Clinical skills training for speech and language therapists: Using the evidence-base to treat speech sound disorders using electropalatography (EPG)

Speech sound disorders (SSD) affect a large proportion of children on Speech and Language Therapists (SLTs) caseloads. The impact on the child can be far reaching, disturbing both social and educational development. Traditional therapy interventions are often lengthy and do not always resolve the SSDs. Electropalatography (EPG) is an instrumental visual-feedback technique used mainly in research clinics which has proven effective in the treatment of SSDs. This research aimed to train six SLTs in the use of EPG to treat children for whom traditional methods had failed. Workshops were offered to all interested SLTs which targeted: increasing knowledge of SSDs and possible barriers to success in therapy; increasing knowledge of EPG, specifically diagnostic benefits and therapy outcomes; helping SLTs to identify children on their caseload who may benefit from EPG. Following these 28 children were referred for consideration from which 3 children were chosen. Two of the three children responded to EPG therapy and successfully remediated their speech errors within 12 weeks and were subsequently discharged. For the third child who has multiple speech errors and requires ongoing surgical intervention in addition to therapy, EPG proved diagnostically very important as well as allowing progress previously not made in therapy. It became apparent that data security policies in NHS Lothian are incompatible with the Articulate Assistant software required to run EPG. Therefore whilst this method of intervention proved very successful in remediating the SSDs it cannot currently be adopted into the NHS without further considerations. Alternative visual-feedback techniques are being explored.