Research Participant Request from PROMPT

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Research Participant Request

PROMPT, along with NYU, is currently seeking subjects for a research project in

New York City. The study will be conducted in the Department of Speech Language

Pathology and Audiology at New York University (665 Broadway, 9th Floor, New

York, NY). Children will receive PROMPT treatment twice a week for 8 weeks

(sixteen sessions) by a PROMPT Certified clinician, at no cost to the family. If

participants continue to require treatment beyond the eight weeks, they will be

given the opportunity to continue treatment at NYU's Speech and Hearing Clinic.

Parent/guardians will be informed that they will need to pay for ongoing

services. Kinematic data collection will be conducted every two weeks.

For further information Please Click Here

https://promptinstitute.com/uploads/pdfs/Request_For_Participants.pdf

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One of Prompt's long term goals is to understand the function and role of

tactile-proprioceptive-kinesthetic information in the developing, mature and

disordered or unbalanced motor-speech system. Although the profession of

Speech-language Pathology and other cognitive sciences have examined auditory

and visual sensory systems the tactile system has gone largely unstudied.

Several researchers are now becoming interested and the tools available to begin

designing studies for this purpose.

At present, studies are being planned through the University of Queensland, AU.

that will begin investigating some of these questions. As well, research efforts

are ongoing in the area of Cerebral Palsy and movement disorders in Perth, AU.

The study's principal investigator is Roslyn Ward (Certified PROMPT Instructor)

and titled " The Effectiveness of PROMPT Therapy for Children with Cerebral

Palsy. This research is supported by the South Western Cerebral Palsy

Association, Perth, Australia and conducted at The Centre for Cerebral Palsy,

also in Perth. Study results are expected within 2008. Formal efficacy studies

with Autism and Acquired Apraxia have already been published (see our references

section).

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Another project taking place in Australia at the University of Queensland and

developed by Anne , (Certified PROMPT Instructor) is titled,

" The Effectiveness Of Tactual Input In The Treatment Of Speech Disorders. "

This project will:

1. Investigate the effectiveness of using auditory-tactile cues versus

auditory-visual cues to teach speech sounds of English to adults who have normal

speech motor systems.

2. Investigate the use of Electropalatography and Electromagnetic

Articulography (EPG-EMA) instruments (which track jaw, lip and tongue movements

during speech) as tool to measure outcomes of therapy.

Comparing effectiveness of auditory-visual versus auditory-tactual techniques in

teaching speech production skills.

PROMPT technique uses tactual cues which are paired with auditory sensory input

to provide information to client's speech-motor system about the place, timing

and amount of contraction required by the articulators in order to produce a

sound or word. While there is evidence to support the effectiveness of PROMPT

as a therapy model and approach for children and adults with speech sound

disorders the exact role and contribution of the tactual input provided in

therapy has not been researched. New research and current theories regarding

the neural underpinnings and nature of motor learning highlights the importance

of sensory feedback, particularly tactile-kinaesthetic and proprioceptive

feedback in developing motor skills. Imaging studies in the area of second

language learning research have also shown that there is more activity in brain

regions involved in oro-sensory processing than auditory processing in

non-native speakers. The aim of this study is therefore to validate the use of

tactual input in the teaching of speech sounds and further elucidate the nature

of motor learning in speech. Evidence such as this will add support to the

ongoing development and use of the most effective and efficient approaches for

the management of speech sound production disorders.

Using Electropalatography (EPG) and Electromagnetic Articulography (EMA) as

tools to measure outcomes of therapy.

Basic perceptual assessments of speech production skills are able to determine

the presence, absence or distortion of consonants or vowels in speech but are

limited in their ability to describe accurately the nature of or quality of the

production. Electropalatography (EPG) is a physiological tool that can be used

to examine tongue-to-palate contacts as well as the timing and accuracy of

tongue movements in speech (Hardcastle & Gibbon, 1997). Therefore it can more

systematically determine the quantity and quality of change that occurs as a

result of therapy. The Electromagnetic Articulograph or (EMA) is able to track

articulatory movements along the mid-saggital plane during speech alternating

electromagnetic fields and miniature receiver coils affixed to target

articulators such as the tongue, upper and lower lips, mandible and velum. It

records and analyses specific kinematic parameters of speech motor movements

including trajectory, velocity and acceleration. It is these parameters which

PROMPT is uniquely able to train and retrain in comparison to more traditional

articulation or phonological strategies or interventions.

The EMA has been conventionally used to describe speech motor movements across

different clinical groups however its effectiveness as a tool to measure therapy

outcomes has yet to be explored. This study proposes not only to assess if

change has occurred as the result of therapy but describe the characteristics of

this change. It is hypothesized that by using enhanced sensory input through

tactual cues in comparison to auditory-visual methods more accurate placements

for speech sounds will be achieved and more change will be evidenced. Results

from physiological assessment will also be able to add support to theories of

`motor equivalence' which describes how a sound may be perceived as consistently

produced but be variable at the level of the motor system. This will also help

speech language pathologists understand the dynamic nature of speech production

and give insights into the way in which speech develops.

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" Use of physiological assessment to evaluate the efficacy of visual

(bio)feedback and tactile feedback therapy in the remediation of children with

articulation/phonological disorders " is the topic of another current research

project which is driven by the need for more objective assessment and effective

treatment approaches in the management of school-aged children with

developmental speech disorders of unknown origin.

The limitations of auditory-perceptual judgements, typically employed in the

assessment of speech disorders, are widely recognised. The physiological

instrumentation available, to date, is able to fulfil this role of providing

objective information on the articulatory system that can supplement the

perceptual findings in assessment. The persistent nature of speech errors

observed in this unique group of children, with minimal success in traditional

auditory-visual treatment approaches, has also provided an impetus to look into

the type of specific sensory input/feedback that could more effectively treat

the underlying nature of the disorder.

The current research aims to address both assessment and treatment aspects in

the management of children with APD. Firstly, the underlying pathophysiology of

the tongue movements during speech will be investigated with the

Electropalatography (EPG) and Electromagnetic Articulography (EMA). Secondly,

the potential of the EMA as a visual (bio)feedback tool to be used in the

remediation of speech errors in children with APD will be explored. Lastly, the

effects and potential of tactile input in the remediation of speech errors in

children with APD would be explored when visual (bio)feedback treatment

involving the EPG and/or EMA is ineffective. Such information may contribute

further to our understanding on the role of sensory input in helping a child to

learn and/or relearn oral movements involved in the production of speech.

Eva Wei-Lyn Loh1

Advisors: Professor Bruce Murdoch1, Dr e Goozée1

Co-investigators: Deborah Hayden 2, Anne 1

1Motor Speech Research Unit

Division of Speech Pathology

The University of Queensland

2The Prompt Institute, Sante Fe

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PROMPT has been interested in organizing a data base project that will allow us

to study single subjects with exacting protocols so that these studies may be

replicated over several sites with different populations. Our first effort

involves a joint venture with the University of New Mexico (and hopefully New

York University) which is nearing protocol completion. Initially we plan to run

pilot subjects at UNM. Subject selection will include children with phonological

and mild motor/CAS issues, ages 4-7. If you are interested in having your child

considered for this study, please write us!

Also in development is " An investigation of the perceptual and articulatory

changes in speech production following PROMPT treatment: A case study " . Grigos,

M.I. & Eigen, J.-Department of Speech and Language Pathology. New York

University.

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