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A feasibility study of visual feedback speech therapy for nasal speech associated with velopharyngeal dysfunction

A feasibility study of visual feedback speech therapy for nasal speech associated with velopharyngeal dysfunction
A feasibility study of visual feedback speech therapy for nasal speech associated with velopharyngeal dysfunction
Nasal speech associated with velopharyngeal dysfunction (VPD) is seen in children and adults with cleft palate and other conditions that affect soft palate function, with negative effects on quality of life. Treatment options include surgery and prosthetics depending on the nature of the problem. Speech therapy is rarely offered as an alternative treatment as evidence from previous studies is weak. However there is evidence that visual biofeedback approaches are beneficial in other speech disorders and that this approach could benefit individuals with nasal speech who demonstrate potential for improved speech. Theories of learning and feedback also lend support to the view that a combined feedback approach would be most suitable. This feasibility study therefore aimed to develop and evaluate Visual Feedback Therapy (VFTh), a new behavioural speech therapy intervention, incorporating speech activities supported by visual biofeedback and performance feedback, for individuals with mild to moderate nasal speech. Evaluation included perceptual, instrumental and quality of life measures. Eighteen individuals with nasal speech were recruited from a regional cleft palate centre and twelve completed the study, six female and six male, eleven children (7 to 13 years) and one adult, (43 years). Six participants had repaired cleft palate and six had VPD but no cleft. Participants received 8 sessions of VFTh from one therapist. The findings suggest that that the intervention is feasible but some changes are required, including participant screening for adverse response and minimising disruptions to intervention scheduling. In blinded evaluation there was considerable variation in individual results but positive changes occurred in at least one speech symptom between pre and post-intervention assessment for eight participants. Seven participants also showed improved nasalance scores and seven had improved quality of life scores. This small study has provided important information about the feasibility of delivering and evaluating VFTh. It suggests that VFTh shows promise as an alternative treatment option for nasal speech but that further preliminary development and evaluation is required before larger scale research is indicated.
Phippen, Ginette
64299b9e-07ed-4a23-bbee-36bd604da830
Phippen, Ginette
64299b9e-07ed-4a23-bbee-36bd604da830
Fader, Miranda
c318f942-2ddb-462a-9183-8b678faf7277
Rushforth, Helen
a12eb91b-bee7-477b-9e1f-37fb3cbc0384

Phippen, Ginette (2013) A feasibility study of visual feedback speech therapy for nasal speech associated with velopharyngeal dysfunction. University of Southampton, Faculty of Health Sciences, Doctoral Thesis, 352pp.

Record type: Thesis (Doctoral)

Abstract

Nasal speech associated with velopharyngeal dysfunction (VPD) is seen in children and adults with cleft palate and other conditions that affect soft palate function, with negative effects on quality of life. Treatment options include surgery and prosthetics depending on the nature of the problem. Speech therapy is rarely offered as an alternative treatment as evidence from previous studies is weak. However there is evidence that visual biofeedback approaches are beneficial in other speech disorders and that this approach could benefit individuals with nasal speech who demonstrate potential for improved speech. Theories of learning and feedback also lend support to the view that a combined feedback approach would be most suitable. This feasibility study therefore aimed to develop and evaluate Visual Feedback Therapy (VFTh), a new behavioural speech therapy intervention, incorporating speech activities supported by visual biofeedback and performance feedback, for individuals with mild to moderate nasal speech. Evaluation included perceptual, instrumental and quality of life measures. Eighteen individuals with nasal speech were recruited from a regional cleft palate centre and twelve completed the study, six female and six male, eleven children (7 to 13 years) and one adult, (43 years). Six participants had repaired cleft palate and six had VPD but no cleft. Participants received 8 sessions of VFTh from one therapist. The findings suggest that that the intervention is feasible but some changes are required, including participant screening for adverse response and minimising disruptions to intervention scheduling. In blinded evaluation there was considerable variation in individual results but positive changes occurred in at least one speech symptom between pre and post-intervention assessment for eight participants. Seven participants also showed improved nasalance scores and seven had improved quality of life scores. This small study has provided important information about the feasibility of delivering and evaluating VFTh. It suggests that VFTh shows promise as an alternative treatment option for nasal speech but that further preliminary development and evaluation is required before larger scale research is indicated.

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Published date: June 2013
Organisations: University of Southampton, Faculty of Health Sciences

Identifiers

Local EPrints ID: 354121
URI: http://eprints.soton.ac.uk/id/eprint/354121
PURE UUID: 45f93d12-2e9b-44e7-a3cc-454b0d72ef01

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Date deposited: 08 Jul 2013 12:12
Last modified: 18 Jul 2017 03:58

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Contributors

Author: Ginette Phippen
Thesis advisor: Miranda Fader
Thesis advisor: Helen Rushforth

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