Using ultrasound visual biofeedback to treat persistent primary speech sound disorders

Abstract

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.

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

“…Although the focus throughout this discussion was on the specific context of treatment for /r/, these procedures can readily be adapted when training other speech sounds or when working with a variety of populations. Ultrasound feedback of the tongue can be useful for remediation of lingual sounds other than /r/, including vowels, velar and alveolar stops and nasals, and lingual fricatives and affricates 21,23 .…”

“…Such procedures are useful if one intends to measure the contour of the tongue 23,35,36 and stabilization can also overcome some of the problems such as the drift in the position of the probe over time; however, head stabilization during ultrasound imaging of the tongue can lead to practical limitations (e.g., uncomfortable head-mounted devices) and thus the ultrasound user must make decisions about the relative trade-off of such procedures. Studies are underway exploring specific modifications to the procedures (e.g., the amount of practice with ultrasound that is ideal, the role of cueing only oral constrictions vs. oral and pharyngeal constrictions) to determine the methods that are optimally effective.…”

“…Studies have also reported the use of ultrasound to treat errors on other lingual phonemes such as /s k g l ʃ ʧ / 23,24 . Additional populations that may be candidates include individuals with speech disorders related to cleft palate, or individuals learning pronunciation of sounds in a non-native language 25 .…”

O contraste entre oclusivas alveolares e velares em dados típicos de fala: análises acústica e ultrassonográfica

“…Stops, the target segments of the present study, have been investigated using acoustic parameters (3,(6)(7)(8)(9)(10)(11)(12)(13) and, less extensively, using articulatory parameters, such as those obtained by ultrasound images of tongue movement (13)(14)(15)(16)(17)(18)(19)(20)(21)(22).…”

“…To date, stop consonants have been described in relation to constrictions of tongue curves during production of different stops (16,19,21,22) and complex articulatory parameters (13,18,23) . Tongue ultrasound studies in BP are even more scarce.…”