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Speech and Feeding Disorders Lab Research

Assessing and Restoring Lip Motor Function Following Facial Transplantation 

To date, over 30 facial transplantation surgeries have been performed worldwide. While facial mobility appears to be slowly improving in these patients, mild to moderate communication and swallowing deficits persist. Because the procedure is new and has been performed on only a small number of patients, there is much to learn about the course of facial motor recovery following implantation and the best surgical and post-surgical interventions to maximize recovery.

Now that feasibility of this surgery has been established, the next step to improving outcomes requires the development of better assessment tools and the testing of promising new therapies that may improve long-term outcomes.

The SFDL is working with the facial transplantation team directed by Dr. Bohdan Pomahac at Brigham and Women’s Hospital to better understand the course of facial motor recovery following surgery using 3D facial motion analysis and to test the benefits of lip strength exercises on the recovery of speech, facial expression, swallowing, and quality of life.

Speech motor impairments – Amyotrophic Lateral Sclerosis (ALS)

Approximately 30,000 people are diagnosed with ALS, also known as Lou Gehrig's Disease, in the US, with 5,600 new diagnoses each year. The disease results in the selective deterioration of both upper and lower motor neurons. A sudden impairment of speech and swallowing are frequent first indicators of the disease with bulbar onset (head and neck) in approximately 25% of all ALS cases.

Bulbar symptoms associated with ALS have a devastating effect on quality of life and significantly shorten survival. Despite advances made in research and supportive therapy, the diagnosis of ALS remains elusive and options for treatment are limited. The goals of this research is to identify sensitive, quantitative indicators of disease progression that can be used for improving the detection of bulbar onset, the prediction accuracy of disease progression in bulbar ALS, and the identification of bulbar subtypes of ALS. Watch video on research on speech impairments due to ALS.

Using computers to assist persons with speech impairments: A “virtual vocal tract”

In this project, Dr. Green and his collaborators, Dr. Jun Wang (University of Texas at Dallas) and Dr. Ashok Samal (University of Nebraska-Lincoln), are developing a speech device that is controlled in real-time by the movements of the lips and tongue. The device generates words or phrases that are articulated silently. This technology is most frequently called a “silent speech interface.”

The purpose of the technology is to provide an alternative mode of oral communication for persons with speech impairments or for persons with the inability to use their voice due to, for example, throat cancer. Because the device can be tuned to the movements of an individual speaker, it can generate clear speech even when it is poorly articulated. Although the device is still in the experimental phase, the research team has published numerous articles demonstrating the feasibility of the approach.

Consulting for Therapeutic Trials

The Speech and Feeding Disorders also advises and consults with pharmaceutical companies developing new therapeutic drugs for diseases impacting speech and swallowing. Objective clinical endpoints of speech and swallowing are needed for use in clinical trials, but existing measurements are often subjective and too coarse to detect intervention effects. Using the techniques and tools developed by our lab, we are able to provide scientifically validated speech and swallowing outcome measures for behavioral, surgical, and pharmacological interventions.