Cleland Joanne, McCluskey Robyn, Dokovova Marie, Crampin Lisa, Campbell Linsay
Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK.
Royal Hospital for Children, NHS Greater Glasgow and Clyde, Glasgow, UK.
Int J Lang Commun Disord. 2025 Jan-Feb;60(1):e13144. doi: 10.1111/1460-6984.13144.
Ultrasound visual biofeedback (UVBF) has the potential to be useful for the treatment of compensatory errors in speakers with cleft palate ± lip (CP±L), but there is little research on its effectiveness, or on how acceptable families find the technique. This study reports on parents' and children's perspectives on taking part in a pilot randomized control trial of UVBF compared with articulation intervention.
To determine the acceptability of randomization, UVBF and articulation intervention to families. We set feasibility criteria of at least 75% of responses rated as acceptable or positive in order to determine progression from a pilot to a full randomized control trial.
METHODS & PROCEDURES: A total of 19 families who received UVBF therapy (11 families) and articulation intervention (eight families) were invited to participate. Mixed methods were employed: two questionnaires to determine the acceptability of UVBF and articulation intervention, respectively; and semi-structured focus groups/interviews. Questionnaires were analysed for frequency of positive versus negative acceptability and the focus groups/interviews were analysed using thematic analysis and coded using the theoretical framework of acceptability.
OUTCOMES & RESULTS: More than 75% of families rated randomization as acceptable and more than 75% of families rated both interventions as acceptable, with the caveat that half of the participants did not wish to continue articulation intervention after the study. For some families, this was because they felt further intervention was not required. Six families (three in each intervention) volunteered to take part in the focus groups/interviews. Results showed more positive than negative themes regarding acceptability, particularly affective attitude where high levels of enjoyment were expressed, although some participants found the articulation intervention 'boring'. In both groups, there was a considerable burden involved in travelling to the hospital location.
CONCLUSIONS & IMPLICATIONS: Randomization in a clinical trial is acceptable to families; UVBF and articulation intervention are acceptable and indeed enjoyable. The burden of the additional outcome measures required for a clinical trial is manageable, although there is a travel burden for participants. Future studies should seek to mitigate the travel burden by considering additional locations for intervention.
What is already known on the subject UVBF shows potential for teaching children with speech sound disorders new articulations. Previous studies looking at the acceptability of using ultrasound in speech intervention have only asked for the drawbacks of the intervention: finding the ultrasound gel to be cold and sticky and the probe to be uncomfortable. SLTs, however, believe that the technique offers advantages due to its ability to visualize tongue movements. What this paper adds to the existing knowledge This study asks parents and children for their full views about using ultrasound in speech intervention and compared this to articulation intervention. We also asked parents how they feel about being randomized to one of these interventions. Results were positive for both interventions, with parents highlighting the importance of intelligible speech to their child. Children enjoyed both interventions, though the articulation intervention could be 'boring' or 'repetitive'. For all families, there was a considerable burden travelling to clinics. What are the potential or actual clinical implications of this work? Clinicians can be assured that both articulation therapy and ultrasound therapy are acceptable to families. Efforts could be made to ensure that articulation intervention is not repetitive and that appointments are offered at locations which are accessible to families where possible.
超声视觉生物反馈（UVBF）有可能用于治疗腭裂±唇裂（CP±L）患者的代偿性发音错误，但关于其有效性以及家庭对该技术的接受程度的研究较少。本研究报告了家长和孩子对参与一项UVBF与发音干预的试点随机对照试验的看法。
确定随机分组、UVBF和发音干预对家庭的可接受性。我们设定了可行性标准，即至少75%的反馈被评为可接受或积极，以便确定从试点试验推进到全面随机对照试验。
共邀请了19个接受UVBF治疗的家庭（11个家庭）和接受发音干预的家庭（8个家庭）参与。采用了混合方法：分别使用两份问卷来确定UVBF和发音干预的可接受性；以及半结构化焦点小组/访谈。对问卷进行分析，以确定积极与消极可接受性的频率，并使用主题分析对焦点小组/访谈进行分析，并使用可接受性的理论框架进行编码。
超过75%的家庭认为随机分组是可接受的，超过75%的家庭认为两种干预都是可接受的，但有一半的参与者在研究结束后不希望继续接受发音干预。对于一些家庭来说，这是因为他们觉得不需要进一步干预。六个家庭（每种干预各三个）自愿参加焦点小组/访谈。结果显示，在可接受性方面，积极主题多于消极主题，特别是在情感态度方面，参与者表达了高度的愉悦感，尽管一些参与者觉得发音干预“无聊”。在两组中，前往医院所在地都有相当大的负担。
临床试验中的随机分组对家庭来说是可接受的；UVBF和发音干预是可接受的，而且确实令人愉快。临床试验所需的额外结果测量负担是可以管理的，尽管参与者有出行负担。未来的研究应考虑增加干预地点，以减轻出行负担。
关于该主题的已知信息UVBF显示出教语音障碍儿童新发音的潜力。以往研究在探讨超声在语音干预中的可接受性时，只询问了干预的缺点：发现超声凝胶冷且粘，探头不舒服。然而，言语治疗师认为该技术因其能够可视化舌头运动而具有优势。本文对现有知识的补充本研究询问了家长和孩子对在语音干预中使用超声的全面看法，并将其与发音干预进行了比较。我们还询问了家长对被随机分配到其中一种干预的感受。两种干预的结果都是积极的，家长强调了孩子清晰发音的重要性。孩子们对两种干预都很喜欢，尽管发音干预可能“无聊”或“重复”。对所有家庭来说，前往诊所都有相当大的负担。这项工作的潜在或实际临床意义是什么？临床医生可以放心，发音治疗和超声治疗对家庭来说都是可接受的。可以努力确保发音干预不重复，并尽可能在家庭方便到达的地点安排预约。
