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.

Study Overview

• Status: Not yet recruiting
• Conditions: Speech Dysfunction
• Intervention / Treatment: Other: speech therapy treatment and strengthening exercise; Other: speech therapy treatment

Detailed Description

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).

• Study Type: Interventional
• Enrollment (Estimated): 80
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Gali Dar, PhD; Phone Number: +972505662054; Email: gdar@univ.haifa.ac.il

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: Yes

Description

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.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: excercise; will receive speech therapy treatment and, in addition, exercises for the neck and upper extremities.	Other: speech therapy treatment and strengthening exercise; speech therapy treatment and strengthening exercise
Active Comparator: Control; will receive regular speech therapy treatment according to their disorder	Other: speech therapy treatment; regular treatment to enhance good pronunciation
No Intervention: healthy control; healthy control for baseline comparison, no treatment

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Treatment success	number of treatments until good pronunciation is achieved	at completion of intervention - up to 10 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
neck muscle strength	flexion and side flexion neck muscle strength via hand held dynamometer. Recorded in kilograms of force (kgf)	baseline, at completion of intervention - - up to 10 weeks
Tongue strength	Tongue strength will be assessed using a digital measuring spoon. Measurements will be recorded in g/cm2	base line, at completion of intervention - - up to 10 weeks
Jaw closing strength	jaw closing strength via Byte device	base line, at completion of intervention- - up to 10 weeks
Tongue thickness	Tongue thickness will be measured using ultrasonography. Measurements will be recorded in millimeters (cm).	base line, at completion of intervention- - up to 10 weeks

Collaborators and Investigators

• Sponsor: University of Haifa

Study record dates

Study Major Dates

• Study Start (Estimated): July 1, 2026
• Primary Completion (Estimated): July 1, 2028
• Study Completion (Estimated): July 1, 2028

Study Registration Dates

• First Submitted: June 3, 2026
• First Submitted That Met QC Criteria: June 13, 2026
• First Posted (Actual): June 16, 2026

Study Record Updates

• Last Update Posted (Actual): June 16, 2026
• Last Update Submitted That Met QC Criteria: June 13, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: strength; posture; tongue; muscles; pronunciation
• Additional Relevant MeSH Terms: Therapeutics; Patient Care; Rehabilitation; Aftercare; Continuity of Patient Care; Rehabilitation of Speech and Language Disorders; Speech Therapy
• Other Study ID Numbers: 237/26

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No