Industry Buzz

Hand-Held Tools for Hard-to-Train Speech Sounds

When treating articulation disorders, I've had my fair share of frustration with those "problem" phonemes, namely /r, l, s, sh, ch/. For many of the children on my caseload, this frustration stemmed primarily from an inability to achieve proper tongue placement. If I could just get a first correctly produced target sound, even in isolation, I could really hit the ground running.

I also was frustrated that while my colleagues in audiology have digital hearing aids, for example, I didn't have a tool set at my disposal. I certainly did my own experimentation with household items like spoons and coffee stirrers to provide that crucial sense of touch in treatment, but my patients found these items uncomfortable, their parents found them unprofessional, and I found them imprecise and often inaccurate. So I enlisted the help of a medical device engineer to come up with a better way to start with results and, ultimately, to maximize therapy outcomes.

The solution we developed over the past four years is tactile feedback using Speech Buddies®, a set of FDA-listed, hand-held tools used inside the mouth for hard-to-train speech sounds. These tools, developed and manufactured by Articulate Technologies, allow the patient to feel where in the mouth the tongue should be placed during real-time speech therapy training exercises.

Since many children are strong tactile learners, it's important to allow them to access everything they could benefit from. In addition, since the tongue movements crucial to the problem phonemes are relatively complex and occur behind the dentition barrier, traditional visual and verbal cues can be less effective. Biofeedback tools such as electropalatography and ultrasound have been used effectively in articulation treatment, but I wanted to deliver the power of effective biofeedback at a fraction of the cost.

Tactile feedback has been shown to be effective in articulation treatment.1 Dennis Ruscello, PhD, CCC-SLP, a professor at West Virginia University, published an overview of the use and potential of appliances in articulation therapy.2 He is an expert on the /r/ sound and the use of tools and appliances in speech therapy and a scientific advisor to Speech Buddies.

Synthesizing what has made tactile cuing so effective, Speech Buddies have been optimally designed and engineered to be safe and minimally invasive and to minimally impede airflow and coarticulation. Parents and caregivers were involved in the development process.

Most parents are highly motivated to become more involved in their child's therapy, and the highly intuitive therapy and design concept behind Speech Buddies allows direct parent involvement at an early stage in the speech therapy process. The placement of the Speech Buddy target for a particular sound is straightforward and requires only minimal training. With the guidance of an experienced speech-language pathologist, parents can complement the work done in therapy sessions. In addition, children can take their Speech Buddy with them to and from speech therapy, like they would a musical instrument or pair of soccer cleats, so they can practice in therapy and at home.

This approach is supported by an online exercise program that allows therapists to assign stimulus items as homework. That allows them to pick up where they left off in the last session and maintain their therapy momentum.

Speech Buddies are effective in group therapy as well. Group training for articulation disorders can be frustrating for school-based speech-language pathologists because the necessary in-session exercises require intensive, direct feedback with regard to what children are doing with their speech articulators. Tactile feedback with Speech Buddies allows students to achieve correct tongue positioning with less direct, real-time attention from the therapist, thus allowing school-based clinicians to conduct group therapy sessions more effectively. This can help dramatically reduce articulation caseloads.

Articulate Technologies is committed to providing a strong base of evidence for the use of Speech Buddies in widespread clinical practice. Currently, a controlled, randomized, single-blind efficacy study involving 20 children in the New York City area is testing the Speech Buddy for /s/. Preliminary results show that the use of Speech Buddies in therapy results in more than twice the number of correct responses at the conclusion of a therapy cycle (71 percent correct) compared to traditional therapy methods alone (32 percent correct). These data represent a dramatic improvement over many current leading methods.

Since Speech Buddies was launched in 2009, we have partnered with a number of leading speech-language therapy centers around the country. These facilities have used Speech Buddies successfully with a variety of populations, including patients with cognitive and hearing impairment.

1. Clark, C.E., Schwarz, I.E., Blakeley, R.W. (1993). The removable R-appliance as a practice device to facilitate correct production of /r/. American Journal of Speech-Language Pathology, 2: 84-92.
2. Ruscello, D.M. (1995). Speech appliances in the treatment of phonological disorders. Journal of Communication Disorders, 28: 331-53.

Gordy Rogers is co-founder and chief scientific officer of Articulate Technologies Inc. He currently practices in New York City. For more information, call (415) 997-9038, e-mail, or go online at

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