Speech Sound Disorder
Conditions
Keywords
speech, articulation, auditory perception
Brief summary
This research will meet a public health need by evaluating the efficacy of speech intervention supplemented with real-time visual-acoustic biofeedback when delivered using remote technologies.
Detailed description
In a crossover design, participants will be randomly assigned to receive 10 weeks/20 sessions of visual-acoustic biofeedback treatment via telepractice followed by a 10-week period of no treatment, or the same two conditions in the reverse order. Production accuracy will be assessed with standard probes (20 syllables, 30 words, and 10 sentences containing /r/ in various phonetic contexts) administered prior to the beginning of treatment (baseline), after the first 10-week phase, and again at the end of the study.
Interventions
BEHAVIORALVisual-Acoustic Biofeedback Treatment
In visual-acoustic biofeedback treatment, the elements of traditional articulatory treatment (i.e., auditory models and verbal descriptions of articulator placement) are enhanced with a dynamic display of the speech signal in the form of the real-time LPC (Linear Predictive Coding) spectrum. Because correct vs incorrect productions of /r/ contrast acoustically in the frequency of the third formant (F3), participants will be cued to make their real-time LPC spectrum match a visual target characterized by a low F3 frequency. They will be encouraged to attend to the visual display while adjusting the placement of their articulators and observing how those adjustments impact F3.
OTHERNo Treatment
10-week period of no treatment
Sponsors
Montclair State University
National Institute on Deafness and Other Communication Disorders (NIDCD)
New York University
Syracuse University
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
All perceptual ratings will be obtained from blinded, skilled clinician listeners recruited through online crowdsourcing. Following protocols refined in previous published research, binary rating responses (1=correct; 0=incorrect) will be aggregated over at least 9 unique listeners per token.
Intervention model description
This is a randomized, two-period crossover trial. Participants will be randomly assigned to one of two sequences: (1) 10 weeks (20 sessions) of visual-acoustic biofeedback treatment via telepractice followed by 10 weeks of no treatment, or (2) 10 weeks of no treatment followed by 10 weeks (20 sessions) of biofeedback treatment. Outcomes will be assessed at baseline (before the first phase), after 10 weeks (post-Period 1), and after 20 weeks (post-Period 2). The primary outcome is production accuracy, measured using standardized probes with 50 words containing the target /r/ sound in various phonetic contexts. Randomization determines the order of treatment and control phases for each participant.
Eligibility
Sex/Gender
ALL
Age
9 Years to 15 Years
Healthy volunteers
Yes
Inclusion criteria
* Must be between 9;0 and 15;11 years of age at the time of enrollment. * Must speak English as the dominant language (i.e., must have begun learning English by age 2, per parent report). * Must speak a rhotic dialect of English. * Must pass a pure-tone hearing screening at 20dB hearing level. * Must pass a brief examination of oral structure and function. * Must exhibit less than 30% accuracy, based on consensus across 2 trained listeners, on a probe list eliciting rhotics in various phonetic contexts at the word level. * Must exhibit no more than 3 sounds other than /r/ in error on the Goldman-Fristoe Test of Articulation-3 (GFTA-3).
Exclusion criteria
* Must not receive a T score more than 1.3 SD below the mean on the Wechsler Abbreviated Scale of Intelligence-2 (WASI-2) Matrix Reasoning * Must not receive a scaled score of 7 or higher on the Recalling Sentences and Formulated Sentences subtests of the Clinical Evaluation of Language Fundamentals-5 (CELF-5). * Must not have an existing diagnosis of developmental disability or major neurobehavioral syndrome such as cerebral palsy, Down Syndrome, or Autism Spectrum Disorder
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Rhotic Accuracy (/r/) | BL - (Initial Assessments:1-2 weeks), MP-(Midpoint assessment -1 day following First Period (10 weeks), MN - (Maintenance Assessment -1 day following Second Period (10 weeks). | To evaluate the generalization of treatment effects to untreated words, participants will complete standardized word probes comprising 50 target words. The primary outcome measure is the proportion of words rated as "correct" across all tokens, reflecting perceptual accuracy of the participant's responses. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Social-emotional Well-being | Survey completed at BL ( evaluation) and MN ( 1 day following Second period duration). Same for both groups. | An 11-item survey was developed to assess parent perceptions of the impact of their child's /r/-related speech sound disorder on life participation and satisfaction. Each survey item was mapped to the most relevant chapter within the Activities and Participation domain of the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework. Most items corresponded to chapters on interpersonal interactions and relationships, and major life areas; two items were categorized under communication. Each item was rated on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree), with higher average scores indicating greater perceived negative impact of the speech sound disorder. |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORElaine R. Hitchcock, PhD
Montclair State University
Baseline characteristics
| Characteristic | — |
|---|---|
| Age, Continuous | 11.27 years STANDARD_DEVIATION 2.18 |
| Race (NIH/OMB) American Indian or Alaska Native | 2 Participants |
| Race (NIH/OMB) Asian | 2 Participants |
| Race (NIH/OMB) Black or African American | 0 Participants |
| Race (NIH/OMB) More than one race | 4 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 2 Participants |
| Race (NIH/OMB) White | 30 Participants |
| Rhotic accuracy | 12 percent accuracy STANDARD_DEVIATION 14.4 |
| Sex: Female, Male Female | 6 Participants |
| Sex: Female, Male Male | 12 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 19 | 0 / 21 |
| other Total, other adverse events | 0 / 19 | 0 / 21 |
| serious Total, serious adverse events | 0 / 19 | 0 / 21 |
Outcome results
None listed