Electropalatongraphy Paper

The most recent standardized test administered was The Goldman Fristoe Test of Articulation 2nd Edition (GFTA-2). The results were as followed. The raw score for the patient was 44. This raw score is the total number of articulation errors. The clients standard score was 60. This provides a means to compare one individual to another based on age and gender. The client was in the 3rd percentile which indicates he did 3% better than children of the same age on the same test. The client was at the age equivalent of a 2 year, 2 month old. The client is 5 years old which shows that he is below the typical developing child of his age. His overall score indicates that his articulation skills have progressed since being tested in February of 2016

Summary of Interpretation: Given the information provided in Interpretation A, the clinician diagnosed Kara-Lynn with a severe phonological disorder. This diagnosis was made based on evidence provided by testing results, clinician observations, and speech analyses. Kara-Lynn demonstrated phoneme collapses into /d/ in place of stops (/p/, /t/, /k/, /g/), fricatives (/s/, /z/, /θ/, /ð/), and some consonant clusters (/tr/, /gr/) across all word positions. For example, Kara-Lynn produced /diə/ for “seal,” /dædɚ/ for “treasure,” and /dədudɚ/ for “computer.” Kara-Lynn also presented with active phonological processes of final consonant deletion (/fɪ/ for “fish”), cluster reduction (/tul/ for “school”), vocalization (/ɛləkə/ for “helicopter”), and deaffrication (/ʃi/ for “cheese”). She also presented with inconsistent patterns of initial-consonant deletion (/ɑʊps/ for “house”, /ɪʒ/ for “bridge”). In most instances, Kara-Lynn presented with both final consonant deletion and another phonological process, which markedly impacted her speech intelligibility, as when she produced /lɑʊ/ for “clown,” demonstrating both final consonant deletion and cluster reduction. She also expressed a high percentage of CV (27%) and CVC (29%) syllable and word shapes, with little other variation. Analysis of Kara-Lynn’s speech sample revealed similar errors exhibited during formal assessment, including phoneme collapse into /d/, high occurrences of initial and final consonant deletion and cluster

The opportunity to observe the work overview of a Speech Pathologist, has tremendously solidified my interest in this field. At the Diana Rogovin Speech Center at Brooklyn College, I observed clients of various ages with different speech language disorders including articulation, language, voice, fluency and accent modification. Observing clinicians at the speech center gave me the opportunity to learn how important client-clinician interaction is for the session and how essential it is to build a good relationship with the client. Although I learned the

The cleft needs to be repaired (through surgical interventions like palatoplasty) because it’s extremely important for feeding and swallowing, as well as speech. Similar to sleep, without sufficient nutrition, an individual will not be able to fully develop. A lack of sufficient nutrition will affect an individual’s cognitive ability, as well as their physical health. This is why surgical intervention is such a critical component of the process and one of the steps that is completed earlier on in the process. In addition to cleft palates, velopharyngeal insufficiency is a common symptom for about forty percent of individuals with TCS, and is often related to a cleft palate. Velopharyngeal insufficiency can be related to issues with breathing and feeding. It is also related to articulation problems and hypernasality. The articulation issues are likely due to the lack of ability to build pressure and without pressure consonants are altered (Goorhuis-Brouwer & Priester, 2008,

Preschoolers with verbalization sound disorders have clinically consequential impairments in the engenderment of sound production of the ambient language. Although many of these produced sound errors resolve after several years (with or sometimes without intervention), developmental appropriate speech sound production is not always achieved. Some sound errors may continue into adulthood. Concretely, (Preston, Hull, & Edwards, 2013) intended to determine if preschool verbalization error types (e.g., atypical sound errors and distortion errors), which may reflect different levels of psycholinguistic processing, are indicative of school-age phonological awareness and verbalization sound outcomes.

Ava Bracciante, an eight year-one month old female, who has been attending Lehman College Speech and Hearing Clinic since spring 2014 due to parental concerns regarding her articulation. She is currently attending the clinic once a week for 50-minute sessions. Ava’s parents, Mr. and Mrs. Bracciante, provided the case history report and stated that Ava received a speech-language evaluation at the Ampark School in 2014. The evaluation revealed gliding of the lingua-palatal rhotic /r/ and vocalization of the rhotic diphthong /ɚ/; her intelligibility was not compromised; therefore, she did not qualify for services. Mrs. Bracciante reported that she has seen an improvement in Ava’s speech and is an active participant to her progress.

Kara-lynn is a 3 year; 6 month old female presenting with a severe phonological disorder. Her results from testing indicate that her speech intelligibility is significantly reduced due to multiple phoneme collapses into /d/ of the following phonemes and consonant clusters: /p/, /g/, /k/, /s/, /z/, /θ/, /ð/, /tr/,and /gr/. In addition, the use of multiple phonological processes, including: final consonant deletion, initial consonant deletion, cluster reduction, vocalization, and deaffrication also significantly contribute to her reduced intelligibility. Her speech intelligibility in known context was calculated to be 64%, which is low for a child who is 3 years; 6 months(consider adding reference). Reduced intelligibility can impact a child’s ability to communicate wants and needs, making Kara-Lynn’s speech intelligibility an area of need.

The scope of practice of speech-language pathology describes the ethical and clinical responsibility of clinicians to implement therapy techniques, which contains efficacy that is supported by evidence. Non-speech oral-motor exercises (NSOMEs), in particular have raised controversy among speech-language pathologists (SLPs) and researchers when treating children with articulation and phonological disorders. The use of NSOMEs is a debated issue in the profession due to the lack of evidence based practice (EBP), poor clinical assumptions, and the avoidance of meeting the client’s needs.

The purpose of this evidence based research paper is to evaluate the efficacy of the cycles approach when compared to the traditional articulation therapy approach in the treatment of children who are highly unintelligible. The Cycles Phonological Remediation Approach (Hodson, 2011) is a treatment method for children with severe speech sound disorders. This approach targets phonological pattern errors in a sequential manner. During each cycle, one or more phonological patterns are targeted and after each cycle is complete, another cycle begins. Recycling of phonological patterns continues until the targeted patterns are generalized into the child’s conversational speech. The cycles approach is meant to mirror typical phonological development in children (Hodson, 2011).

Ibrahim, Kilpatrick, Reilly, and Vogel (2009) performed a comparative study of the acoustic measures of hypernasality in the speech of school-aged children aged 2-14 years, some with cleft lip/palate and others without cleft lip/palate. Ibrahim, Kilpatrick, Reilly, and Vogel (2009) provided perceptual ratings of the hyper/hyponasality of vowel production in the children’s speech. Any child who was sick or had acquired an upper respiratory infection was excluded from the study, as was any child with cleft lip/palate who also had any other disorders or comorbidities. The study included a perceptual assessment in which two speech therapists were required to agree upon the perception of the phonemes the child produced. Each child held and sustained two vowels, followed by production of two CVC words without nasal phonemes. This process was repeated five times with each child. The

Clinical Implications: Minimal-contrast treatment is effective and efficient for treating children with phonological disability. Avoiding listener confusion is motivating for suppressing process use.

In the research article “The Use of Electropalatography (EPG) in the Assessment and Treatment of Motor Speech Disorders in Children with Down’s Syndrome: Evidence from Two Case Studies,” the authors, S. Wood, J. Wishart, W. Hardcastle, J. Cleland, and C. Timmins, discuss the use of Electropalatography therapy on children who have Down’s syndrome. However, the main purpose of the article is to discuss the outcomes of the two case studies involving the efficacy of EPG therapy on individuals with Down’s syndrome and to accentuate why this therapy is useful and effective (Wood et al., 2009). The authors stated that these test “provide more objective, laryngeal and respiratory activities involved in speech and are better able to represent the continuous nature of speech events” (Wood et al., 2009). The authors focused mainly on answering the question why Electropalatography therapy should be used on individuals who are diagnosed with mental retardation whom already experience problems

In Intensive Voice Treatment (LSVT LOUD) for Children With Spastic Cerebral Palsy and Dysarthria by Fox, Cynthia Marie, Boliek and Carol Ann, the participants were five children between the ages of 5 and 7 years with a medical diagnosis of predominantly spastic Cerebral Palsy. A telephone screening questionnaire was first given to the parents and then the children went through a face-to-face screening process to be considered for the study. To be selected for this study participants had to have Dysarthria, hearing that was within normal limits or close enough to normal limits, no vocal fold pathology as determined by an otolaryngologist, the ability to follow directions for the study tasks, and on stable medications if needed.

The study by the department of Psychology and Neuroscience at the University of Colorado combines surface electromyography along with motion analysis and outcome measures in a dart-throwing task. Interestingly enough, I found that this is really the first study that includes a comprehensive analysis of changes in motor performance as a function of attention focus. This research was based off Willingham’s Control Based Learning Theory of motor control, which was theorized around the years 1998 and 1999. It was wonders to why the shifting of attention in order to explicitly control a demanding skill hurt performance and leads to the coined term “choking”. It further proposes several stages of neurological representation and motor control. You may constantly ask yourself, does a high-pressure

“Phonological disorders in children can result from physical or organic causes or may be functional in nature ("Phonological disorders in," 2013)”. Children with a phonological disorder may experience a higher risk for reading and writing disabilities. “If left unresolved, phonological disorders have long-term consequences that may interfere with an individual's future social, academic, and vocational well-being, largely resulting from persistent, reduced intelligibility of speech ("Phonological disorders in," 2013).”