Seeing is treating: 3D electromagnetic midsagittal articulography (EMA) visual biofeedback for the remediation of residual speech errors

Production distortions or errors on the sounds /s/ and /r/ are among the most resistant to remediation with traditional speech therapies, even after years of weekly treatment sessions (e.g., Gibbon et al., 1996; McAuliffe & Cornwell, 2008; McLeod, Roberts, & Sita, 2006). In this study, we report on the results of treating residual speech errors in older children and adults with a new visual biofeedback treatment called Opti-Speech. Opti-Speech uses streaming positional data from the Wave EMA device to animate real-time motion of a tongue avatar on a screen. Both the clinician and the client can visualize movements as they occur relative to target shapes, set by the clinician, intended to guide the client to produce distortion-free and accurate speech sounds. Analyses of positional data and associated kinematics were completed during baseline, treatment, and follow-up phases for four participants, two who produced pre-treatment residual errors on /s/, and two with residual errors on /r/. Measures included absolute position of the 5 tongue sensors, variability of position, perceptual quality ratings, and acoustic measures of the consonants. Results indicate that Opti-speech effectively remediated the residual speech errors with corresponding evidence of generalization to untreated contexts and maintenance of improvements at follow-up.