Ultraphonix : using ultrasound visual biofeedback to teach children with special speech sound disorders new articulations

Cleland, Joanne and Scobbie, James and Roxburgh, Zoe and Heyde, Cornelia and Wrench, A.A. (2017) Ultraphonix : using ultrasound visual biofeedback to teach children with special speech sound disorders new articulations. In: 7th International Conference on Speech Motor Control, 2017-07-05 - 2017-07-08.

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Abstract

Background: Ultrasound Visual Biofeedback (U-VBF) provides learners with “knowledge of performance” (Maas et al., 2008) that enables them to establish new, more accurate motor programmes for previously in-error speech sounds. The evidence for U-VBF is promising, with around 30 small studies. Although more recent studies differentiate acquisition, retention and generalisation of target articulations (see Sjolie et al., 2016) no studies report in detail when children who begin intervention not stimulable for a particular sound are first able to produce that new articulation. This is an important issue for establishing the dosage of U-VBF. The current study is an investigation of the effectiveness of U-VBF, with particular attention paid to when and how children acquire new articulations. Participants: Fifteen children aged 6 to 15 with SSDs affecting vowels and/or lingual consonants in the absence of structural abnormalities. Method: Single-subject multiple (3) baseline design, with untreated wordlists. Ultrasound was recorded synchronously with audio and used to review dynamic information about the children’s speech errors for diagnostic purposes. Each child received 10-12 sessions of U-VBF with each child required to perform at 80% accuracy at each level of performance before moving on to a motorically more demanding level (for example, from single syllable words to disyllabic words). Analysis: Narrow transcription of wordlists was undertaken and percentage targeted segments correct calculated. Prior to intervention the ultrasound data was analysed both qualitatively and quantitatively to identify errors. Results: Six children were treated for velar fronting; three for post-alveolar fronting; three for the unusual pattern of backing to pharyngeal or glottal; one for production of all syllable onsets as [h]; one for vowel merger and one for lateralised sibilants. Most children (10/15) achieved the new articulation in the first or second session. Four children took until the 6th to 9th session to achieve the new articulation and one never did. Those children who acquired the new articulation earlier in the therapeutic process were able to integrate that new articulation into words and sentences more quickly and generalise to untreated words more successfully. 13/15 children made improvements of more than 20 percentage points increase in the accuracy of targeted segments in untreated wordlists. One child made no improvement and one moved towards a phonetically closer approximation of the target.