Recent Advances in Speech and Language Therapy
Dylan Freestone - Writer
Speech and Language Therapy is a field of medical science that I am hoping to study in the future and I think the most fascinating aspect of it is the fact that it is an ever- developing science which requires innovation and creativity in the formation of new practices to treat conditions like stuttering and aphasia (the impairment of speech following damage to the brain). I would like to share a few examples of new technologies applied in this field and what it will mean for the future of patients with speech disorders.
If you’ve seen The King’s Speech (2010), you’ll remember Colin Firth’s portrayal of a frustrated King George VI who had a severe stammer, working tirelessly alongside his speech therapist Lionel Logue, played by Geoffrey Rush. The practice of speech therapy at this time was in its infancy and, as one would expect, very limited. The treatment of the King’s stutter involved prolonged sessions of breathing and voice exercises to increase fluency and this practice had developed from surgeons, neurologists and people interested in elocution and public speaking (Stansfield, 2020).
Nowadays however, technology has brought a plethora of new possibilities to the treatment of speech defects.
The treatment of a stutter today still requires long programmes of therapy with a qualified speech and language pathologist however a new method to speed up fluency training has been researched and trialled by University of Oxford. The method involves a small electrical stimulation of the brain which aims to increase the firing rate of neurons, allowing moments of fluent speech to become entrenched more quickly. For instance, one trial involves the participant reading out loud, aiming for one syllable in time with one beat of a metronome which has been shown to produce fluency in those who stutter. When this is combined with electrical stimulation of the brain, the theory is that this fluency will become the norm. Despite a relatively small sample size, the published report found that ‘speech fluency significantly increased’ in the metronome exercise. (Garnett et al, 2019). Research into further uses of electrical stimulation is still on the rise. Many of these technological advancements have not replaced traditional therapy sessions but demonstrate a potential for faster progress in patients of all kinds.
Another example of this is Sheffield-based SWORD which is a therapy program aimed to ‘kick start’ damages nerve centres to help stroke victims to speak again. This software involves 70 pre-loaded highly functional words, with sounds, pictures and videos in order to train the generalisation of word production. This holistic approach believes that rather than only developing certain aspects, a wider intense stimulation of nerve centres in the brain can help in improving speech. The SWORD website states that ‘Computers can help communication and provide therapy to those who have problems with their communication and understanding,’ and clinical trials have shown improved fluency and
accuracy in patients with disorders like aphasia. This means that patients can take part in therapy from home, aiding recovery time and complimenting normal therapy sessions.
One area that interests me in particular is the intersection of speech therapy with music therapy. Music therapy as a medical approach has its uses in treating mental disorders as well as physical rehabilitation but its association with speech disorders is developing. Research has shown neural networks shared between speech and music (Nester, 2016). Not only can it help with motivation, but occasionally a patient may have a therapy session with both a music therapist and a speech therapist who work together. Nester’s survey of speech and language pathologists found that ‘music is used more often than not in therapy, considered to be beneficial, and incorporated into therapy of all different types of disorders,’ and this was either by creating a relaxed atmosphere with music to benefit therapy, singing exercises or in one case to use lyrics to teach concepts of language and vocabulary. In the same way that electrical stimulation or the use of computers both aimed to invigorate the brain, music is increasingly being used by speech and language pathologists to utilise different parts of the brain to aid therapy and help their clients improve even faster.
Perhaps one of the greatest breakthroughs in recent years relates not to therapy itself but giving a voice to people who have severely limited speech. Dr. Rupal Patel, the founder of VocaliD attended an assistive technology conference and saw a young girl and an older man communicating with each other, using the same automated voice. She realised that there ought to be a personalisation of automated voices and set out to develop that technology. VocaliD takes donor voices (where volunteers will provide a few hours of speech) and mixes it with a voice imprint from the patient (where even one vowel is enough) allowing them to speak in their own unique voice, something that can reflect personality unlike a robotic- sounding computerised speech program. This is a truly remarkable breakthrough and paves the way for future technology in providing a personal voice for everyone. In her TED talk about this, Patel quotes the poet Henry Wadsworth Longfellow, who said ‘the human voice is the organ of the soul’, and therefore it is imperative that everyone is given the opportunity to speak.
Photo credit: https://unsplash.com/photos/LETdkk7wHQk
Jois Stansfield, ‘Giving voice: an oral history of speech and language therapy’, International Journal of Language and Communication Disorders, 55/3 (2020), pp.320-331.
Garnett et al - https://www.frontiersin.org/articles/10.3389/fnhum.2019.00411/full