How To Get Started With Ultrasound Technology for Treatment of Speech Sound Disorders

Abstract

Although providing visual feedback with ultrasound is becoming more and more popular among speech-language pathologists, it is still not widely used, perhaps because many speech-language pathologists are unfamiliar with its application to treatment of speech sound disorders. This report introduces basic information on ultrasound for new users and summarizes existing studies conducted with ultrasound to provide clinical evidence for speech treatment. This report also presents a clinical case using ultrasound and discusses a treatment protocol for establishing postvocalic /r/ to illustrate an example of how ultrasound was used in a clinical setting.

Do Participants Report Any Undesired Effects in Ultrasound Speech Therapy?

“…In addition to a focus on clinical efficacy, clinical research should ethically attend to any unintended effects of treatments, such as perceived physical or psychological effects or discomfort. Therefore, speech-language pathologists and clinical researchers who use ultrasound should have an understanding of the basic underlying principles of ultrasound (Lee et al, 2015). To collect images of the tongue during speech, ultrasounds use B-mode imaging (Bressmann, 2008).…”

“…ltrasound imaging has been used in medicine to visualize internal body structures for over 70 years. In the past few decades, there has been an increasing interest in ultrasound as a tool to provide visual feedback of the tongue during treatment for speech sound production difficulties (Lee, Wrench, & Sancibrian, 2015;Preston, McAllister Byun, et al, 2017). A number of studies have demonstrated that a treatment program that includes ultrasound visual feedback can lead to speech sound learning (e.g., Adler-Bock, Bernhardt, Gick, Bacsfalvi, & Adler-Bock, 2005;McAllister Byun, Hitchcock, & Swartz, 2014;Sjolie, Leece, & Preston, 2016).…”

“…Ultrasound transducers transmit high-frequency sound waves (well beyond the frequency range of the human ear), which are reflected at a tissue boundary (i.e., top contour of the tongue) and are received again by the transducer. These reflected waves are converted to images by a computer, which can be displayed in near real time (Lee et al, 2015). Thus, the images are generated by sound waves, not ionizing radiation that might be encountered with X-rays.…”

Ultrasound Images of the Tongue: A Tutorial for Assessment and Remediation of Speech Sound Errors

“…Ultrasound imaging of the tongue using diagnostic mode can be a fast, safe, and effective technology for visualizing tongue movements in real time 30,32 . This information can be used to contrast correct and incorrect productions of speech sounds as a way to understand speech errors and teach desired movements for a variety of speech sounds.…”

“…Diagnostic ultrasound probes are used to image the tongue. A frequency range between approximately 3 -8 MHz with a frame rate of about 30 frames per second is recommended for clinical imaging the tongue 32 . NOTE: The instructions below apply to the diagnostic Ultrasound System (see Materials Table) with a C6-2 transducer, which was selected based on visual comparison of ultrasound images collected from several transducers available for this system.…”