Clinical Applications of Articulation Therapy Chapter 4 Perry C. Hanavan, Au.D.

Cineradiography Ken Stevens x-ray film

Strain Gage The Iowa Oral Performance Instrument (IOPI) is used to objectively measure tongue and lip strength and enduranceIowa Oral Performance Instrument –Also provides biofeedback for oral motor exercise

X-ray Microbeam M icrobeam analyzes speech patterns by tracking small pellets placed on the subject’s tongue, teeth and nose Tracking accomplished by a very narrow x-ray beam passing through the subject area and detected by a sodium iodide crystal located behind the head Dense pellets block the x-rays from reaching the crystal Allows study of speech patterns in real time

Ultrasound Speech therapists are using ultrasound imaging Speech therapists are using ultrasound imaging

Electropalatography SmartPalate

Oral Devices Electropalatography Glossometry Video with Dr. Samuel Fletcher

Palatometry Device that consists of electrodes mounted on a thin acrylic plate which is custom made to cover the individual’s hard palate and upper teeth and measures tongue and palate contact patterns from electrodes.

Glossometry Device that consists of electrodes mounted on a thin acrylic plate which is custom made to cover the individual’s hard palate and upper teeth and measures optical tracking of tongue surface using LED.

MRI Primarily suitable for static production Attempted to acquire dynamic MRI image sequences, i.e. MRI "movies" One technique involves acquisition of single images from an utterance repeated over and over A new technique for magnetic resonance imaging (MRI) allows movements of joints and organs to be captured in real timenew technique for magnetic resonance imaging (MRI)

Electromagnetic Articulography See inside patients’ mouths to track their speech movements. Only about 40 in the world, Holds out promise as a therapy tool for people who have lost ability to speak. Small sensors attached to thin wires placed inside mouth with magnified images of mouth movements appearing on screen helps patients by showing how to position tongue to create speech sounds

Source Filter Theory and Problems in Speech Production Source-filter a way of conceptualizing problems of speech production –Dysarthria—neurologic disorder with weak speech musculature –Hearing loss—difficulty with relationship with acoustic input and speech production –Phonological disorders—often phoneme perceptual problems –Tracheotomy—larynx development, tongue movement –Cleft Palate—velopharyngeal problems (resonance—nasality problems)

Dysarthria Neurological disorders with weak speech production –"Slurred" speech –Speaking softly or barely able to whisper –Slow rate of speech –Rapid speech rate with a "mumbling" quality –Limited tongue, lip, and jaw movement –Abnormal intonation (rhythm) when speaking –Hoarseness, breathiness –Drooling or poor control of saliva –Chewing and swallowing difficulty Sample

Vowel Space

Slope index This parameter is measured in Hz per msec, is based on the relationship between the F2 transitions and place of articulation

“Deaf Speech” Individuals with congenital or pre-lingual hearing loss vs. post-lingual loss Loss of speech intelligibility Difficulty in segmental aspects of speech Difficulty in control of suprasegmental aspects of speech Difficulty co-articulating

Segmental Problems Most frequent errors in spoken language of deaf –Vowel problems (tend to neutralize vowels) –F1/F2/ charts shows marked limitations in both horizontal and vertical degree of tongue movements for vowels –Consonant errors common—omissions and substitutions involving voicing and manner of artic –Place of production errors common because of imprecise tongue position and reduced articulatory movement

Acoustic Analysis of Speech Alveolar and velar stops produced further back in the vocal tract than normal –Provides clues for speech therapy

Suprasegmental Aspects Incorrect Fo in word and sentence production Not enough variation in Fo to differentiate between declarative vs. interrogative utterances Sample

Speech Therapy Emphasis Some programs put emphasis on speech in education process, others some, and yet others put none Maasen & Povel (1985) research showed improving segmental production caused 50% improvement in intelligibility with major increase resulting from correcting vowel production

Phonological Disorders Speech disorder known as an articulation disorder. Do not use some or all of the speech sounds expected for their age group. Phonological processes –Children use alternative articulation or simpler articulatory gestures in place of the adult model –May produce a /t/ for /k/ sound –SampleSample

Tracheostomy Surgical procedure to create an opening through the neck into the trachea Developmental consequences in infants including: –Prevention of larynx from making developmental descent –Thus limiting movement of tongue –Reduction in articulatory movements –Alteration of resonance characteristics –SampleSample –SampleSample

Cleft Palate Congenital split in the roof of the mouth. Resonance issues High incidence of conductive hearing loss (typically middle ear infections) Sample