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World-class speech therapy project helps Lothian children find their voice

The first project of its kind is helping children in Edinburgh and the Lothians to overcome speech sound disorders at Queen Margaret University (QMU).

Experts from the pioneering Clinical Audiology, Speech and Language Research Centre (CASL) and the University of Strathclyde are working with Articulate Instruments Ltd to help 20 youngsters aged six to 15 find their voices with unique ultrasound technology and clinical treatment methods.

The £140,000 UltraPhonix project is evaluating the effectiveness of using ultrasound as a visual biofeedback tool to help treat a range of speech sound disorders that have been unresponsive to traditional speech therapy methods.

Speech sound disorders are very common in childhood, affecting at least 6.5% of primary school-aged children - around two children in every classroom. Such disorders make children’s speech difficult to understand, in turn affecting social skills and educational attainment.

Most children who have difficulty creating the correct speech sounds receive therapy which relies on listening skills. The child must listen to their own speech sounds and follow instructions provided by the clinician to try to modify them. However, with these more traditional methods, some children struggle to improve their speech, and the clinician might even be uncertain about what is really going on inside the mouth.

Since speech is made with the tongue, and the tongue is largely hidden from view, this means that observations of the speech disorder and feedback on how to improve it need to be indirect.

Ultrasound makes it possible for children to visualise their efforts to make new tongue shapes and sequences of tongue movements, getting direct and immediate feedback which also lets the clinician guide their progress on the basis of otherwise inaccessible information.

Unique software designed by the group provides example target shapes and sequences for the children to attempt to copy and allows the children’s own efforts to be played back so that they can see and hear their progress.

Instrumentation is not often used in speech and language therapy practice due to start-up costs or incompatibilities with the clinical environment such as portability, complexity and time needed to operate and maintain the technology. These factors then contribute to a lack of rigorous evidence that demonstrates effectiveness. The UltraPhonix project is an important step towards breaking this cycle and providing the evidence needed to support the use of ultrasound, by providing clinical treatment at QMU by a dedicated research team.

The 18-month month UltraPhonix project is due to be completed in November 2016.

Dr Joanne Cleland (University of Strathclyde), the lead clinical researcher on the project, said: “The research is already showing positive results, with children learning to produce speech sounds they have previously found impossible within just a few session of ultrasound-based therapy.

“It is hoped the research will inform the future development of ultrasound technology and clinical treatment methods to help people overcome speech sound disorders across the World.”

Professor Jim Scobbie, Director of the Clinical Audiology, Speech and Language Research Centre (CASL) at QMU, explained: "We’re forging ahead as leaders in this field. We are the main group in Europe for the investigation and development of ultrasound as a speech and language therapy assessment and treatment tool. While ultrasound is also being investigated by colleagues in North America and Australia, this collaboration between QMU and the University of Strathclyde is the first in the world to treat such a wide range of persistent speech sound disorders.

“Recorded data from the project will then provide a unique resource for teaching and research, letting us investigate the children’s gradually improving speech in great detail - thanks to QMU’s unique high-speed ultrasound system.”

The UltraPhonix project is being funded by the Scottish Government Chief Scientist Office (CSO). CSO supports and promotes high quality research aimed at improving the quality and cost-effectiveness of services offered by NHS Scotland.

Visit the UltraPhonix project page on our website for more information, or contact Professor Jim Scobbie Director of the Clinical Audiology, Speech and Language Research Centre (CASL) at QMU, E: JScobbie@qmu.ac.uk, E: ultraphonix@qmu.ac.uk or T: 0131 474 0000.

CASE STUDY: Rosie Pink Smith (11), Linlithgow

Rosie Pink Smith (11), who attends St Joseph’s RC Primary, and formerly Donaldson’s School in Linlithgow, is one of 20 local youngsters benefiting from the UltraPhonix project at QMU.

Rosie was diagnosed with Developmental Verbal Dyspraxia in 2010 and was referred to speech and language experts at QMU by NHS Lothian in July 2015.

Developmental Verbal Dyspraxia is a condition where children have difficulty in making and co-ordinating the precise movements needed to produce clear speech with their mouths. Children with Developmental Verbal Dyspraxia find it hard to produce individual speech sounds and to put sounds together in the right order in words. As a result, their speech is often hard to understand.

Rosie received 16 intensive speech and language therapy sessions (six assessment sessions and 10 hour long therapy sessions) at QMU over six months, as part of the UltraPhonix project.

There was a marked improvement in Rosie’s ability to produce a variety speech sounds during this period, including the letters ‘K’ and ‘G’. Rosie’s speech assessments show that her production of the letters ‘K’ and ‘G’ has increased by over 50%. At her first baseline assessment, Rosie scored 1% (1/109) and her final maintenance session, she scored 55% (60/109).

Rosie’s mother, Anna Pink, said: “We’re really pleased with the significant progress Rosie has made with her speech since receiving help from QMU.

“The intensive series of speech and language therapy sessions and assessments allowed us to see a rapid change in the quality of Rosie’s speech in a relatively short period.

“We hope that Rosie’s positive experience with QMU will help other children with speech and language difficulties benefit from the expert support on offer at the University.”