Gradient speech change during intervention for school-aged children and adults with cleft palate ± lip.

Gradient speech change, where speech sound production develops in a broadly step-wise fashion towards the standard adult form, is a well-recognised phenomenon in children developing typical speech, but is much less studied in speakers with developmental speech sound disorders. Instrumental techniques, such as electropalatography (EPG), may be useful for identifying gradient speech change and may supplement phonetic transcription in important ways. This study investigated whether gradient speech change occurred in six participants with cleft palate ± lip undergoing intervention within a usage-based phonology framework (2/6 participants with speech distortions; 4/6 with pattern-based speech substitutions; combined total of 25 speech sounds targeted for intervention). Participants received weekly therapy in a hospital setting and were aged 10-27 years. Gradient speech change with target speech sounds was examined using EPG analysis, which was undertaken after every fifth session of therapy. The presence of gradient change was determined by visually examining EPG palatograms and EPG indices for target speech sounds across successive EPG test points. This study found gradient speech change occurred in 22/25 target sounds over the course of intervention. This gradient change occurred for both speech distortions and pattern-based speech substitutions. The remaining 3/25 target sounds showed categorical change. Usage-based phonology was suggested as a theory with potential for explaining gradient speech change, with both typical and atypical speech, and with speech distortions and pattern-based speech substitutions. This finding adds to other research showing that the objective data provided by instrumental techniques, such as EPG, may be a valuable complement to phonetic transcription.

Clinical application of usage-based phonology: Treatment of cleft palate speech using usage-based electropalotography.

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.

The space between words: on the description of Parkinson's disease in Jonathan Franzen's 'The Corrections'.

Disability or health-related literature has potential to shape public understanding of disability and can also play an important role in medical curricula. However, there appears to be a gap between a health humanities approach which may embrace fictional accounts and a cultural disability studies approach which is deeply sceptical of fiction written by non-disabled authors. This paper seeks to reconcile these perspectives and presents an analysis of the language used by Jonathan Franzen in his description of Parkinson's disease in the novel The Corrections We use detailed linguistic analysis, specifically stylistics, to identify the techniques Franzen adopts to represent aspects of impairment and disability. We describe four specific linguistic devices used in the novel: reflector mode, iconicity, body part agency and fragmentation. We show how stylistics offers a unique analytical perspective for understanding representations of disability and impairment. However, we emphasise the need to promote critical and even resistant understandings of such representations and we discuss the potential role of patient/service user input to assess fictional accounts.

The acquisition of newly emerging sociophonetic variation: /str-/ in American English.

Eight children aged 4;1-8;1 and their primary caregivers participated in a study designed to evaluate their use of the onset cluster /str-/ in both read and conversational speech. The cluster is currently undergoing a reported sound change in many varieties of English, with the initial /s/ being retracted to [ʃ]. The study compared the initial fricative of the cluster in both the children and their mothers. Acoustic analysis was carried out in order to categorize tokens as either [s] or [ʃ] using spectral peak analysis. Results found that children as young as 5;1 were starting to exhibit the usage patterns of their mothers. The distribution of the novel variant suggests that the children may be learning this form via a process of lexical diffusion rather than by rule. Implications for the study of dialect acquisition and phonological acquisition in general are discussed.

Repair sequences in dysarthric conversational speech: a study in interactional phonetics.

This paper presents some findings from a case study of repair sequences in conversations between a dysarthric speaker, Chris, and her interactional partners. It adopts the methodology of interactional phonetics, where turn design, sequence organization, and variation in phonetic parameters are analysed in unison. The analysis focused on the use of segmental and prosodic variation found during attempts by Chris to repair a previously identified trouble source. The results indicate that trouble sources were extremely common in the recorded conversations, but that repair attempts were almost always communicatively successful. Analysis of the fragments revealed that repair sequences are often collaborative achievements, with the participant's conversational partners signalling the specific trouble source within a turn, or providing feedback about repair attempts. It was also observed that successful repair attempts were not always simple repetitions of the trouble source, but varied in other linguistic areas. It is suggested that intelligibility repairs should be studied using both experimental and qualitative methods.

The importance of narrow phonetic transcription for highly unintelligible speech: some examples.

The importance of the use of narrow phonetic transcription in transcribing a variety of speech disorders is emphasized. This point is illustrated with clinical data from the authors' own research. The examples used are the transcription of a severely disfluent client, a child with progressive hearing loss, repair sequences in dysarthric speakers, a child with idiosyncratic velar articulations, and an adult with progressive speech degeneration. The use of the extended International Phonetic Alphabet (IPA) for the transcription of disordered speech and the Voice Quality Symbols (VoQS) system for transcribing voice quality is introduced and illustrated in the examples provided. The need for training in narrow transcription is discussed as part of a combination of impressionistic and instrumental description techniques.