130 Journal of Intellectual Disability - Diagnosis and Treatment, 2022, 10, 130-137

Effect of Oral Placement and Expressive Therapies on Speech

Intelligibility of Adolescents with Articulation Disorder

Temitope Adebisi Amodu1,*, Ayodele Osisanya2, Oluseyi Akintunde Dada3, Janet Sunday
Petters4, Margaret Okwuonu Uzor5, Francis Kibai Sarimiye6, Andrew Oghenerukevwe
Orovwigho7, Uzoamaka Nneka Mbaekwe8, Victoria Enefiok Etim9, Maria Enemeba Ngwu4,
Ololade Olayinka Nnamani10 and Samuel Orim Orim3

1
Child and Adolescent Unit, Federal Neuropsychiatry Hospital, Oshodi, Lagos, Nigeria
2
Dept. of Special Education, University of Ibadan, Nigeria
3
Dept. of Special Education University of Calabar, Nigeria
4
Dept. of Guidance and Counseling, University of Calabar, Nigeria
5
Federal College of Education, Obudu, Nigeria
6
Dept. of Mental Health, Niger Delta University, Nigeria
7
Federal Neuropsychiatry Hospital, Enugu, Nigeria
8
Elnathan Learning Centre Trans Amadi, Port Harcourt, Nigeria
9
Dept. of Linguistic and Nigeria Language, University of Calabar, Nigeria
10
Neuropsychiatric Hospital, Aro, Abeokuta, Nigeria
Abstract: Intelligible speech is vital to every adolescent's life, but this skill can be confounded with the presence of
articulation disorder. Meanwhile, studies have been conducted using different therapies to improve speech intelligibility.
This study investigated the effect of oral placement and expressive therapies on speech intelligibility among adolescents
with articulation disorders.
The study adopted a pretest-posttest, control group, quasi-experimental research design with a 3x2x2 factorial matrix.
Three special centers were randomly selected, and purposive sampling was used in selecting 60 adolescents having
articulation disorders comprising 34 males and 26 females. These adolescents were randomly assigned to Experimental
Group 1 (n= 22), Experimental Group 2 (n= 21), and Control (n= 17). Speech Intelligibility Assessment Scale (r=0.92)
was the instrument used for the study. Participants in the experimental groups were exposed to the oral placement and
expressive therapeutic treatments, while those in the control groups were sensitized to a placebo. Three hypotheses
were tested at a 0.05 level of significance, while data were analyzed using Analysis of Covariance (ANCOVA), mean
scores, and Bonferroni Post Hoc Test.
Findings revealed that there was a significant main effect of treatments F(2,56) = 112.52; p <0.05 (oral placement therapy,
expressive therapy, and control group with placebo), and also a significant interaction effect of treatments, gender, and
age F(2, 47) = 7.37; p <0.05 on speech intelligibility of adolescents with articulation disorders despite the presence of
placebo. Oral placement and expressive therapies were effective in managing the speech intelligibility of adolescents
with articulation disorders.
Therefore, speech therapists should adopt these therapeutic interventions in rehabilitating adolescents with articulation
disorders.

Keywords: Expressive therapy, Oral placement therapy, Speech intelligibility, Articulation disorders.

INTRODUCTION intelligibility. According to Polat and Atas [1], better

speech perception, which is central to improving
Speech as a voluntary act resulting from the communication and understanding speech in the
activation of respiration, phonation, and articulation is presence of background noise, is challenging for any
key to oral communication. Successful communication listener. It is therefore important to consider utterance
of one’s ideas rests on one’s self-confidence in one's recognition in natural communication situations.
speech. Therefore, the need to cultivate the skill of Lochland [2] buttresses that utterance recognition on
effective speech is unequivocally essential. The the listener's part in the intelligibility of speech is as
foregoing clearly indicates the imperative of speech necessary as speaker-related factors.

In relation to speech intelligibility, articulation and

*Address correspondence to this author at the Child and Adolescent Unit, phonology are key, but articulation tests and
Federal neuropsychiatry Hospital, Oshodi, Lagos, Nigeria; Tel: 08188715856;
E-mail: [email protected] phonological evaluations are not necessarily
E-ISSN: 2292-2598/22 © 2022 Lifescience Global
Effect of Oral Placement and Expressive Therapies on Speech Journal of Intellectual Disability - Diagnosis and Treatment, 2022, Volume 10, No. 3 131

assessments of intelligibility [3]. Anyway, the When articulation disorder occurs all the time, it
procedures for measuring speech intelligibility vary on reduces speech intelligibility in a child. However, an
a number of dimensions, the primary variable being the impairment exists when errors are seen beyond an age
linguistic level of the material being evaluated (Single where a child should have learned the correct
words, words, sentences, and conversations). There productions of words and sentences. According to the
are two kinds of tasks that can be used to quantify American Speech, Language and Hearing Association
speech intelligibility, and both are applicable to [7], by eighteen months of age, someone should be
conversational speech. These tasks include scaling able to understand 50% of their toddler's speech. By
procedures where the listener estimates the proportion age two, average intelligibility should be 50% to 75%.
of the intended targets that were understood and word By age 3, somebody should be able to understand
identification tests in which the listener attempts to nearly everything their child says or 75% to 100%. At
determine (by transcription in the case of age 4, strangers should also be able to understand
conversational speech) exactly what was said. Scaling what someone's child says, and by age 5, despite a
procedures are probably the most frequently used of few lingering errors, a child should be understood by
the two because of their simplicity and efficiency. most people in most situations.

A speaker with a persistent articulation disorder on In most cases, articulation disorder occurs as a
segmental units is tested in minimal-pair lexical result of structural issues, such as a cleft palate, brain
contrasts in initial, medial, and final positions as damage, or neurological dysfunction, as in a child with
appropriate to the language. For instance, the /p/-/b/ Down syndrome, fetal alcohol syndrome, or autism and
contrast is tested in the word pairs pit-bit, dapper- cerebral palsy. A type of articulation disorder is called
dabber, and cap-cab can be highly intelligible. primary articulation disorder, which refers to a disability
Similarly, some speakers with a phonological disorder in articulation without other speech or linguistic
can be understood by listeners who are familiar with disabilities, and without a known cause [8]. However,
the phonological pattern. Articulation and phonology other types of articulation disorders have varying
are relevant to interpreting an intelligibility deficit, which etiologies, including structural, neurological, and
is usually determined by other means [4]. That is, auditory causes. A child’s inability to coordinate the
intelligibility is ascertained by methods other than muscle movements (as in children with cerebral palsy)
articulation tests or phonological evaluations, although necessary to produce speech, faulty speech models
they may be closely related in a clinical assessment or during the crucial years for speech and language
research interpretation. It is certainly possible for the development, as seen in adolescents with a history of
results of articulation tests and phonological chronic ear infections or hearing problems, In many
evaluations to be highly correlated with independent cases, there is not a clearly identifiable reason for the
judgments of intelligibility. The reasons for this problem, often, a child has completely normal,
correlation can be determined by closely examining the functioning articulators, but simply has difficulty making
factors that relate to speech intelligibility. particular sounds. In essence, an articulation disorder
is a speech disorder that affects the production of
Speech sound disorders are errors made by individual consonant and vowel sounds correctly [9].
children in which they have difficulty correctly This may be due to imprecise placement, timing,
pronouncing sounds. These errors often result in pressure, speed, or flow of movement of the lips,
difficulty understanding the child. Often, a child is able tongue, or throat. A child's ability to produce sounds
to say the sound correctly but may not use it in the occurs gradually with development. Although we
correct position in the word. Speech sound disorders expect certain sounds to be produced by a certain age,
can be categorized into two primary types: articulation every child develops speech at his or her own rate [7].
and phonological disorders. A child with an articulation Speech sounds are physical sounds that are the end
disorder has difficulty producing a particular sound, products of articulation. When a person's oral
while phonological disorders refer to the use of a communication differs from normal speech to the point
pattern of errors [5]. In general, a child with articulation of interfering with communication, it is labeled a speech
disorder is often more difficult to understand in disorder [6].
conversation and can also have additional difficulties
with language and literacy skills, which may cause poor However, many adolescents outgrow their speech
speech intelligibility during communication as a result sound issues. As the opening sentence reflected, some
of weakened articulators [6]. adolescents do not. Speech development charts are
132 Journal of Intellectual Disability - Diagnosis and Treatment, 2022, Volume 10, No. 3 Amodu et al.

easily accessible on the Internet that show the ages at teaching technique used for adolescents and adults
which adolescents should acquire certain sounds. with oral placement disorders who cannot learn
According to ASHA [7], a child should be able to standard speech sound production using auditory and
produce all English sounds correctly by the age of eight visual teaching methods alone. Since non-verbal
years. Suppose speech sound issues have not been adolescents with articulation disorders have difficulty in
eliminated naturally by age eight. In that case, the making a purposeful speech, OPT emerged to help
issues are referred to as "residual" or "persistent" these adolescents develop their sound productions.
speech sound errors, and therapy should be sought for Idiculla [15] stated that oral placement as therapy is
these errors to be eliminated [10]. Articulation errors, or more effective when compared with other conventional
an incorrect pronunciation of speech sounds, lead to techniques of speech therapy in enhancing the speech
articulation disorder, the most common of early development of children with peculiar disabilities such
childhood communication disorders [11]. Articulation as Down syndrome, autism, cerebral palsy, and
errors can make the spoken language difficult for a childhood language disorders, developmental delays,
communication partner to understand. Articulation and apraxia.
disorder can occur in isolation (one at a time) or
clusters (multiple errors). An adolescent who makes Similarly, Expressive Therapy (ET) is a multimodal
many errors in articulation will be more difficult to approach that uses all forms of reinforcement to bring
understand than an adolescent who makes only a few out speech and expression of feelings and emotions in
errors during communication. Therefore, the speech adolescents. Expressive therapy is a broad category
intelligibility of adolescents with an articulation disorder and can be used to treat various conditions of speech
needs to be enhanced for better communication. Many sound disorders by helping adolescents familiarize
therapies, including oral placement and expressive themselves with their own emotions and expressions.
therapies, have been viewed as effective interventions This can be used for adolescents suffering from
for better speech production for adolescents with articulation disorder, self-esteem issues, learning
articulation disorders. problems, and eating disorders. Expressive therapy
uses Arts work to access imagination and creativity,
Oral placement therapy (OPT) is a type of oral- which can generate new models of living and contribute
motor therapy used by Speech and Language to the development of a more integrated sense of self,
Pathologists to target specific movements needed for with increased self-awareness and acceptance [16].
speech clarity. It is one aspect of an oral "motor" Adolescents may interact with art therapy, music
therapy program that addresses the "motor" therapy, writing therapy, drama therapy, or dance
components and movements used in speech therapy. Each of these channels allows the individual to
production. This therapy differs from traditional speech emphasize their own emotions through creative
therapy in that the strategies used continue to utilize expression. For some, it may be extremely difficult to
auditory and visual stimuli (watch and listen) while speak about internal battles that they are facing
adding the tactile and proprioceptive sensory systems. verbatim. By representing an event or feeling through
This allows the client to feel the movements as well as aesthetics, they feel more comfortable. The therapist
hear and see them. uses modality to help the patient explore themselves
and communicate their concerns with others in an
Oral placement therapy, propounded by Sara1 honest manner.
Rosenfeld-Johnson, is facilitated when a child cannot
produce an ordinary speech sound. Oral placement Expressive therapy can address individual
therapy uses tools from Talk tools to increase the differences in the way people communicate. Pascoe,
child's awareness of his or her mouth and placement of Stackhouse, and Wells [1] noted that the approach is
each part of the mouth and its muscles [12]. Purdy et especially useful for people who do not know how to
al. [13] note that the purpose of oral placement therapy use feeling words. Some people are more tactile, while
ranges from helping to increase the awareness of the others respond more to visual cues. These differences
oral mechanism to helping to increase the precision of allow therapists to use the appropriate therapy with
volitional movements of oral structures for speech particular patients. During art therapy, the client will
production. Speech-language Pathologists believe that either draw or paint images that reflect their thoughts
students enjoy these tools because they see their and emotions on paper instead of verbally. This is a
usage of these tools as fun, and also, they learn to way to improve the speech sound disorder present
experiment with their oral muscles [14]. OPT is a tactile during words and sentence formation.
Effect of Oral Placement and Expressive Therapies on Speech Journal of Intellectual Disability - Diagnosis and Treatment, 2022, Volume 10, No. 3 133

In effect, adolescents with articulation disorders Participants

have anatomical (structural) and physiological
(functional) defects in the mouth and throat areas that The population for the study comprised all
make it more difficult for them to make precise adolescents with articulation disorders. The study
movements of the articulators [17]. A combination of adopted purposive sampling in selecting 60
anatomical and physiological difficulties sometimes adolescents with articulation disorders from three
results in open mouth posture and tongue protrusion. special centers in Lagos State, comprising 34 males
and 26 females. These were randomly divided into
Many adolescents with articulation disorders have
experimental group 1 (Oral Placement Therapy) with
hypersensitive (tactile defensive) or hypersensitive
22 adolescents’ experimental group II (Expressive
reactions to touch around the mouth. The inability of
Therapy) with 21 adolescents, and Control Group (with
adolescents with articulation disorders to make a
placebo) with 17 adolescents. The special centers used
meaningful speech is a constant concern to parents
are (1) Child and Adolescent Center, Oshodi, (2) Lagos
and teachers. Hence, intervention strategies are
University Teaching Hospital, Yaba, Lagos, and (3)
needed to address this problem among adolescents.
AMTOWA Special and Inclusive Centre, Ikorodu,
Objective of the Study Lagos.

Ethical Issue
1. To investigate the effect of Oral Placement as
therapy on speech intelligibility of adolescents Participants’ consent was obtained through the filing
with articulation disorders. of consent forms which was done by the directors of
the special centers used for this study.
2. To investigate the effect of Expressive Therapy
on speech intelligibility of adolescents with Intervention Procedure
articulation disorders.
Participants in this study were exposed to
3. To determine the moderating role of gender and treatments three times a week, and the treatment
age on the effect of the therapies on speech lasted for six (6) weeks. During the period, participants
intelligibility of adolescents with articulation in each of the experimental groups were treated with
disorders. oral placement and expressive therapies, while the
control group was held with an ordinary placebo
Hypotheses
method. The researchers carried out the treatment
packages themselves with the assistance of speech
The following null hypotheses were tested in the study:
pathology experts. At the end of six weeks, post-test
H01: There is no significant main effect of treatments measures were conducted.
on speech intelligibility of adolescents with Instrument
articulation disorders
The research instrument utilized in the study was
H02: There is no significant interaction effect of
Speech Intelligibility Assessment Scale (SIAS). The
treatments and gender on speech intelligibility of
SIAS is an observation rating scale to determine the
adolescents with articulation disorders
speech intelligibility of the participants. It was used to
establish the baseline of the speech and at the end of
H03: There is no significant interaction effect of
the treatment to assess the effectiveness of oral
treatments and age on speech intelligibility of
placement and expressive therapies. The instrument
adolescents with articulation disorders
was standardized with a reliability coefficient of 0.91
METHOD after its pilot testing. Oral Placement and Expressive
therapies were used as treatment packages. The
Design treatments lasted for eight weeks, out of which two (2)
weeks were used for pre and post-treatment
The study adopted a pre-test, post-test, control assessments. The researchers engaged four research
group quasi-experimental research design with a 3x2x2 assistants who are speech pathologist graduates to
factorial matrix. help in the administration of the instrument.
Participants were exposed to treatments for six (6)
134 Journal of Intellectual Disability - Diagnosis and Treatment, 2022, Volume 10, No. 3 Amodu et al.

weeks, three times per week. During the period, main effect of treatments (oral placement and
participants in each of the experimental groups were expressive therapies) on the speech intelligibility of
treated with oral placement and expressive therapies, adolescents with an articulation disorder. Apparently,
while the control group was held with an ordinary participants in expressive therapy performed better
placebo. The researchers carried out the treatment than those in oral placement therapy. This was
packages themselves with the assistance of speech discovered using multiple classification analysis and
pathology experts. At the end of six weeks of Bonferroni post hoc test analysis. The result of the test
treatment, post-test measures were conducted. is presented in Tables 2 and 3, respectively. The MCA
analysis in Table 2 shows that expressive therapy has
Analysis the highest mean, followed by oral placement and
finally the control group (34.40, 29.86, and 12.78,
Analysis of covariance (ANCOVA) and Bonferroni
respectively).
Post-Hoc test were used to analyze the results
obtained in the study. Hypothesis Two

Participants’ Characteristics There is no significant interaction effect of treatment

and gender on speech intelligibility of adolescents with
Participants for this study were mainly adolescents
articulation disorders.
with articulation disorders. 60 adolescents that
participated in this study include 24 males and 36 It can be observed that the p-values of both the
females. The participants were divided into three covariant (gender) and the grouping variable (treatment
groups; two experimental groups and one control * gender) were not significant hence the reason for
group. Group 1 (Oral Placement Therapy) with 22 accepting the null hypothesis. The effect of size for the
participants, group 11 (Expressive Therapy) with 21 2
interaction effect, as seen in the partial eta square (η ),
participants, and group 111 (control group) with 17 was 0.023. This indicates that only 2.3% of the total
participants. variance is explained by the interaction effect of
treatment and gender, while the remaining 97.7% are
RESULTS
explained by other variables unknown to the
Hypothesis One researcher. The implication of this result is that there is
no significant interaction effect of treatment and gender
There is no significant main effect of treatments on on speech intelligibility of adolescents with an
the speech intelligibility of adolescents with articulation articulation disorder.
disorders.
Hypothesis Three
The effect for treatment is high, as shown in partial
2 There is no significant interaction effect of treatment
eta square (η = 0.80). This indicates that 80% of the
and age on speech intelligibility of adolescents with
total variance is explained by the treatment. The
articulation disorders.
implication of this result is that there is a significant

Table 1: Analysis of Covariance (ANCOVA) of the Main Effect of Treatments on Speech Intelligibility of Adolescents
with an Articulation Disorder

Source Types III sum of Squares df Mean Square F-ratio p-value Partial Eta
Squared

a
Corrected model 5075.59 3 1691.86 76.3 0.00 0.803
Intercepts 640.67 1 640.67 28.89 0.00 0.340
Prescore 192.84 1 192.84 8.69 0.00 0.134
Treatment 4989.67 2 2494.83 112.52 0.00 0.801
Error 1241.65 56 22.17
Total 47661.00 60
Corrected Total 6317.25 59
a
R Squared = 0.803 (Adjusted R Squared = 0.793).
Effect of Oral Placement and Expressive Therapies on Speech Journal of Intellectual Disability - Diagnosis and Treatment, 2022, Volume 10, No. 3 135

Table 2: Analysis of Covariance (ANCOVA) of the Interaction Effect between Treatment and Gender on Speech
Intelligibility of Adolescents with an Articulation Disorder

Source Types III sum df Mean of Squares F-ratio Square p-value Partial Eta

a
Corrected model 5106.412 6 851.069 37.252 0.000 0.808
Intercepts 612.068 1 612.068 26.791 0.00 0.336
Prescore 190.286 1 190.286 8.329 0.006 0.136
Treatment 4806.797 2 2403.399 105.20 0.000 0.799
Gender 2.839 1 2.839 0.124 0.726 0.023
Treatment * gender 29.134 2 14.567 0.638 0.533 0.023
Error 1210.838 53 22.846
Total 47661.000 60
Corrected Total 6317.250 59
a
R Squared = 0.808 (Adjusted R Squared = 0.787).

Table 3: Analysis of Covariance (ANCOVA) of the Interaction Effect between Treatment and Age on Speech
intelligibility of Adolescents with an Articulation Disorder

Source Type III Sum of Squares df Mean Square F-ratio p-value Partial Eta Square

a
Corrected model 5118.137 6 853.023 37.70 0.000 0.810
Intercepts 592.866 1 592.866 26.20 0.00 0.331
Prescore 212.451 1 212.45 9.390 0.003 0.151
Treatment 4944.981 2 2472.491 109.28 0.000 0.805
Age 18.238 1 18.238 0.806 0.373 0.015
Treatment * gender 22.748 2 11.374 0.503 0.608 0.019
Error 1199.113 53 22.625
Total 47661.000 60
Corrected Total 6317.250 59
a
R Squared = .810 (Adjusted R Squared = .789).

The result above shows that the F(2,53) was 0.50 of speech intelligibility among adolescents with
while the p-values were 0.60. Firstly, it can be articulation disorders. Both therapies proved to be
observed that the p-values of both the covariant (age) effective in the treatment of articulation disorders. The
and the grouping variable (treatment * age) was not finding is in line with the study conducted by Kumin [8],
significant hence the null hypothesis is accepted. The who found out that a diagnosis of difficulty with oral
effect size for the interaction effect, as seen in the motor skills is more frequently given to children with
2
partial eta square (η ), was 0.019. Therefore, there is speech intelligibility than a diagnosis of apraxia. 60.2%
no significant interaction effect of treatment and age on of children with Down syndrome who received oral
the speech intelligibility of adolescents with articulation placement therapy, as buttressed by Kumin [8], who
disorders. also recorded a positive effect. The findings of this
study are also a confirmation of the comment of Idiculla
DISCUSSION [15], who stated that after using oral placement as
therapy for over five years, along with other
The Main Effect of Treatments on Speech conventional techniques of speech therapy, it had been
Intelligibility of Adolescents with an Articulation discovered that oral placement has been very effective
Disorder in assisting children Down syndrome, autism, cerebral
palsy, childhood language disorders, developmental
The result showed that oral placement and delays, and apraxia, who was non-verbal before to
expressive therapies were effective in the development
136 Journal of Intellectual Disability - Diagnosis and Treatment, 2022, Volume 10, No. 3 Amodu et al.

become verbal and started making sounds and intelligibility of adolescents with an articulation disorder.
producing words. However, the finding revealed that there is no
significant interaction effect of treatment and age on
To attest to the importance of expressive therapy, speech intelligibility of adolescents with articulation
Abiodun, Osisanya, and Bamigboye [18] affirmed in disorders. This implies that the effectiveness of both
their study that the receptive language skills strength of oral placement and expressive therapies was not
the participants is higher than their expressive affected by the age of the research participants. In line
language skills strength, expressive language skills with this result, studies such as Shapiro, Shaft, Risley,
strength based on neuropathological conditions was and Gygi [24] and Stehr et al. [25] have shown that age
comparable; and participants exposed to speech differences of adolescents with articulation disorder
therapy have better receptive and expressive language have no significant main effect on their speech
skills than participants without. intelligibility.
Interaction Effect of Treatments and Gender on The finding of this study supports the work of other
Speech Intelligibility of Adolescents with an
scholars such as Kwon [19], Shapiro et al. [24], and
Articulation Disorder
Stehr et al. [25], who found out that age has no effect
The findings of this study show indicate that there is on the speech intelligibility of adolescents with an
no significant interaction effect of treatments and articulation disorder. A study by Oyundoyin and
gender on speech intelligibility of adolescents with Adeleke [21] also revealed that physical exercise as
articulation disorders. Kwon [19] attests to the fact that therapy was effective for both younger and older
the speech intelligibility of adolescents with articulation participants in reducing hyperactivity among children
disorder is not influenced by gender differences. with severe mental retardation. However, a study by
Abiodun, Osisanya, and Bamigboye [18] discovered in Oyundoyin and Adeleke [23] revealed that age did not
their study that receptive and expressive language have any intervening effect on the use of outdoor
equivalent was not gender-sensitive. activities and enhancing the attention of children with
autism.
This finding supports the finding of Dada et al. [20]
in a study on the use of music as therapy in enhancing CONCLUSION
the attention of children with intellectual disabilities.
It becomes more challenging when an adolescent
The study revealed that sex does not affect the effect
child cannot adjust to the social environment due to
of music therapy in enhancing the attention of the study
speech intelligibility deficiency. The situation becomes
participants. In the same vein, a study by Oyundoyin
more worrisome when an adolescent child is diagnosed
and Adeleke [21] on physical exercise as therapy in
with an articulation disorder. The risk factor includes
reducing hyperactivity among children with severe
sound speech disorder. As an attempt to provide a
mental retardation established that both male and
solution to the problem of speech intelligibility,
female participants responded equally to the therapy.
especially with adolescents facing articulation disorder,
In the same vein, a study by Dada et al. [22] revealed
this study has found an oral placement and expressive
that there is no significant main effect of gender in
therapies are of positive impact on adolescents with an
using cumulative rehearsal as therapy in enhancing
articulation disorder.
auditory verbal memory of persons with Down
syndrome. However, the finding of this study negates RECOMMENDATIONS
the result of the study by Oyundoyin and Adeleke [23]
in a study on outdoor activities in enhancing the social Oral placement and expressive therapies have been
competence of children with autism. The finding of the discovered to be useful in enhancing the speech of
study revealed that male children with autism adolescents with articulation disorders. Therefore, the
responded better than female children with autism. two therapies should be adopted as viable tools in the
treatment of speech intelligibility of adolescents with
Interaction Effect of Treatments and Age on
articulation disorders. Non-Governmental Agencies and
Speech Intelligibility of Adolescents with an
Articulation Disorder Governments should create awareness, and early
diagnosis and intervention should be encouraged to
Treatments used in the present study were seen as prevent secondary disability. All public and private
having a significant positive effect on the speech special centers should be mandated with a speech
Effect of Oral Placement and Expressive Therapies on Speech Journal of Intellectual Disability - Diagnosis and Treatment, 2022, Volume 10, No. 3 137

Down syndrome. In J. Miller, M. Leddy and L. A. Leavitt.

therapist who will attend to the disorder when identified Improving the communication of people with Down syndrome.
in young children. In cases of the nonexistence of a Baltimore, MD: Paul H. Brookes 2014.
therapist, an appropriate referral should be made. [11] Turnbull R, Seyfarth S, Hume E, Jaeger TF. Nasal place
assimilation trades off inferrability of both target and trigger
General society should be encouraged to change its words. Laboratory Phonology: J Assoc Lab Phonol 2018; 9(1): 1-
negative attitude toward those with articulation 27.
https://doi.org/10.5334/labphon.119
disorders both in their academic, personal-social, and
[12] Rosenfeld-Johnson S. Oral Placement Therapy. Commun Disord
vocational life. Quart 2001; 9(6): 11-20.
[13] Purdy SC, Welch D, Giles E, Morgan CLA, Tenhagen R,
ACKNOWLEDGEMENT Kuruvilla-Mathew A. Impact of cognition and noise reduction on
speech perception in adults with unilateral cochlear implants.
Cochlear Implants Int 2017; 18(3): 162-170.
Efforts of all contributors to the success of this study https://doi.org/10.1080/14670100.2017.1299393
are well appreciated. The Director of Child and [14] Lof GL, Watson J. Oral motor exercises and treatment outcomes.
Adolescent Center, Oshodi, University Teaching Perspectives on Language Learning and Education 2008; 10(1):
7-11.
Hospital (LUTH), Idiaraba-Surulere, and Head-teacher https://doi.org/10.1044/lle10.1.7
of AMTOWA Special and Inclusive Centre, Ikorodu, all [15] Idiculla S. What is Oral Placement Therapy? 2017. Retrieved on
April 1, 2022. From: https://www.playstreet.in/2017/ 08/15/oral-
in Lagos State, are all appreciated for their cooperation placement-therapy/.
and supports to the success of this study. Our [16] Dunphy K, Mullane S, Jacobsson M. The effectiveness of
appreciation also goes to the parents of all persons expressive art therapies: A review of the literature. Melbourne:
PACFA 2013.
with adolescents who participated in the study. Sincere
[17] Egaga PI, Amodu TA, Dada OA. Effectiveness of oral motor
thanks to all speech pathology experts who served as exercise on speech articulation and production of children with
research assistants during the study. orofacial myofunctional disorder. Int J Res Sci Innovat (IJRSI)
2018; 5(4): 49-52.

REFERENCES [18] Abiodun K, Osisanya A, Bamigboye G. Evaluation of receptive

and expressive language skills of children with language
impairment in Lagos State. Br J Human Soc Sci 2012; 4(1): 95-
[1] Pascoe M. Stackhouse J, Wells B. Phonological Therapy within a 103.
Psycholinguistic Framework: Promoting change in a child with
Persistent Speech Difficulties. Int J Commun Disord 2005; 40(2):
[19] Kwon HB. Gender differences in speech intelligibility tests and
acoustic analyses. J Prosthodont 2010; 2(3): 71-6.
189-220.
https://doi.org/10.4047/jap.2010.2.3.71
https://doi.org/10.1080/13682820412331290979
[20] Dada AO, Adeleke OP, Aderibigbe MA, Adefemi MA, Apie MA.
[2] Lochland P. Intelligibility of L2 speech in ELF. Aust J Appl
Music Therapy in Enhancing Learning Attention of Children with
Linguist 2020; 3(3): 196-212.
Intellectual Disability. J Intell Disabil-Diagn Treat 2021; 9(4): 363-
https://doi.org/10.29140/ajal.v3n3.281
367.
[3] Audio N. Speech Intelligibility Measurement with XL2: Application https://doi.org/10.6000/2292-2598.2021.09.04.2
note 2020. Retrieved in March 2022. From:
https//www.nti.audio.com.
[21] Oyundoyin JO, Adeleke OP. Physical Exercise as a Therapeutic
Strategy in Reducing Hyperactivity among Children with Severe
[4] Murphy J. Intelligible, comprehensible, non-native model in Mental Retardation. Afr J Spec Educ Needs (Ghana) 2010; 5(1):
EAP/EFL pronunciation teaching. System 2014; 42: 258-69. 58-59.
https://doi.org/10.1016/j.system.2013.12.007
[22] Dada OA, Okpara AC, Adeleke OP, Okon MO, Merimekwu A,
[5] Kumar A, et al. Speech sound disorders in children: An Anagbogbu GE, Petters J, Edu GO, Eno A, Akah LU, Olufu MA.
articulatory phonology perspective. Front Psychol Lang Sci 2020. Cumulative Rehearsal and Verbal Memory of Persons with Down
[6] Bauman-Waengler J. Articulation and phonology in speech Syndrome. Journal of Intellectual Disability: Diagn Treat 2022;
sound disorders: A clinical focus. Boston: Pearson Education, 10(1): 114-121.
Sixth Edition 2020. https://doi.org/10.6000/2292-2598.2022.10.02.6
[7] American Speech-Language-Hearing Association, ASHA. [23] Oyundoyin JO, Adeleke OP. Outdoor Activities as a Therapy in
Appropriate school facilities for students with speech-language- Enhancing Social Competency among Children with Autism in
hearing disorders 2014. https://www.asha.org/policy. Lagos state, Nigeria. Afr J Pedag 2012; 4: 91-101.
[8] Kumin L. Differential diagnosis and treatment of speech sound [24] Shafiro V, Sheft S, Risley R, Gygi B. Effects of age and hearing
production problems in individuals with Down syndrome. Down loss on the intelligibility of interrupted speech. J Acoust Soc Am
Syndr Quart 2006; 8: 7-18. 2015; 137(2): 745-756.
https://doi.org/10.1121/1.4906275
[9] Bahr D, Rosenfeld-Johnson S. Treatment of children with Speech
Oral Placement Disorders (OPDs): A Paradigm Emerges. [25] Stehr DA, Hickok G, Ferguson SH, Grossman ED. Examining
Commun Disord Quart 2010; 20(10): 1-8. vocal attractiveness through articulatory working space. J Acoust
https://doi.org/10.1177/1525740109350217 Soc Am 2021; 150(2): 1548-1564.
https://doi.org/10.1121/10.0005730
[10] Shriberg RT, Kwiatkowski PD, Gruber SN. Communication
intervention: Improving the speech intelligibility of children with

Received on 06-05-2022 Accepted on 25-06-2022 Published on 15-07-2022

https://doi.org/10.6000/2292-2598.2022.10.03.2