Award Title: Speech Therapy Animation and imaging Resource (STAR)
Funder: Economic and Social Research Council

Abstract: We will work with qualified Speech and Language Therapists (SLTs), the educational providers registered to license them, and SLT Clients and their carers, to create freely-accessible, online vocal-tract imaging resources and animations to improve pre-registration SLT training, aid continuing professional development (CPD) and provide an engaging visual resource for use in Clinic and at home. Our research aims will address the current debates for SLTs about how best to deliver both SLT training and Speech Therapy in remote/blended forms, especially for paediatric care.

Our main aims are to:
1. Create clinically-focussed, online vocal-tract-imaging and animated resources to allow users to view the movements of both the hidden and visible speech organs. Using existing ultrasound tongue imaging (UTI), and magnetic resonance imaging (MRI) vocal-tract research datasets of child and adult speech, we will create resources housed on two connected Websites; one for SLT training and CPD, the other for use in Clinic with paediatric Clients, or for Clients' use at home. 
2. In doing this, we aim to extend the reach of audio-visual therapies for remediation of speech delay/disorder to children outside face-to-face clinic sessions, by providing accessible online resources for independent home practice. Our Clinical paediatric Website will contain simplified, but accurate and engaging animations of the vocal-tract during speech-sound production. Key speech sounds will be animated, based on real children's and adults' speech. Animations will demonstrate differences in tongue shape and placement. Interactive exercises for Clients/Client's carers will facilitate aspects of practise homework set by SLTs in Clinic, e.g. speech-articulator identification, speech-sound discrimination tasks.
3. Our training Website aims to promote understanding, familiarity and use of articulatory imaging in (motor-based) Speech and Language Therapy. UTI-based visual biofeedback and visual articulatory animated model (VAAM) based therapies are important specialist tools in speech therapy intervention and clinical diagnosis. By adding dynamic visual material to audible speech recordings, breakthroughs in the treatment of persistent disorders can be achieved. However, imaging technologies are not widely used in general paediatric clinics. Many SLTs are unfamiliar with this technology. Our site will provide introductory explanations and comparison of imaging techniques, demonstrations of use, and links to literature.
4. With both Websites we aim to augment the audio-visual resources currently available to train and support Speech and Language Therapists (SLTs) for both consulting and specialist roles. SLTs will be able to better explain the movements of the hidden, as well as the visible, speech articulators and articulatory movement to Clients with the material on the paediatric clinical Site. The training Web-site will be suitable for preregistration SLT phonetics learning, but also inter-professional education, as well as for reference, revision and CPD. The training Web-site will contain much sought after resources such as (a) a clickable chart containing the extended-International Phonetic Alphabet (ext-IPA) speech symbols linked to MRI, UTI and animated video of performance of extIPA disordered speech sounds (b) a filterable database containing UTI-based recordings of examples of disordered speech sound productions, produced by children (c) a filterable database containing UTI-based recordings of non-disordered adult and child speech. 
5. We aim to work with SLTs, trainers, and students, Clients and carers, to evaluate qualitatively and quantitatively the Web resources created. We will determine which resources are most helpful and effective for each user group.

Lay Abstract: Speech and Language Therapy training and practice is dominated by approaches involving listening to sounds, feeling the movements of the speech organs and verbal descriptions of how speech sounds are produced. However, recent research involving use of visual information about hidden speech organ movement in particular (e.g. tongue movement) has shown that visual approaches to speech therapy can be game changing, providing breakthroughs after years of conventional therapy. One of the main advantages of visual approaches is that viewing dynamic imaging of the hidden speech organs has been shown to be a more intuitive method of demonstrating target speech articulations, particularly for children, avoiding complex, abstract descriptions of how speech organs move.

Several technologies can be used to reveal the hidden speech organs. Ultrasound Tongue Imaging (UTI), using standard medical ultrasound machines, has emerged as a promising therapy tool, allowing users to view target tongue movements and compare them to their own. Magnetic Resonance Imaging provides a more comprehensive view, showing all parts of the vocal tract, but is not suitable for use in day-to-day therapy. Costs, training and accessibility prevent the general use of these technologies in Speech Therapy clinics; however, clinical and phonetic researchers have collected a large number of UTI and MRI video recordings of both disordered and non-disordered speech. These represent a valuable training/therapeutic resource, but cannot be accessed in their current form, as most UTI/MRI datasets can be viewed only using expensive and technically-sophisticated specialist software. UTI and MRI reveal a greater variety of strategies for speech-sound production than are generally considered, and therefore provide a greater number of strategies for Clients to try. The benefit for Speech Therapy Clients is a better understanding of tongue movement and placement in speech-sound production, a more intuitive means of understanding vocal-organ movement and visual input, which can be particularly useful for those who learn more effectively through visual demonstration.
 
This project will create bespoke resources for Speech Therapists' training and use in Clinic; the Speech Therapy Animation and imaging Resource (STAR). Existing vocal-tract-imaging recordings from six different clinical and non-clinical speech-research projects will be made available online, in the most accessible formats and user-friendly interfaces. Additionally, MRI recordings of speech will be used to create accurate, simplified vocal-tract animations for use by paediatric Speech Therapy Clients, in Clinic and at home. These animations will show how the vocal organs move in the production of speech sounds. STAR will consist of two Web sites; one for Speech Therapists' training, reference and continuing professional development, and the other for use by paediatric Clients and their families, in Clinic, and at home.

The training site will contain vocal-tract animations and explanations of UTI and MRI technology and recording processes. It will contain much needed databases of UTI videos of disordered and non-disordered speech, showing a variety of speech-errors and disorders, as well as normative speech-sound production in a variety of English accents. 

The clinical site will contain clear and informative animations explaining how the vocal tract works and showing speech-sound production in different syllable positions. It will also contain interactive animated homework exercises to facilitate aspects of practise homework set by Therapists in Clinic. 

STAR will make available these resources at a time when the need for remote quality clinical teaching has never been greater. The research strand of our project will be to work with the SLT community and Clients, to assess how best to deliver remote and/or blended training and therapy, which meets the challenges of the current and post-COVID-19 environment

Research Activity Codes: 5.7 PHYSICAL;8.1 ORGANISATION AND DELIVERY OF SERVICES
Health Categories: MENTAL HEALTH