Presentation summary
There is consensus that the act of speaking is the result of multiple sub-systems (respiration, phonation, articulation and resonance) and articulators working together as coordinated movements or synergies (Kelso, 1995; Namasivayam et al., 2020). Despite its importance, information about what constitutes a synergy, how these coordinated movements develop, and their implications for assessment and treatment are not typically included in university curricula. This knowledge gap is particularly significant in the context of Speech Sound Disorders (SSDs), a broad term encompassing a range of difficulties in producing speech sounds in both children and adults.
Traditional approaches to the assessment, diagnosis, and treatment of SSDs are grounded in psycholinguistic theory and rely heavily on auditory-perceptual, transcription-based methods. While these methods have been foundational, they often fail to detect underlying speech motor development and control issues (Hardcastle & Morgan, 1982; Kent, 1996). For instance, undifferentiated lingual gestures—a hallmark of motor-based difficulties—are frequently misinterpreted as linguistic-phonological errors, such as phonological substitutions (Gibbon, 1999; Gibbon & Wood, 2002). Instrumental evidence from technologies like ultrasound and electropalatography underscores this discrepancy, revealing that approximately 71% of so-called "phonological errors" stem from underlying speech motor issues (Gibbon, 1999; Goozée et al., 2007). This finding aligns with the understanding that speech production results from intricate synergies among multiple speech subsystems interacting with higher-level cognitive-linguistic processes (Green et al., 2000, 2002; Nip et al., 2009; Green & Nip, 2010). However, this perspective remains underemphasized in traditional clinical education and practice (Hagedorn & Namasivayam, 2024; Namasivayam et al., 2020).
Addressing this disconnect is critical for advancing the field toward precision medicine, which emphasizes accurately aligning interventions with the underlying nature of a problem. Precision medicine in the context of SSDs requires a paradigm shift from transcription-based auditory-perceptual analysis to approaches informed by instrumental evidence and speech motor theory. In this clinical practice workshop, we aim to bridge this gap by defining and presenting evidence for speech synergies, showcasing clinical assessments through video demonstrations, and offering strategies for integrating movement synergies into intervention plans. By highlighting the limitations of transcription-based analyses and emphasizing the role of speech motor foundations in SSDs, this work seeks to realign clinical practices with the broader, evidence-based understanding of speech production.
Ultimately, the integration of movement synergies into assessment and intervention has the potential to enhance outcomes for individuals with SSDs. Equipping clinicians with the tools and knowledge to recognize and address speech motor issues is essential for advancing the profession and improving the accuracy and efficacy of treatment. By embedding this knowledge into curricula and clinical training, the field can move closer to a precision medicine approach that optimally supports individuals with speech disorders.
Morning
- Development of Speech Motor Control
- Speech Motor Synergies
- Development of Speech Motor Synergies
- Speech motor and language interactions
- Relationship between Language, Phonology, Phonetics and Speech Motor Synergies
- Implications for the Classification of Speech Sound Disorders
Afternoon
- Speech Motor Control Assessments
- WHO-ICF-CY Levels of Measurement
- Clinical Speech Motor Assessments
- Objective Measures for Assessing Speech Motor Control.
- Differential diagnosis of pediatric speech sound disorders.
- Speech Motor Intervention
- Goal selection: Problem with speech sound norms
- Synergy based alternatives to using sound norms in motor speech intervention
How the presentation contributes to greater understanding of issues related to audiology or speech-language pathology practices:
By attending this mini-workshop participants will develop a deeper understanding of speech motor development and how that relates to SSDs in children. The goal of the workshop presentation is to initiate a collaborative discussion among the stakeholders and stimulate a paradigm shift in clinical thinking regarding SSD diagnosis and intervention in children.
Participants will be able to:
- Describe the historical nature and limitations of IPA transcription based linguistic-phonological interpretation of speech sound errors in children.
- Describe recent instrumental evidence supporting speech motor basis for speech sound errors in children.
- Describe the development of speech motor synergies.
- Identify types and measures for assessing speech motor synergies.
- List three ways to incorporate synergy-based assessment results into treatment.
Föreläsare: Dr. Aravind Namasivayam, Ph.D., S-LP(C), Reg. CASLPO
Dr. Aravind Namasivayam is an internationally recognized expert in speech motor control and pediatric speech disorders. He holds a clinical degree in Speech-Language Pathology, with advanced specialization in Neuroscience at the doctoral and post-doctoral levels. Dr. Namasivayam has led several government- and industry-funded randomized clinical trials, driven policy changes and shaping evidence-based care pathways for children. He has authored 53 peer-reviewed articles and book chapters and delivered over 80 presentations and workshops at international conferences. He has received numerous prestigious awards, including recognition from the American Speech-Language-Hearing Association (ASHA), the Stuttering Foundation of America (SFA), Apraxia Kids, and the National Award for Excellence in Applied Research from Speech-Language and Audiology Canada (SAC). Dr. Namasivayam teaches speech physiology, research methods, and pediatric speech sound disorders at the University of Toronto. In 2018, he founded the Speech Research Centre Inc., dedicated to making evidence-informed practices accessible to clinicians worldwide. He is also the co-founder of Hear2Speak.org, a non-profit organization committed to improving speech-language pathology and audiology services in underserved regions globally.