Growing evidence suggests that speech intervention using visual biofeedback may benefit people for whom visual skills are stronger than auditory skills (for example, the hearing-impaired population), especially when the target articulation is hard to describe or see. Diagnostic ultrasound can be used to image the tongue and has recently become more compact and affordable leading to renewed interest in it as a practical, non-invasive visual biofeedback tool. In this study, we evaluate its effectiveness in treating children with persistent speech sound disorders that have been unresponsive to traditional therapy approaches. A case series of seven different children (aged 6-11) with persistent speech sound disorders were evaluated. For each child, high-speed ultrasound (121 fps), audio and lip video recordings were made while probing each child's specific errors at five different time points (before, during and after intervention). After intervention, all the children made significant progress on targeted segments, evidenced by both perceptual measures and changes in tongue-shape.

Claire (2008) The relationship between speech, oromotor, language and cognitive abilities in children with Down's syndrome. Accessed from:http://eresearch.qmu.ac.uk/155/ Repository Use PolicyThe full-text may be used and/or reproduced, and given to third parties for personal research or study, educational or not-for-profit purposes providing that:• The full-text is not changed in any way • A full bibliographic reference is made • A hyperlink is given to the original metadata page in eResearch eResearch policies on access and re-use can be viewed on our • Details to come. © the individual authors 2008This series consists of unpublished "working" papers. They are not final versions and may be superseded by publication in journal or book form, which should be cited in preference.All rights remain with the author(s) at this stage, and circulation of a work in progress in this series does not prejudice its later publication.Comments to authors are welcome. 1The relationship between speech, oromotor, language and cognitive abilities in children with Down's syndrome AbstractBackground: Children and young people with Down's syndrome (DS) present with deficits in expressive speech and language, accompanied by strengths in vocabulary comprehension compared to nonverbal mental age. Speech intelligibility is particularly impaired, but whether speech is delayed or disordered is a controversial topic. Most studies suggest a delay, but no studies explore the relationship between cognitive or language skills and intelligibility. This study sought to determine whether severity of speech disorder correlates with language and cognitive level and to describe the types of errors, developmental or non-developmental, that occur in the speech of children and adolescents with DS. Methods & Procedures: 15 children and adolescents with DS (aged 10 to 18) were recruited. Participants completed a battery of standardised speech, language and cognitive assessments. The phonology assessment was subject to process analyses. Results from each test were correlated to determine relationships. Outcome & Results:People with DS present with deficits in receptive and expressive language that is not wholly accounted for by their cognitive delay. Receptive vocabulary is a strength in comparison to language skills, but it was unclear whether it is more advanced compared to non-verbal cognitive skills. The majority of speech errors were developmental in nature but all of the children with DS showed at least one atypical or non-developmental speech error. Conclusions: Children with DS present with speech disorders characterised by (often unusual) atypical errors alongside many developmental errors. Lack of correlation between speech and cognition or language suggests that the speech disorder in Down's syndrome is not simply due to cognitive delay.

Objective: This study investigated whether adding an additional modality, namely ultrasound tongue imaging, to perception-based phonetic transcription impacted on the identification of compensatory articulations and on interrater reliability. Patients and Methods: Thirty-nine English-speaking children aged 3 to 12 with cleft lip and palate (CLP) were recorded producing repetitions of /aCa/ for all places of articulation with simultaneous audio and probe-stabilised ultrasound. Three types of transcriptions were performed: 1. Descriptive observations from the live ultrasound by the clinician recording the data; 2. Ultrasound-aided transcription by two ultrasound-trained clinicians; and 3. Traditional phonetic transcription by two CLP specialists from audio recording. We compared the number of consonants identified as in error by each transcriber and then classified errors into eight different subcategories. Results: Both the ultrasound-aided and traditional transcriptions yielded similar error-detection rates, however these were significantly higher than the observations recorded live in the clinic. Interrater reliability for the ultrasound transcribers was substantial (k=0.65), compared to moderate (k=0.47) for the traditional transcribers. Ultrasound-aided transcribers were more likely to identify covert errors such as double articulations and retroflexion than the audio-only transcribers. Conclusion: Ultrasound-tongue imaging is a useful complement to traditional phonetic transcription for CLP speech.

This study involved a qualitative analysis of speech errors in children with autism spectrum disorders (ASDs). Participants were 69 children aged 5-13 years; 30 had high functioning autism and 39 had Asperger syndrome. On a standardised test of articulation, the minority (12%) of participants presented with standard scores below the normal range, indicating a speech delay/ disorder. Although all the other children had standard scores within the normal range, a sizeable proportion (33% of those with normal standard scores) presented with a small number of errors.Overall 41% of the group produced at least some speech errors.The speech of children with ASD was characterised by mainly developmental phonological processes (gliding, cluster reduction and final consonant deletion most frequently), but nondevelopmental error types (such as phoneme specific nasal emission and initial consonant deletion) were found both in children identified as performing below the normal range in the standardised speech test and in those who performed within the normal range. Nondevelopmental distortions occurred relatively frequently in the children with ASD and previous studies of adolescents and adults with ASDs shows similar errors, suggesting that they do not resolve over time. Whether or not speech disorders are related specifically to ASD, their presence adds an additional communication and social barrier and should be diagnosed and treated as early as possible in individual children. Speech in ASD 3Articulation and phonology skills are often a relative strength in children with autism spectrum disorders (ASDs), with most studies reporting either age-appropriate or superior speech compared to other expressive language abilities (Rapin & Dunn, 2003). Kjelgaard and TagerFlusberg (2001, p. 287) studied 89 children with ASD and concluded that "among the children with autism there was significant heterogeneity in their language skills, but across all the children, articulation skills were spared". An earlier study by Boucher (1976) reached a similar conclusion. She used the Edinburgh Articulation Test (Anthony, Bogle, Ingram, & McIsaac, 1971) to compare articulation in children with autism, delayed language development and receptive dysphasia. The results showed that the children with autism had superior articulation compared to the children in the other two groups.However, a recent study by Rapin et al. (2009) has shown that a significant proportion of children with ASD do present with impaired speech. They used standard scores from an articulation test to drive cluster analysis of language abilities in 62 school-aged children with ASD (mean age 8;6) and proposed two main types of language disorders in this age group: severe impairment in expressive phonology (24%) and borderline/normal phonology with impaired comprehension (76%). Since there was no analysis of the actual errors made by the children it is not possible to know whether they were presenting with a delayed or disordered profile.Some earlier studies suggest th...

Background: As cost and access barriers to ultrasound technology have decreased, interest in using ultrasound visual biofeedback (U-VBF) as a tool for remediating speech sound disorders (SSD) has increased. A growing body of research has investigated U-VBF in intervention for developmental SSD; however, diversity in study design, participant characteristics, clinical methods and outcomes complicate the interpretation of this literature. Thus, there is a need for a synthesis and review of the evidence base for using U-VBF in intervention for SSD. Aims: To synthesise and evaluate the research evidence for U-VBF in intervention for developmental SSD. Methods: A systematic review was conducted. Eight electronic databases were searched for peer-reviewed articles published before 2018. Details about study design, participants, intervention procedures, service delivery, intervention intensity and outcomes were extracted from each study that met the inclusion criteria. The included studies were rated using both a critical appraisal tool and for their reporting of intervention detail. Main Contributions: Twenty-eight papers, comprising 29 studies, met the inclusion criteria. The most common research design was single-case experimental design (44.8% of studies). The studies included between one and 13 participants (mean = 4.1) who had a mean age of approximately 11 years (range = 4;0-27 years). Within the research evidence, U-VBF intervention was typically provided as part of, or as an adjunct to, other articulatorybased therapy approaches. A range of lingual sounds were targeted in intervention, with 80.6% of participants across all reviewed studies receiving intervention targeting rhotics. Outcomes following therapy were generally positive with the majority of studies reporting that U-VBF facilitated acquisition of targets, with effect sizes ranging from no effect to a large effect. Difficulties with generalisation were observed for some participants. Most studies (79.3%) were categorised as efficacy rather than effectiveness studies and represented lower levels of evidence. Overall, the reviewed studies scored more highly on measures of external validity than internal validity. Conclusions: The evidence base for U-VBF is developing; however, most studies used small sample sizes and lower strength designs. Current evidence indicates that U-VBF may be an effective adjunct to intervention for some individuals whose speech errors persist despite previous intervention. The results of this systematic review underscore the need for more high-quality and large-scale research exploring the use of this intervention in both controlled and community contexts.