New speech & hearing research centre gets people talking
On Monday 16 th May, Queen Margaret University will launch its new Clinical Audiology, Speech and Language Research Centre (CASL). The aim of the Centre is to apply cutting edge techniques which will assist in the diagnosis and treatment of a wide variety of communication disorders.
In the UK alone, 2.5 million people have a communication disorder. In childhood, speech sound disorders (SSD) are the most common communication impairment, affecting 6.5% of all UK children - that’s around two children in every classroom. SSD makes it difficult for people to communicate with their peers and integrate into society. This can restrict educational attainment, as well as having a negative impact on social and professional relations in future life.
Stammering and developmental delays are familiar childhood speech problems, but many other conditions can also be associated with specific types of speech difficulties. Examples include cleft palate, Downs Syndrome, autism and hearing impairment.
QMU has an international reputation for its outstanding research in the area of speech sciences, and over the last few years, the specialist area of audiology has been added to the portfolio. The new Centre will draw together the research and clinical practice expertise of both audiology and speech & language therapy.
Professor Jim Scobbie, Director of the new Centre, said: “Speech, hearing and language are intimately linked. It is very difficult for people who have speech difficulties to improve their pronunciation if they also have impaired hearing. For example, a child with profound hearing loss faces particular challenges in learning to speak clearly. If you can’t hear the sounds that you are supposed to be making, then how can you achieve them? It is therefore hugely beneficial to have experts from both specialist areas working in synergy.”
The Clinical Audiology, Speech and Language Research Centre builds on years of pioneering work achieved in the area of speech sciences. Much of the work has focused on developing technologies, in collaboration with engineers and computer scientists, which provide visual images of the tongue and its movement inside the mouth during speech.
Professor Scobbie explained: “Finding out exactly what the tongue is doing inside the mouth during speech is extremely difficult. But without this information it can be impossible for people with speech difficulties to correct their speech. QMU has therefore developed different technologies to view and record tongue movements. These images provide a new type of feedback which the speech therapy client can use to help them learn new patterns. This can help both children and adults to master hard sounds such as ‘R’ and ‘L’, and to distinguish sounds made in different locations in the mouth, such as ‘T’ and ‘K’, for example.”
Electropalatography, or EPG, is a technique which is not yet routinely available in NHS clinics. It records where and when the tongue makes contact with the roof of the mouth during speech. It can be a particularly useful means of helping some children with speech difficulties to improve their speech because it provides visual feedback to the child, which is not ordinarily available, and does not rely purely on what the child hears. Children with, for example, hearing impairments and Down’s Syndrome often respond well to visual feedback because other channels of feedback are impaired.
EPG requires that an artificial palate, like a dental plate, be custom made for the child. The child wears the palate which contains 62 electrodes that detect the child’s tongue movement on the roof of the mouth when they speak. These can be analysed and compared to typical speech patterns to help the speech and language therapist identify more accurately errors in the child’s speech. During a session, the therapist will also wear a palate that models the correct patterns to the child. The child can clearly see the images which the tongue makes on the computer screen. The child tries to copy the therapists tongue movements by trying to recreate the same pattern which shows on the computer screen. The child can then view their own tongue pattern and compare this to the pattern made by the therapist. This visual stimulus is incredibly effective in helping the child achieve more normal sounding speech.
One such child who had outstanding success with EPG was Lily Davidson. Lily became deaf shortly after birth and had a cochlear implant when she was nearly three years old. This small device was implanted into the cochlea in the inner ear. A processor worn externally then translates speech and environmental sounds into electrical impulses that stimulate the auditory nerve and allow Lily to hear all of the sounds crucial for speech. Like all young cochlear implant users, Lily received intensive speech and language therapy from a young age.
Dr Sara Wood, a Speech and Language Therapist at QMU, began working with Lily when she was 10 years old – shortly after she received a second cochlear implant. As a bright young child, Lily had already made remarkable progress in learning language and her speech was considered to be quite good. However, she still struggled to produce clear speech and there was definite room for improvement. Her family were particularly concerned that her speech difficulties would have a negative impact on her social relationships and the way in which she was perceived by others.
Dr Wood explained: “We began using EPG therapy with Lily to help improve her speech intelligibility. She had difficulty with specific speech sounds including the sound of the letter ‘L’. This was particularly important to Lily as it meant that she had problems clearly pronouncing her own name.”
Lily explained: “Because I couldn’t hear anything at all...I didn’t learn to speak normally like a baby does, just lying gurgling in my cot, testing out how to make sounds. I had silence for three years. Then when I was three and got my implant I had to guess how to move the inside of my mouth to make words and I just made it up – so I had some odd ways of saying a word. Like saying ‘orange’ – I would say ‘oh-in-j’. It worked okay for one word but as I got older and spoke more quickly the words didn’t run together properly. The EPG helped me relearn how to speak.”
With EPG therapy, Lily’s speech quickly improved.
She said: “I didn’t realise what I was doing wrong before but seeing the shapes my tongue made on a computer screen made it easy for me to learn how to change my words. Also, working on a computer and seeing the images was much more fun than just repeating the words over and over again – that’s boring!”
Sara explained: “The technique gave her the tools to be able to improve her speech intelligibility which in turn boosted her confidence.”
Lily confirmed: “People understand me so much better now and I don’t have to repeat what I say nearly so much. Having better speech gave me the confidence to be a speaker at a conference for parents of deaf babies earlier this year. I wanted to show those parents how well their children could do when they grow up. Lots of the mums and dads were so moved by my story that they cried – even my mum.”
Carolyn Davidson, Lily’s mum also noticed the change in her daughter. She said: “Not only had the clarity of her words improved, she also grew in confidence, especially when meeting new people. I also believe that this will help her socially and professionally as she moves into adult life.”
More recently, Professor Jim Scobbie has been pioneering the use of ultrasound technology as another method of viewing the movement of the tongue inside the mouth during real time speech. Lily was the first person with a cochlear implant to receive EPG therapy at QMU. It significantly helped her improve the production of “L” and some other speech sounds. However, she still had difficulty with the pronunciation of the sound ‘R’.
Dr Wood explained: “By positioning an ultrasound probe under his chin, Professor Scobbie was able to show Lily how to produce the ‘R’ sound by having her watch images of his tongue moving in real time. In turn, she then watched her own tongue moving inside her mouth during speech. She was able to copy what she saw in the ultrasound image and reproduce it correctly. It only took one ultrasound session for Lily to get it right!”
“Most people trying to correct speech problems rely on using auditory feedback”, said Professor Scobbie. “However, as soon as Lily had the opportunity to use the new visual feedback, her speech improved dramatically.”
Dr Jo White, Audiology Research Lead at Queen Margaret University’s new Clinical Audiology, Speech and Language Research Centre , has known and worked with Lily since she was two years old. She said “Lily has always been an intelligent and gifted child, but without a combination of ground-breaking technology and dedicated therapists and researchers, Lily would not have achieved her full potential in the hearing world. She is now a remarkably articulate teenager with a very bright future.”
Lily believes that she has been extremely lucky to have benefitted from the different speech and hearing technologies that have helped her develop her speech. She explained: “I’m the only one of all my deaf friends who has had EPG and that’s not fair. Everyone should have an equal chance to improve their speech.”
Professor Jim Scobbie concluded: “We want this new research Centre to build on its world-wide reputation for research in speech and hearing sciences and to make sure that as many people as possible, both in the UK and abroad, can benefit from the techniques we have developed.”
For further media information contact Lynne Russell, Press and PR Officer, Queen Margaret University, Edinburgh on tel: 0131 474 0000, mob: 07711 011239; E: firstname.lastname@example.org