Posture, Tongue Position and Pronunciation

The Relationship Between Posture, Tongue Position and Hebrew Sibilant Consonants Pronunciation, and the Effect of Muscle Strengthening Program in Children and Teenagers

Background: The main speech organ that affects the pronunciation of the various vowels is the tongue. The relationships between posture and voice, and between the position of the tongue at rest and posture, have been proven, but the relationship between pronunciation and posture has not yet been proven. The rationale for examining this relationship is that the imbalance and differing loads in poor neck and head posture cause different muscular arrangements of the muscles that support the jaw, tongue, and neck, which will thus affect pronunciation.

Objectives: To examine the relationship between posture, tongue position, and the correct pronunciation in subjects with and without pronunciation disorders. In addition, to examine the effect of a muscle strengthening program on these characteristics.

Methods: The study will include two parts. The first part will be a cross-sectional study using a questionnaire to examine speech therapists' perceptions of the relationship and importance of posture and pronunciation. The second part will include a prospective interventional clinical study to examine the relationship between tongue position at rest and pronunciation, posture, and muscle strength. In addition, the effect of adding muscle-strengthening training to conventional pronunciation therapy on the process of acquiring correct pronunciation will be examined.

This study will examine the relationship between posture, tongue position, and correct pronunciation in subjects with and without pronunciation disorders. In addition, we will examine the effect of a muscle-strengthening program on these characteristics.

The first part will include an online questionnaire to examine speech therapists' perceptions of the relationship and importance of posture in speech therapy treatment.

The second part will include a prospective interventional clinical study with participants with and without pronunciation disorders. The evaluation measures will include: assessment of the pronunciation by a speech therapist, assessment of posture (mobile app), assessment of tongue position at rest and during pronunciation (observation and ultrasound), measurement of neck and upper limb muscle strength (manual dynamometer), tongue strength (digital measuring spoon), jaw closing muscle strength (Byte), breathing, and swallowing (observation).

The study group with pronunciation disorder will be divided into 2 groups: the intervention group will receive an exercise program to strengthen the neck and upper-limb muscles in addition to regular speech therapy treatments. The control group will receive the regular speech therapy treatments. The evaluation measures will be reviewed again at the end of the treatment series (up to 10 treatments).

Inclusion Criteria:

• People with normal hearing
• with and without pronunciation disorders

Exclusion Criteria:

• Children and teenagers who study in special education settings,
• children and teenagers with phonological disorders at the prosodic or segmental level,
• children and teenagers whose parents are under the impression that they do not hear well.