Evaluating Ultrasound Visual Biofeedback Therapy in Treating Residual Speech Sound Disorder

Abstract

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.