EPG for treatment of articulation errors: /r/

Wouldn’t it be great if there were some sort of fancy biofeedback device that could be used for the treatment of articulation disorders? There is! One example is electropalatography (EPG) devices like the SmartPalate, now commercially available, increasingly affordable by clinics and school districts, and marketed for the correction of speech sound errors (/r/ in particular).

But, do we have evidence to support that EPG devices work for speech? That’s exactly what Hitchcock et al. attempt to tackle. Five elementary-aged children—all with very low accuracy for /r/, four previously treated for /r/ and one with no treatment history—were provided twice-weekly EPG therapy sessions for two months, using SmartPalate. At the end of treatment, all of the children made some gains with /r/, but it was quite variable, with only some of the children generalizing what’s they’d learned to untreated /r/ targets.

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So, what do we do with this information? Well, the good news is we know it can work for some kids! The bad news is this study is very small, and represents only the beginning of the type of data that needs to be collected in order to make truly informed decisions about the need for such technology. We have no idea how EPG biofeedback fares compared to other types of biofeedback, including ultrasound biofeedback (like this or this) and visual–acoustic biofeedback (seeing visual representations of acoustic features, e.g. on a computer screen). And, realistically, what is best may vary per child characteristics and treatment target—that is, acoustic biofeedback versus tongue shape biofeedback (as in ultrasound) versus tongue-to-palate contact information (as in EPG) could all be more or less ideal depending on what speech sound you’re working on. For example, with EPG treatment of /r/, the child is getting feedback about lateral bracing only (what’s lateral bracing? Read this). However, “…articulatory imaging has shown that speakers produce English rhotics using a variety of different tongue shapes…”


Hitchcock, E.R., Byun, T.A., Swartz, M., & Lazarus, R. (2017). Efficacy of Electropalatography for Treating Misarticulation of /r/. American Journal of Speech-Language Pathology. Advance online publication. doi:10.1044/2017_AJSLP-16-0122.