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

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.

SIG 5 Perspectives Vol. 25, No. 2, October 2015

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Speech Science Applications for Practicing Clinicians and Audiology or Speech-Language Pathology Students

The advent of widely available, free, and user-friendly speech analysis software in the late 1990s has made it possible to perform acoustic analyses in clinical and educational settings. However, despite the widespread availability and relative ease of use of speech analysis programs, some clinicians are reluctant to adopt hands-on acoustic analyses into their practice. The purpose of the present paper is threefold: (1) to dispel the myth that speech science and acoustic analyses are difficult and only marginally useful for clinical practice, (2) to demonstrate the practical utility—even necessity—of acoustic analyses for practicing as well as future audiologists and speech-language pathologists, and (3) to briefly outline a highly interactive speech science course with integrated hands-on acoustic analyses. Today, more than ever before, a solid background in speech science and extensive experience with acoustic analyses is a necessary part of audiologists' and speech-language pathologists' education, because incorporating speech analyses can enhance clinical practice. Moreover, new technologies demand that clinicians understand the principles behind the programs they and their clients use.

Surgical Considerations and Choices in the Management of Velopharyngeal Dysfunction

Determining the type of secondary surgical management to treat velopharyngeal dysfunction requires the incorporation of surgical indications and principles to the perceptual, acoustic/airflow, and imaging results of a comprehensive evaluation by a speech-language pathologist. In addition, how the specific type of surgical technique (primary and/or secondary) may affect velopharyngeal function also should be considered. The purpose of this paper is to consider three standard techniques commonly employed in speech surgery—Pharyngeal Flap; Sphincter Pharyngoplasty; and Furlow Double Opposing Z-Plasty—and provide examples of the specific imaging parameters that support the choice of surgical technique. In addition, information is provided regarding the characteristics of different primary surgical techniques for cleft palate which can influence velopharyngeal closure, given that the most common cause of velopharyngeal dysfunction seen in the clinic is a patient with a history of repaired cleft palate.

The Nature of Nasal Fricatives: Articulatory-Perceptual Characteristics and Etiologic Considerations

Nasal fricatives (NFs) are unusual, maladaptive articulations used by children both with and without palatal anomalies to replace oral fricatives. Nasal fricatives vary in articulatory, aerodynamic, and acoustic-perceptual characteristics with two generally distinct types recognized. One type is produced with velopharyngeal (VP) constriction that results in turbulent nasal airflow and, frequently, tissue vibration (flutter) at the VP port. Trost (1981) described these as posterior NFs that have a distinctive snorting quality. A second type of NF is produced without significant VP constriction resulting in turbulent airflow generated at the anterior liminal valve of the nose. Of importance, both types are “active” alternative articulations in that the speaker occludes the oral cavity to direct all airflow through the nose (Harding & Grunwell, 1998). It is this oral gesture that differentiates NFs from obligatory (or passive) nasal air escape that may sound similar due to incomplete VP closure. The purpose of this article is to (1) describe the articulatory, aerodynamic, and acoustic-perceptual nature of NFs, and (2) propose a theoretical framework for the acquisition of NFs by children both with and without cleft palate.

Acoustic Characteristics of Stop Consonants in Children with Fetal Alcohol Syndrome

Speech of children with fetal alcohol syndrome (FAS) has been little studied compared to language. Becker, Warr-Leeper, and Leeper (1990), found a relationship between prenatal alcohol exposure, oral motor control, and speech articulation. Behavioral tests suggest deficits in focal oral motor control specific to children with FAS (Bolinger & Dembowski, 2010). The current project extends that investigation through acoustic measures. Peak and mean frequencies of stop consonant releases were used to infer control of place of articulation. Voice onset time (VOT) was used to infer articulatory-laryngeal coordination. Preliminary measures on 3 experimental speakers and 2 matched neurotypical controls suggest higher stop consonant frequencies in the experimental group, with a poorer distinction between alveolar and velar stops than in the control group. Voiced VOT values were significantly longer for FAS children than for controls. Mean voiceless VOTs were similar across groups, but substantially more variable for the FAS children. Values may be interpreted as acoustic evidence for specific speech motor control deficits in FAS children relative to matched neurotypical children.

Cleft Missions: Don't Miss the Opportunity: A Special Opinion Piece

Missions to developing countries to provide surgical care for children and adults with cleft lip and palate constitute unique opportunities for speech-language pathologists (SLPs). The SLP helps determine if a patient will actually benefit from a planned procedure, and occasionally has the chance to perform short-term therapy. The clinical experience gained on a 2-week mission is invaluable.