Clinical application of usage-based phonology: Treatment of cleft palate speech using usage-based electropalatography
Smart mouth-guard feedback can normalize cleft-palate speech in under two months.
01Research in Context
What this study did
Dwyer et al. (2023) tested a new speech therapy for kids born with cleft palate.
Six children wore a smart mouth guard that showed where their tongue touched the roof of the mouth.
They practiced sounds for 15-33 short sessions. The guard gave instant color feedback.
What they found
Every child hit almost 100% correct sounds on new words.
Three months later they still spoke clearly in full sentences.
The therapy fixed their speech in under two months of visits.
How this fits with other research
Salim et al. (2016) also used computer speech games and saw fewer word errors. Their kids had delays, not clefts, but both studies show tech practice works.
Annable et al. (1979) used food rewards to pull the tongue back in cerebral palsy. Patrick’s team used tongue-place feedback instead of food, yet both cut oral errors fast.
Smith et al. (2010) stopped tongue poking with beep prompts and praise. Patrick’s method teaches correct tongue placement rather than just blocking the wrong move, a step forward for speech clarity.
Why it matters
If you serve clients with repaired cleft palate, ask your SLP about electropalatography. The mouth guard gives clear visual feedback, so you can reinforce accurate sounds right away. Short, high-rep drills led to lasting clear speech in only 15-33 sessions, a fast return for families who drive to clinic. Pair the guard with your usual token board and praise; the tech shows the tongue, you reinforce the win.
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02At a glance
03Original abstract
Abstract Purpose To investigate whether a novel electropalatography (EPG) therapy, underpinned by usage-based phonology theory, can improve the accuracy of target speech sounds for school-aged children and adults with persistent speech sound disorder (SSD) secondary to cleft palate +/− lip. Method Six consecutively treated participants (7–27 years) with long-standing speech disorders associated with cleft palate enrolled in a multiple baseline (ABA) within-participant case series. The usage-based EPG therapy technique involved high-volume production of words. Speech was assessed on three baselines prior to therapy, during weekly therapy, at completion of therapy, and 3 months post-therapy. Percent correct of target phonemes in untreated words and continuously connected speech were assessed through acoustic phonetic transcription. Intra- and inter-transcriber agreement was determined. Result Large to medium treatment effect sizes were shown for all participants following therapy (15–33 sessions). Percentage of targets correct for untreated words improved from near 0% pre-therapy, to near 100% for most target sounds post-therapy. Generalisation of target sounds to spontaneous connected speech occurred for all participants and ranged from 78.95−100% (M = 90.66; SD = 10.14) 3 months post-therapy. Conclusion Clinically significant speech change occurred for all participants following therapy. Response to the novel therapeutic technique is encouraging and further research is indicated.
International Journal of Speech-Language Pathology, 2023 · doi:10.1080/17549507.2023.2238924