Completed Research Activity in Child Speech Disorder in the UK

Sara Wood. (2016) Improving the speech communication abilities of children with Down's Syndrome: A new model of service delivery using Electropalatography (EPG).

Children with Down’s syndrome (DS) present with specific difficulties with speech production which are not in line with their cognitive abilities. These difficulties often lead to poor speech intelligibility and communication breakdown. This in turn can cause frustration, behaviour difficulties, academic failure and social exclusion all of which can have a negative impact on the child’s psychosocial wellbeing. Furthermore, the speech of children with DS tends to be resistant to traditional methods of speech therapy so speech and language therapists often focus on total communication, which may involve signing or picture symbols.

This project set out to investigate the use of Electropalatography (EPG), a visual biofeedback technique used in specialist research clinics, to improve the speech intelligibility of children aged 6 to 10 years with DS. Previous research conducted at Queen Margaret University (QMU) trialling the use of EPG with children with DS had shown that speech intelligibility could be significantly improved. This project planned to extend the success of earlier research by taking the specialised intervention into schools thereby making the technique more readily available. The aim was to develop and evaluate a consultative model of intervention which would provide specialised training to educational support staff who would deliver speech input within the child’s normal school environment. It was proposed that this would allow for more intensive intervention which children with DS require due to learning and memory difficulties.

Results indicate that a consultative model is viable and that improvements in intelligibility as measured by pre and post therapy questionnaires were evident. A significant improvement in speech accuracy as measured by an increase in percent consonants correct was also recorded.

This research was funded by the Nuffield Foundation.

A copy of the full report can be downloaded from the Nuffield Foundation.

Sara Wood. (2016) Clinical skills training for SLTs: using the evidence-base to treat Speech Sound Disorder (SSD) using Electropalatography (EPG).

Speech sound disorders (SSD) affect a large proportion of children on Speech and Language Therapists (SLTs) caseloads. The impact on the child can be far reaching, disturbing both social and educational development. Traditional therapy interventions are often lengthy and do not always resolve the SSDs. Electropalatography (EPG) is an instrumental visual-feedback technique used mainly in research clinics which has proven effective in the treatment of SSDs.

This research aimed to train six SLTs in the use of EPG to treat children for whom traditional methods had failed. Workshops were offered to all interested SLTs which targeted: increasing knowledge of SSDs and possible barriers to success in therapy; increasing knowledge of EPG, specifically diagnostic benefits and therapy outcomes; helping SLTs to identify children on their caseload who may benefit from EPG. Following these 28 children were referred for consideration from which 3 children were chosen.

Two of the three children responded to EPG therapy and successfully remediated their speech errors within 12 weeks and were subsequently discharged. For the third child who has multiple speech errors and requires ongoing surgical intervention in addition to therapy, EPG proved diagnostically very important as well as allowing progress previously not made in therapy.

It became apparent that data security policies in NHS Lothian are incompatible with the Articulate Assistant software required to run EPG. Therefore whilst this method of intervention proved very successful in remediating the SSDs it cannot currently be adopted into the NHS without further considerations. Alternative visual-feedback techniques are being explored.

This research was funded by Clinical Skills Managed Educational Network.

The final full report can be downloaded from Queen Margaret University.

Sharynne McLeod. (2015) Sound Start: Innovative technology to promote speech and pre-literacy skills in at-risk preschool children.

The Sound Start Study was a cluster randomised controlled trial which took place in New South Wales preschools from 2013 to 2015. The trial tested an intervention for children's speech sound disorder, specifically the delivery of the Phoneme Factory Sound Sorter software (Wren & Roulstone, 2013) delivered by teaching assistants in the participating preschools. The results of the study are reported in McLeod et al, (July, 2017). To summarise, the study found that there was no significant difference in the progress made in speech development between those children who received the Sound Sorter intervention delivered by teaching assistants and those who received typical care. The paper discusses possible reasons for these findings including whether it was the intervention itself or whether the method of delivery by teaching assistants rather than speech and language therapists could have had an impact.

This research was funded by an Australian Research Council Development Grant.

Yvonne Wren. (2014) A pilot study of speech development in typically developing 12 month olds.

The purpose of this pilot study was to examine the relationship between patterns of interaction and early speech output, using LENA (Language Environment Analysis).  LENA is small recording device placed into a pocket of a vest worn by the child.

This research was funded by North Bristol Hospital Trust Springboard Fund.

Jane Speake. (2013) Intelligibility in children with Persistent Speech Disorder (PSD).

The study focused on children with persisting speech difficulties (PSD) presenting with severe and ongoing impairments in segmental and prosodic output which resulted in poor intelligibility. I examined the speech processing skills and intelligibility of four children with PSD, carried out detailed phonetic and phonological analysis, and investigated of their speech output and intelligibility in single words (SW) and multi-word utterances (MWU). These assessments were carried out twice with an average of 12 months between each testing period. Samples of SW and MWU were played to adult listeners who responded orthographically; these utterances were matched to the children’s known output to assess intelligibility. 

Psycholinguistic tasks revealed that the children had pervasive and complex speech processing difficulties. Phonological process analysis based on traditional SW sampling failed to capture important aspects of children’s speech; analysis of MWU revealed phonetic and prosodic features essential to describing and understanding children’s development of “real talk”(Howard, 2007, p. 20).  Intelligibility outcomes revealed listeners’ recognition was better for MWU in three of the children; intelligibility was better for all children at second testing.

The study concluded that children with PSD benefit from thorough investigation of input and output speech processing skills; assessment of MWU is essential in capturing segmental and prosodic aspects of speech output to explain poor intelligibility and plan intervention.

This research was funded by a fee bursary from University of Sheffield.