Measuring and Training Speech-Language Pathologists' Orofacial Cueing: A Pilot Demonstration.

Aravind Kumar Namasivayam,Rohan Bali,Tina Yan,Pascal Van Lieshout,Deborah Hayden,Roslyn Ward,Krystal Danielle Tieu

doi:10.1155/2018/4323046

Abstract

Tactile-kinesthetic-proprioceptive (TKP) input used to facilitate speech motor control is considered an active ingredient within speech motor interventions. Objective metrics identifying skill level differences across speech-language pathologists (S-LP) providing TKP cues are crucial for monitoring treatment delivery fidelity. The study examined three kinematic measures indicating accuracy and consistency of TKP inputs by 3 S-LPs with varying experience levels (S-LP 1: novice; S-LP 2 and S-LP 3: advanced). Confidence interval measures were used to compare the accuracy of jaw movement amplitudes of the vowel /a/ made by a model participant versus S-LPs giving the TKP input. Generalised Orthogonal Procrustes Analysis (GPA) and cyclic Spatial Temporal Index (cSTI) were used to determine movement consistency. Results revealed passive jaw excursions induced by S-LP 2 and 3 to be not statistically significant from the model participant's active jaw movements. cSTI values decreased with advanced level of experience (19.28, 12.14, and 9.33 for S-LP 1, S-LP 2, and S-LP 3, respectively). GPA analyses revealed a similar pattern for S-LPs with more experience demonstrating lower mean RMS values (0.22, 0.03, and 0.11 for S-LP 1, S-LP 2, and S-LP 3, respectively). Findings suggest kinematic measures adapted from the motor control literature can be applied to assess S-LP skill differences in providing TKP cues.

Highlights

Aravind Kumar Namasivayam,1,2 Rohan Bali,1 Roslyn Ward,3,4 Krystal Danielle Tieu,1 Tina Yan,1 Deborah Hayden,5 and Pascal van Lieshout1,2,6
Unpaired t-tests indicated that, for speech-language pathologists (S-LP) 2 and 3, passive jaw excursions induced were not statistically different from actual active jaw movements made by the model participant (Table 1)
We found that, in the task of accurately estimating a client jaw movement range, changes in consistency of an S-LPs own finger-hand movements when providing TKP cues and of the induced orofacial movements in a model participant varied as a function of the S-LP’s training and experience. ese findings suggest that kinematic measures adapted from the speech and limb motor control literature can be successfully applied to quantify S-LP skill levels in providing TKP cues. e broader clinical implications of these findings will be discussed

Summary

Introduction

Aravind Kumar Namasivayam ,1,2 Rohan Bali, Roslyn Ward, Krystal Danielle Tieu, Tina Yan, Deborah Hayden, and Pascal van Lieshout. Tactile-kinesthetic-proprioceptive (TKP) input used to facilitate speech motor control is considered an active ingredient within speech motor interventions. Objective metrics identifying skill level differences across speech-language pathologists (S-LP) providing TKP cues are crucial for monitoring treatment delivery fidelity. E study examined three kinematic measures indicating accuracy and consistency of TKP inputs by 3 S-LPs with varying experience levels (S-LP 1: novice; S-LP 2 and S-LP 3: advanced). Findings suggest kinematic measures adapted from the motor control literature can be applied to assess S-LP skill differences in providing TKP cues. E effectiveness of TKP cues in improving accuracy of words and phrases, facilitating movement generalization, and establishing, refining, and integrating normalized speech movement patterns within several articulatory subsystems (e.g., mandibular, labial-facial, and lingual) has been demonstrated in a number of behavioral studies Research in other disciplines has recommended the active measurement of provider skill acquisition [11,12,13]; there is scarce literature in the area of communication disorders on the assessment of training effectiveness, standardization of clinical procedures, and reporting of treatment fidelity (e.g., [14, 15])

Methods

Results

Conclusion