MSc in Speech and Language Therapy

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

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A comparison between autocorrelation and CPPS derived voice onset thresholds for Phonation Stabilisation Time
(Queen Margaret University, 2017)
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.
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.
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.
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.
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.
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.
Are Nursing Staff Achieving Accurate Consistencies of Thickened Fluids Following IDDSI Implementation and What Factors Do They Perceive to Influence This? An Extended Proposal
(2020-04)
Thickened fluids are a popular management method for dysphagia as thicker fluids move more slowly meaning individuals with dysphagia have more time to protect their airway. However, research has shown that nursing staff do not always achieve accurate consistencies when thickening fluids and this can have negative impacts on patients’ health, including dehydration if fluids are too thick, and aspiration which can result in a chest infection if fluids are too thin, or too thick. It was proposed that the provision of consistent terminology would be a potential solution to this issue, and therefore the International Dysphagia Diet Standardisation Initiative (IDDSI) was introduced to provide globally standardised terminology for thickened fluid consistencies. The first phase of the proposed study intends to use a descriptive, non-experimental design to observe the percentage of fluids thickened inaccurately by nursing staff. There are other factors aside from inconsistent terminology that could impact upon the accuracy of consistency of thickened fluids such as subjective measurements used to check consistency, a lack of training in how to thicken fluids, a lack of understanding for the rationale of thickened fluids and a lack of compliance with recommendations for thickener. Therefore, the second phase of the proposed study will use interpretative phenomenological analysis to interview nursing staff to acquire their perspectives on factors that they feel affect their ability, competence and willingness to thicken fluids to accurate consistencies, as well as their opinion on the implementation of IDDSI within their setting. Results from this mixed methods study will suggest how often fluids are thickened to inaccurate consistencies by nursing staff and suggest what factors are influencing this. By gaining this knowledge, actions can be proposed that are likely to improve nursing staffs’ ability, competence and willingness to thicken fluids to accurate consistencies.
Assessing Scottish Speech Sound Disorders: An Analysis of Assessment Tools’ Compliance with Good Practice Guidelines for the Transcription of Children’s Speech
(2019-04)
Background: There is a high prevalence of developmental speech difficulties in the UK, and speech sound disorders (SSDs) often make up a large portion of individual clinical caseloads. Children with SSD are shown to have an increased risk of difficulty in areas such as social integration, literacy and education. Speech and Language Therapists (SLTs) play an important role in improving outcomes for children with SSD by providing timely involvement. This relies on a process of efficient, effective assessment and diagnosis which forms a basis for successful therapeutic intervention. Aims: This study aimed to determine whether published speech sound assessments commonly used by paediatric SLTs in Scotland elicit sufficient speech sound data to make an informed diagnosis of SSD. Effectiveness of the assessments was measured by comparison to the Good Practice Guidelines for the Transcription of Children’s Speech issued by the Royal College of Speech and Language Therapists (RCSLT). Method: Using Scottish Standard English (SSE) as the target accent, the word lists of eight speech sound assessments were analysed according to pre-determined phonetic and phonological criteria as a measure of content validity. In parallel with this analysis, data was collected via a questionnaire which sought to explore current SLTs’ practices regarding the assessment of SSD. Results: None of the eight assessments analysed were able to fulfil all pre-determined criteria for completeness. Respondents to the survey (n=9) indicated that they had used six of these assessments in the past year to assess phonological delays or disorders. They also reported that access to resources was the most common factor which influenced their decision to use a particular speech sound assessment. Conclusions: This study demonstrates that many of the published speech sound assessments currently in use in Scottish clinics do not match good practice guidelines recommended by the RCSLT. SLTs working with paediatric caseloads should be supported to expand their battery of speech sound assessments to ensure that the process of diagnosing SSD is as rigorous and complete as possible.
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.
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.
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.
Developmental Language Disorder: An Education Staff perspective
(2021)
This study investigates education staff’s current training, experience and knowledge of Developmental Language Disorder (DLD) and wider speech, language and communication needs (SLCN) in Jersey. DLD is a common but hidden disorder which makes is difficult to identify. Additionally, this is an under-researched area in proportion to its prevalence in the population. Consequently, children with DLD are currently not receiving the support that they deserve. Speech and Language Therapy (SLT) is a cost effective method of ensuring these children receive the interventions the require to help minimise further potential costs to the individual and society as a whole. 44 participants from a range of educational backgrounds completed a questionnaire asking about their background; their knowledge, training and experiences of SLCN; their awareness and understanding of DLD as well as their confidence in identifying and supporting the needs of a child with DLD; the ways in which they support language development in the classroom; and finally, about their engagements with the SLT service, the ways in which they value it and how support could be improved. It was found that more needs to be done to better support education staff in relation to SLCN. The research concludes that more need to be done to improve the collaborations between Speech and Language Therapists (SLTs) and both education staff and parents, improve training opportunities for education staff as well as make changes to service delivery, improve resources and employ more staff. There are no quick solutions that will solve the current problems in service delivery, research and awareness of DLD, but this research does recommend some ways to shape future research and clinical practice which hope to improve the situation that children with DLD helplessly find themselves in.
Developmental Language Disorder: From a Health Professionals’ Perspective
(2019-04)
Language Disorder (LD) is a common yet widely misunderstood diagnosis, affecting access to support and underrepresentation in research. The requirement for clarity surrounding terminology and diagnostic criteria associated with LD led Bishop and colleagues (2016; 2017) to run a Delphi panel in order to reach a common consensus on the matter and raise the public profile of the topic. It was decided that Specific Language Impairment (SLI) will be replaced by Developmental Language Disorder (DLD), to describe individuals who have a LD that is not associated with any biomedical condition. The current study was interested in exploring the awareness and understanding of LD amongst health professionals who have the potential to come across this diagnosis in their practice. A group of Health Visitors (HVs, n = 30) and General Practitioners (GPs, n = 78) from a Health Board in Central Scotland participated in an online questionnaire. Results showed that HVs have a better awareness and understanding of the terms LD, SLI and DLD, in comparison to GPs, with all health professionals being most aware of the term LD and least aware of SLI. Health professionals were not aware of the recent terminology changes around LD and the majority expressed having no preference in terminology between DLD and SLI. Although many health professionals had received training in LD at some point in the past, the majority acknowledged that more training would be beneficial to their practice. Possible explanations and implications are discussed. Altogether, findings from this study suggest a requirement for future research to focus on the provision of good quality training for health professionals, exploring who should deliver it, who should receive it, what the content should cover, and how frequent it should be.
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.
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.
The effect of dyslexia on the production of speech errors, repairs and disfluencies
(2020-06)
Tests of verbal working memory are used to measure reading skills in individuals with dyslexia (Shaywitz et al. 2005; Ogino et al. 2017). The production of clear and fluent speech is also dependent on verbal working memory due to a limited capacity to retain and rehearse information and therefore less opportunity to check for errors prior to speech production (Jacquemot and Scott 2006). Despite these links, there is limited evidence regarding the association between dyslexia and the production of speech errors, repairs and disfluencies. The primary aim of the present study is to investigate the link between dyslexia and speech error production, while considering the effect of working memory capacity on speech errors, repairs and disfluencies. An additional aim of the study is to explore the effect of gender on working memory and speech errors. The working memory capacity of each participant is measured using three working memory tasks: reverse digit span, reorganising digits and non-word repetition. Speech errors are induced experimentally using a tongue-twister paradigm while speech repairs and disfluencies are naturally elicited through a spontaneous speech sample. The results are analysed using statistical analysis, exploring the relationship between working memory and speech errors, repairs and disfluencies, and investigating the difference between the speech errors produced in the dyslexia and control groups. It is concluded that individuals with dyslexia produce more speech errors, repairs and disfluencies than those without dyslexia, and that this is linked to verbal working memory. This contributes to evidence that tests of speech errors, repairs and disfluencies could be used as a predictor of dyslexia. The significance of these results, however, is dependent on the type of speech error elicitation task used.
The Effects of the Five Basic Tastes on Oral Transit Time for People with Dementia: An Extended Research Proposal
(2020-04)
Background: Tastes in differing concentration levels heightens sensory input to the cortical swallowing centres. Taste stimulation is an intervention for dysphagia management that introduces a taste into the mouth, in order to modulate the timing of the swallow. This dissertation considers taste stimulation as an intervention directed to help people with dementia with swallowing difficulties. People with dementia often experience difficulties with the voluntary phases of the swallow, resulting in slow or absent initiations of the swallow, leaving individuals malnourished, dehydrated and at high risk of developing aspiration pneumonia. Taste has been identified as a sensory factor that can be manipulated to stimulate an initiation of the swallow, resulting in fewer hospital admissions and better quality of life for individuals and their families. Purpose: This paper aims to identify the taste and concentration level that decreases the oral transit time for people with dementia. Methods: The effects of taste on oral transit time will be measured using Ultrasound Tongue Imaging. A small pilot study was undertaken to determine the feasibility of this method in measuring oral transit time and to identify methodological improvements for transferring the method to a dementia population. All five basic tastes were observed in the small study with three concentration levels for each taste. The results from the pilot study indicated that the bitter taste could be omitted from testing in the research proposal as it had no impact on the swallow. Conclusions: The research proposal hypothesises that the most effective taste and concentration level for people with dementia will be a highly concentrated sour bolus. The results will go some way to improving dysphagia interventions for people with dementia, by advocating for taste stimulation to become a mandatory early intervention for all individuals diagnosed with dementia.
Electropalatography therapy in children with Down syndrome. Does cognitive ability come into play?
(2018)
The present dissertation investigated the relationship between cognitive ability, as measured on the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III UK), and the effectiveness of Electropalatography (EPG) therapy, as measured by % intelligibility on the Children’s Speech Intelligibility Measure (CSIM) and % consonants correct (PCC) from the Diagnostic Evaluation of Articulation and Phonology (DEAP), on the speech intelligibility of individuals with Down Syndrome (DS). Individuals with DS present with impairment in speech and language, alongside their cognitive difficulties, leading to reduced speech intelligibility. EPG therapy has previously been used for speech intelligibility difficulties in individuals with DS. Research in this field has yet to focus on the relation between cognitive ability and EPG therapy in those with DS. 9 children and adolescents with DS, aged 9;10 to 18 years, were recruited from a larger project conducted previously. Participants completed the WPPSI cognitive measure, DEAP phonology sub-test and the CSIM intelligibility measure. The results were analysed both qualitatively and quantitatively and correlated to determine relationships. A significant increase was found in PCC following therapy, indicating that consonant production improved. A correlation was found between PCC and CSIM scores, implying that improved consonant production may lead to better general intelligibility. Most participants showed improvement when evaluating their EPG frames pre-therapy, post-therapy, 3- and 6-months post-therapy and comparing them to typical examples. Some trends were evident in the limited improvement of the participant with the lowest cognitive ability; however, there was no evident difference in improvement of those with higher and lower cognitive abilities. EPG therapy appears a suitable approach for children with DS who present with speech sound disorder to improve intelligibility and research should investigate further whether cognitive ability is related to this improvement.
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.