction time test, the present study was designed to determine whether carbonation, an acidic chemical stimulus, effectively facilitates positive changes, i.e. reduced total swallow duration (TSD), in the swallowing physiology of 30 healthy subjects with normal oropharyngeal swallow. In addition, the study aimed to determine whether thickened boluses will differentially modify swallowing latencies compared with thin carbonated and non-carbonated liquids. Palatability and subjective difficulty of swallow rating scales were also collected for each stimuli to determine an overall effective and palatable stimulus. The test beverages included; filtered tap water, a condition with no stimulation, fizzy water, a stimulation by carbonic acid alone, Ribena, a gustatory stimulation (sweet taste) without carbonic acid and Coca-Cola, a gustatory stimulation (sweet taste) with carbonic acid. Aims; 1. What is the effect of flavoured and non-flavoured carbonated thin liquids on total swallow duration, when compared to flavoured and non-flavoured; (A) Thin non-carbonated liquids (B) Thickened (stages 1-3) non-carbonated (C) Thickened (stages 1-3) carbonated liquids. 2. How do the palatability and SDS ratings of flavoured and non-flavoured carbonated thin liquids differ from, flavoured and non-flavoured; (A) Thin non-carbonated liquids (B) Thickened (stages 1-3) non-carbonated liquids (C) Thickened (stages 1-3) carbonated liquids. It was hypothesised that varying carbonation, consistency and flavour would affect TSD, palatability and SDS and thus provide new data on how they interact with swallowing physiology. The results showed that thin carbonated (T-C) stimuli did not significantly reduce TSD or palatability in comparison with thin non-carbonated stimuli. T-C stimuli did significantly reduce SDS. Thin stimuli significantly reduced TSD, palatability and SDS in comparison with thickened stimuli. Flavour significantly reduced TSD, palatability and SDS when compared to non-flavoured. Possible explanations for differences between the current findings and those of earlier studies are discussed.
Mobile voice monitoring with self-reported mood, stress, activity and fatigue ratings
(Queen Margaret University, 2017)
An Investigation into the Use of Ultrasound Tongue Imaging (UTI) as a Biofeedback Tool for Improving the Speech Production of Non-Native Sounds in Second Language Learners
(Queen Margaret University, 2017)
Ultrasound Tongue Imaging (UTI) has been used to successfully treat a variety of articulation errors in speech disorders. More recently, however, UTI has been applied to second language acquisition research. This study has been developed as a follow-up to an earlier pilot study (Gick, 2008) with the goal of investigating the pedagogic use of UTI in second language acquisition. UTI will be used as a biofeedback tool to try to improve the pronunciation of the non-native English phonemes /ɹ/ and /l/ in Japanese-English speakers. The study will look at the effectiveness of UTI in improving the perceived accuracy and intelligibility of L2 articulation, in contrast to a control intervention using a speech visualisation mobile application. Finally, the study will investigate whether or not there is a cumulative effect when participants receive intervention using both the speech visualisation mobile application and UTI back to back. Aims- for the participants to accurately produce the non-native target sounds /ɹ/ and /l/ in isolation and at word-level and then be able to generalise these to connected speech; for listeners to perceive connected speech featuring target sounds as more accurate and intelligible. Hypothesis- target sounds will be produced and generalised and perceived accuracy and intelligibility will increase after UTI intervention more significantly than with the control group using a speech visualisation mobile application. Those who receive both interventions sequentially will demonstrate the greatest improvement. Method- Participants: Six English-speaking Japanese females (preferably young adults aged 20-30). Recordings, before and after, of target sounds /ɹ/ and /l/ in isolation, single words and sentences. Ultrasound images, before and after, of target sounds. Listener ratings of accuracy and intelligibility of target sounds in connected speech, before and after. Treatment: six 20-30 minutes sessions (weekly) using ultrasound as a biofeedback tool to teach participants tongue placement/articulation of target sounds /ɹ/ and /l/. Design: single participant design/changing criterion design. The design will include 3 phases: baseline, intervention and follow-up (this will include a long-term follow-up). This design allows participants to act as their own control, however, the group will additionally be divided into two groups to provide a further control. 3 participants will initially receive an intervention involving only a mobile application with the hypothesis that this will not result in any marked improvement. They will subsequently receive the UTI intervention. Comparison of final results with those of the other group will establish or rule out any cumulative effect of both interventions versus solely the UTI intervention.
Daily Voice Regimen to Promote Healthy Ageing of Voice: An Extended Research Proposal
(Queen Margaret University, 2017)
The deterioration of muscles and organs, which is part of the normal ageing process, also impacts vocal condition. Anatomical changes within the vocal organs during ageing lead to perceptual/acoustic variations such as changes in F0, increased perceived breathiness and hoarseness, and decreased loudness and maximum phonation time (MPT). The ageing voice may further develop presbyphonia or risk factors for other voice disorders such as hyper-functional vocal misuse. With the growth in the ageing population around the globe, increased focus need to be put on promoting good health and good quality of life for elderly individuals. A large area of focus has been on maintaining physical health through daily physical exercise. However, limited research has addressed how to maintain good vocal quality. While it has been found that vocal function exercise (VFE) and the Lee Silverman Voice Treatment (LSVT) improve the voice quality of elderly individuals, both exercises target the pathological state and are time consuming. Thus, a simple and practical voice regimen is required. In this proposal, a new daily voice regimen based on research evidence and elderly persons' opinions is introduced. A preliminary survey was conducted to collect the opinions of 45 elderly individuals. A pre-test/post-test control group design will be used to examine the effectiveness of the voice regimen within a wide range of acoustic parameters, namely fundamental frequency (F0), jitter, shimmer, noise-to-harmonic ratio (NHR), sound pressure level (SPL) and an aerodynamics measurement: maximum phonation time (MPT). Acoustic data and a qualitative questionnaire collected 6 months after the second data collection will be used to assess the long-term effect of proposed regimen. The study will contribute to increasing knowledge about the ageing voice for use in academic research and clinical practice. The findings will raise awareness of the need for voice care in the ageing population, while demonstrating an effective preventative programme to promote the healthy ageing of the voice. The preventative programme will not only contribute to a better quality of life, but will also provide a cost-effective plan for use in the National Health System.
An electropalatographic investigation of lingual consonants produced by a typically developing 9-year-old boy
(Queen Margaret University, 2017)
Background: Electropalatography has been used for many years in the treatment of children with intractable speech disorders. However, to this day, children's tongue-palate contact patterns are compared to adult patterns as there are no published norms for children. Previous studies have found that children's lingual motor control continues to develop into adulthood. This can cause a problem when comparing to typical adult data, as development may cause a child's tongue-palate contact patterns to be different than adults. The focus of the current pilot study was to find useful information to help in the development of methodologies for future research to eventually develop EPG norms for children. Aims: 1. To identify and chart lingual palatal contact patterns for a range of lingual consonants for a typical 9-year-old boy. 2. To identify any differences in lingual palatal contact patterns between a typically developing 9-year-old boy and adult typical data provided by McLeod and Singh (2009). Methodology: This pilot study analysed pre-existing data to identify tongue-palate contact patterns for a typically developing 9-year-old boy. The lingual consonants of focus were /t/, /d/, /n/, /k/, /g/, /ŋ/, /s/, /z/, /ʃ/, /l/, /ɹ/, and /j/. The phonemes were present in single-word and sentence-level wordlists. These wordlists presented the target phonemes in word-initial and word- final positon and in various vowel contexts. The maximum point of contact was identified for each target sound which enabled the variability index to be calculated and cumulative displays to be created. The tongue-palate contact patterns and the variability index were charted to identify intra-speaker variability, and the cumulative displays were compared to typical adult patterns to identify if any inter-speaker variability could be found. Results: The participants' tongue-palate contact patterns on the most part showed consistent shapes throughout, however, they did remain variable as a decrease in variability over a three-month period was not observed. Vowel context appeared to have an influence on variability for alveolar and velar stops. When comparing to adult patterns, the child appeared to have differences in tongue-palate contact patterns for all the lingual consonants apart from /k/. Conclusions: The findings suggested that the child was continuing to go through a period of refinement of their lingual motor control, as variability was seen throughout the data and differences in contact patterns were observed when compared to adults. However, meaningful conclusions could not be made as the data was limiting due to varying repetitions and vowel/word contexts. Despite this, the current pilot study did find information that is essential to the development of methodologies for future EPG research focusing on typical children. A study was proposed taking the limitations from this pilot study into consideration, so that child EPG norms could be established in the future.
A comparison between autocorrelation and CPPS derived voice onset thresholds for Phonation Stabilisation Time
(Queen Margaret University, 2017)
Acquisition of the word-initial stop voicing contrast: a longitudinal single case study
(Queen Margaret University, 2017)
In order to fully understand disordered speech and be able to treat it we must be able to compare this to typical speech development characteristics. Voicing contrast is a speech characteristic that has received a lot of attention in the literature. This is the difference between a voiced and voiceless phoneme at the same place of articulation (e.g. the difference between a /p/ and a /b/). Acoustically, we can analyse this by recording the voice onset time (VOT) in each phoneme. The length of time between the release of the stop consonant and the onset of the vibration of the glottis, describes VOT. In this study, we looked at the acquisition of voice onset time through a single case study of an English-speaking child. This child's VOT was recorded bimonthly from 70 weeks to 144 weeks old. The labial and alveolar targets were extracted from the data and the VOT was recorded. This data was then analysed using both means and token-by-token data analysis methods. We found similarly to Hitchcock and Koeing (2013, 2015), that VOT acquisition is not a discreet acquisition event and instead it is variable and may take months if not years to reach adult like VOT values consistently.
Clinical Decision Making in the Treatment of Children with Vowel Disorders
(2018)
This study addresses the current clinical decision making within Speech and Language Therapy (SLT) practice, regarding children with vowel disorders, seeking to find out why they are rarely treated in clinical practice. Disorders of the vowel system have implications on speech intelligibility, yet are rarely treated in clinical practice. Vowel disorders remain an under-researched topic within the literature, containing little information on areas relating to assessment, treatment and guidance. The study takes the format of an extended research proposal, incorporating a mixed method design protocol; including both quantitative and qualitative techniques to collect data. The proposal will employ a questionnaire based data collection technique, which is suitable for online completion. The questionnaire is designed to describe practices regarding assessment, transcription, therapy approaches, confidence and guidance for children with vowel disorders. The questionnaire will also require SLTs to demonstrate competency by completing practical tasks surrounding knowledge of vowels. This methodological approach will provide results both objectively and performance based. Having knowledge of clinical decision making in the area of vowel disorders, allows for changes to be made to improve any weak areas of SLT treatment which have been highlighted, such as improved training, making this study a valuable contribution to the field.