EPG and Down s syndrome: where are we now? Sara E. Wood Queen Margaret University, Scotland

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1 EPG and Dwn s syndrme: where are we nw? Sara E. Wd Queen Margaret University, Sctland

2 1999 Single case study MRC Assessment and Treatment f Impaired Speech Mtr Cntrl in Children with DS Baily Thmas Enhancing Speech Intelligibility in Children and Yung Peple with DS PhD Janne Cleland PhD Rebecca Rdgers PhD Claire Timmins Nuffield Fundatin Imprving the Speech Cmmunicatin Abilities f Children with DS: a New Mdel f Service Delivery Using EPG 2

3 Single case study Gibbn, F.E., McNeill, A.M., Wd, S.E. & Watsn, J.M.M. (2003). Changes in lingual palatal cntact pattern during therapy fr velar frnting in a 10-year ld with Dwn s syndrme. Internatinal Jurnal f Language and Cmmunicatin Disrders, 38(1), Accuracy f placement fr /t/ and /k/ targets Centre f gravity measure Variability index t quantify stability f cntact patterns 3

4 Findings f single case study Pre-therapy /t/ & /k/ identical placement N difference in measure f COG between /t/ and /k/ Stable cntact patterns fr /t/ & /k/ Pst-therapy 87% f velars accurate Statistically significant difference in COG measure Stable cntact patterns fr /t/ & /k/ CONCLUSIONS DRAWN: EPG has ptential as an effective diagnstic and therapy prcedure fr articulatin errrs in peple with DS A majr issue still t be addressed, hwever, is the extent t which thers will benefit frm this apprach t interventin. 4

5 3 year MRC prject 30 children with DS Inclusin criteria Chrnlgical age 8-18 years Mental age equivalent 3+ years Hearing n greater than 40dB when aided N nn-crrectable visual impairment Assessments WISC cgnitive prfiling DEAP CSIM EPG assessment 5

6 Speech Severe speech disrders, which d nt crrelate with language r cgnitin PCC range frm 12.93% t 87.92%

7 Errr Types by Number f Children Number f children with 3 r mre Gliding Velar Frnting Pst-Alvelar Frnting Stpping Cntext Sensitive Vicing Devicing Glttal Replacement Deaffricatin Affricatin Backing Palatalisatin Debuccalisatin Lateral Phneme-Specific Nasal Emissin Weak Syllable Deletin Errr Cnsnant Harmny Cluster Reductin Final Cnsnant Deletin Initial Cnsnant Deletin Metathesis Ingressive Ejective Other

8 27 Children with Dwn s Syndrme Speech, Language, Cgnitive Assessments EPG recrding Cnventinal Therapy (EPG assessment) EPG Therapy Cntrl (treatment as usual) Pre-treatment recrdings + 0, 3 and 6 mnth pst-treatment recrdings. EPG (lingual-palatal cntact) DEAP single wrd % phnemes crrect Speech intelligibility measure 8

9 %CC PCC: All grups Increase in PCC p=.001** p=.011* p= Artic EPG Nne Grup

10 EPG measures immediately pst interventin The articulatin grup and the n therapy grup shw n changes in variability The EPG grup shws a reductin in variability f /s/ pst-therapy 5 ut f 7 children had therapy targeting sibilants Changes in EPG patterns pst-therapy are bservable but difficult t quantify, especially in children with atypical anatmy

11 Perceptual measures immediately pst interventin Bth f the therapy grups shw imprvements percentage cnsnants crrect, suggesting that speech disrders can be imprved EPG seemed t shw n advantage ver traditinal therapy Children were randmly assigned t grups and therefre nt specially selected fr suitability fr EPG Many children had issues which culd nt be addressed using EPG (e.g. ingressive fricatives)

12 DEAP % cnsnants crrect Treatment grup utcmes at 3 time pints pst interventin EPG grup DEAP % cnsnants crrect pre-interventin pst-interventin 6 mnth pst-interventin 40 time pint Mean % cnsnants crrect increases immediately pst-interventin, with partial relapse at 6 mnth pstinterventin Mean % cnsnants crrect increases immediately pst-interventin, with further increase at 6 mnth pstinterventin 12

13 PhD cmpletins Janne Cleland (PhD by publicatin) Speech & Prsdy in Develpmental Disrders: Autism & Dwn Syndrme Rebecca Rdgers Vice quality f children and yung peple with Dwn's Syndrme and its impact n listener judgement 13

14 Current PhD Claire Timmins Acustic and Articulatry Analysis f Fricative Prductin in Children with Dwn s syndrme Detailed EPG analysis f 27 children with DS using bth quantitative and qualitative analysis f articulatin Case studies examining the relatinship between mtr cntrl, dentitin and palate shape n articulatin f fricatives Detailed pattern analysis Timmins, C., Hardcastle, W.J., Wd, S.E. & Cleland, J. (2011). An EPG analysis f /t/ in yung peple with Dwn s syndrme. Clinical Linguistics and Phnetics. 25 (11-12)

15 Current funded research Imprving the speech cmmunicatin abilities f children with Dwn s syndrme: a new mdel f service delivery using electrpalatgraphy Aims are tw-fld: T evaluate the feasibility f a new cnsultative EPG-based mdel f interventin T explre the effectiveness f EPG in imprving the speech prductin and intelligibility f children with DS wh are aged 6 t 10 years 15

16 Current funded research 20 children with DS aged 6 t 10 years frm mainstream and special schl Learning Assistants (LA) receive training in speech develpment in DS and EPG Assessment f all children by research SLT and individual therapy plans devised Interventin carried ut daily by LA 10 mins fr 12 weeks using PTU Schl visits every 2 weeks frm research SLT Reassessment immediately pst interventin, 3 & 6m 16

17 Thanks Medical Research Cuncil Baily Thmas Charitable Fund Nuffield Fundatin All the participants, parents & educatinal staff 17