Electropalatography

By: Alex Martinez

Definition
Electropalatography (EPG) is an instrumental technique

for determining tongue/palate contact during speech. It uses an artificial palate with 62 electrodes embedded in its tongue facing surface. The electrodes on the palate are connected to an electronics unit, which collect data from the palate and passes it on to a computer. Each palate is made to fit the subject and requires a dental impression with subsequent fitting. There are two commercially available versions of the EPG that have been most widely used to investigate children with persistent sound system disorders. (EPG3 & American Palatometer.

Population: Consideration for Candidacy

EPG has been used successfully to treat disorders ranging

from Dysarthria, Apraxia, Cleft palate, Dysfluency, and Articulation/Phonological disorders. Children and adults can benefit from this device in improving their overall production of speech. Child must be mature enough in tolerating having a dental impression as well as cognitively developed. They need to comprehend what the device is for and what it is trying to teach them in therapy. For adults the EPG could be used primarily to address dysarthric or apraxic speech.

Advantages
EPG has the facility to provide visual feedback of tongue-

palate contacts. The tongue position is placed on the computer screen and flashing lights indicate the electrode the tongue touched. It records alveolar,post-alveolar, palatal, velar placement, and registers specific characteristics for consonants. The EPG allows objective assessment and provides a dynamic visual presentation of articulatory goals that are normally not seen.

 EPG can contribute to the diagnosis of speech disorders by

revealing information relevant to underlying deficits, information not available from transcription-based analyses. The strategy of the system is to compare the patterns of tongue contact for a pathological speaker with a normal speaker and interpret the differences. The ultimate goal of the therapy is to have the user produce the sounds in all contexts without the pseudopalate and without visual feedback. If these goals are accomplished the subject is well on their way to overcoming their speech difficulties.

Disadvantages
Financial constraints, these palates are very expensive and

must be manufactured for each child. Their period of use is also limited because children grow and it will make them useless. Additional hardware is required including a personal computer and software for proper treatment of these disorders. Access to these techniques are limited and can only be found in a few centers. Proper training is essential in using these methods effectively, while assisting in EPG data interpretation.

Types of Cases
Cochlear Implant User - A Case Study
A 8.9 year-old girl was referred for remediation of her

velar stop consonant production. Child had a profound bilateral sensory-neural hearing loss present from birth. Child was given a cochlear implant three years ago. Child was treated 2 times a week for 45 minute sessions. The aim was to use the EPG to help her achieve the correct articulation by visual feedback initially and eventually by tactile and proprioceptive feedback.

Types of Cases (cont..)

The sessions were divided into two main parts: The

establishment of correct tongue positions using the EPG and to ensure that the positions could be maintained without the artificial palate or visual feedback. The results indicated a significant improvement in the production of voiced/voiceless velar plosives. Improvement was also observed in the production of voiced/voiceless velars. This was maintained 5 weeks after therapy indicating a generalization of skills. Childs responses indicated good intelligibility for all words post EPG therapy, in comparison with speech/language therapy.

Types of Cases (cont..)

Articulation disorders - Gibbon and Hardcastle (1987)

described the effects of using EPG to remediate a lateral lisp in a 12 year-old boy. Therapy involved four 1 hr. weekly sessions, with each time the training progressing. It progressed from producing static lingual palatal contact, to producing contact with an air stream, and through progressively more complex utterances. By the 4th session, the child could produce appropriate /s/ and self-correct when errors occurred. Contact patterns were recorded 6 months after therapy and approached the normal pattern.

 Gibbon and Headcastle (1987) concluded that auditory

impressions and phonetic transcriptions were inadequate at describing ordered speech. With the use of the EPG, they were able to focus therapy on reducing contacts in a specific region of contact (palatal). Without the use of the EPG, this diagnostic and therapeutic intervention would not have been possible. This remediation technique showed that children benefited from learning new articulatory gestures, rather than learning to correct isolated errors.

Types of Cases (cont..)

Phonological disorders.
With these types of problems, children typically can

produce all sounds in their language. Therapy is done to improve phonological processes in teaching the rules for application in an attempt to remediate place and manner of production errors. Gibbon (1993) investigated the possibility that differences between sounds that were heard as being neutralized could be found using the EPG.

 A 9 year-old girl was evaluated in which her productions

included alveolar backing for stop consonants. She had received traditional therapy, but results indicated no success for this problem. After twelve weeks of therapy, the child produced distinct alveolar stops. Her improved articulatory ability corresponded with accurate listener identifications. Finally, her duration of the alveolar stops, pre-post therapy, were quicker and can be as a result of the simplification and a better definition of the demands for her articulatory movements

Conclusion
The electropalatography technique is proving itself to be

useful at providing new insights into the bases for various speech problems and for providing an alternative method of speech remediation. EPG allows for objective assessment, enabling appropriate targeting of therapy. It also provides visual feedback, which assists in therapy and can be motivating for the therapist and client. Therefore, the therapist can target the clients speech problems and they can correct themselves with the aid of the computer screen.

Conclusion (cont)
The accumulated EPG research suggests that EPG can

make a valuable contribution to the assessment, diagnosis, and treatment of children with persistent sound system disorders. The purpose of setting up the EPG network is to facilitate a more widespread use of this relatively specialist instrumental technique for speech language pathologists working in clinical contexts than has been feasible in the past. It has been used successfully to treat articulation (cleft palate) and phonological disorders.

Further Research
In terms of EPG treatment, further systematic research is

needed involving groups of children with persistent sound system disorder, so the effects of treatment can be quantified and identify the children that benefit from visual feedback treatment. More longitudinal studies are needing involving a wider number of subjects. Research must be expanded within the field in providing more training opportunities and data on the results of uses of the EPG in therapy.