Building community

For nearly three decades, researchers at the University of Cincinnati have been advancing the understanding and application of ultrasound technology in clinical speech-language pathology.

In July, the university increased its commitment to furthering the field by co-hosting, in partnership with Cincinnati Children’s Hospital, the inaugural Ultra-SLP Conference: Evidence and Practice in Ultrasound Biofeedback Therapy. 

Ultrasound biofeedback therapy involves placing an ultrasound probe under a person’s chin to visualize the surface of their tongue and track movement in real time. Speech-language pathologists (SLPs) use this type of technology-assisted therapy across various settings and populations, from helping children adjust their tongue movement patterns to learn the American English /r/ sound to treating stroke survivors for dysarthria (slurred speech) and dysphagia (swallowing difficulty).

“Before ultrasound, it was really difficult to see all the critical articulatory movement that happens inside the mouth,” says Sarah Hamilton Dugan, PhD, an SLP at Cincinnati Children’s and an adjunct instructor within the UC College of Allied Health Sciences’ Department of Communication Sciences and Disorders. “Ultrasound is a safe, accessible and low-risk technology that provides speech-language pathologists a picture of what’s happening inside the mouth to help guide clinical intervention.”

From July 15-17, more than 100 clinicians and researchers from across the country gathered at UC’s 1819 Innovation Hub to exchange knowledge about using ultrasound biofeedback therapy to treat speech sound and swallowing disorders, two related but distinct areas of expertise. SLPs practicing in public schools and hospitals attended presentations, workshops and roundtable discussions alongside clinical educators and federally funded researchers. 

“A lot of speech-language pathologists are just beginning to use ultrasound technology without really having a way to know how or feel like they’re part of a community,” says Suzanne Boyce, PhD, a distinguished translational research mentor and professor emerita within UC’s Department of Communication Sciences and Disorders. “We created this conference to bring together a community of clinicians and researchers from different backgrounds who could learn from each other.”

More than 20 clinicians, educators and researchers presented evidence on using ultrasound with different clients and disorders, with experts hailing from UC, Cincinnati Children’s and other hospitals, private practices and universities in Ohio, Indiana, Texas, Florida, New York, New Jersey, North Dakota and Mississippi. Presentation topics spanned historic milestones of ultrasound in speech sound intervention, clinical applications for children with cleft palate and practical methods for funding and acquiring ultrasound technology. 

Roughly two-thirds of attendees were “ultrasound beginners” who were interested in adding this technology to their clinical toolbox. About 50 attendees also participated in a pre-conference workshop for an intensive introduction to the use of ultrasound in swallowing disorders. The conference concluded with dialogue-based roundtables that were intentionally designed to center clinicians’ voices and discussion around the benefits and barriers to implementing ultrasound biofeedback therapy.

As research on using ultrasound for speech and swallowing therapy grows, so does clinical adoption, particularly among university and hospital clinics and some private practices. This is partly due to ultrasound becoming more accessible, as the cost of clinical scanners has decreased, and the availability of portable, low-cost, smartphone-integrated scanning devices has increased.

Ultrasound’s expanded adoption is also fueled by leaders like Boyce and Dugan, who have presented ultrasound research at national conferences and trained countless students and SLPs on how to use ultrasound technology. In 2016, Dugan helped forge a partnership between UC and Cincinnati Children’s by training a core group of the hospital’s clinicians on ultrasound technology and implementing an ultrasound program that has since expanded to five sites.

“Research works best when clinicians are involved, because researchers need to understand which interventions work in specific clinical contexts,” Dugan says. “And the best way for researchers to understand all the different aspects that impact treatment success is through intentionally partnering with clinicians to discuss needs and test new implementation methods they’ve seen work in smaller, more controlled settings.”

The Ultra-SLP Conference reflects not only an evolving collaboration between UC and Cincinnati Children’s but also both institutions’ commitment to eliminating barriers that prevent clinician-researcher partnerships. This was a core focus for Dugan, Boyce and the small group of experts who organized the conference, as evidenced by: 

• Ultra-SLP was purposefully hosted during the summer to be conducive to school-based clinicians’ schedules.
• Conference organizers secured a National Institutes of Health grant to provide travel and childcare funding for those who couldn’t otherwise afford to attend, and UC provided bridge funding before the grant was awarded.
• Dialogue-based roundtables were designed to center clinicians’ voices to reverse the typical flow of knowledge dissemination between researchers and clinicians. 
• Conference attendees could volunteer to participate in a formal post-conference research study focused on understanding barriers to clinical implementation. 
• Conference attendees who were new to ultrasound could opt to be paired with a more experienced clinician or researcher for a year-long mentorship. 

“The Ultra-SLP Conference was founded on the purpose of building a community that’s dedicated to advancing how ultrasound is used in speech-language pathology,” Dugan says. “By creating space for people to share their experiences, ask questions and tear down some of those traditional barriers between researchers and clinicians, we hope to create lasting partnerships that lead to more relevant research questions and stronger, evidence-based clinical uses.”

Research reported in this publication was supported by the National Institute on Deafness and Other Communication Disorders of the National Institutes of Health under Award Number R13DC023787. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.