Speech Sound Disorder
Conditions
Keywords
speech sound disorder, auditory perception, articulation
Brief summary
The objective of this study is to measure the effects of online perceptual training on perception and production in children with RSE who exhibit atypical perception relative to norms from our lab-based pilot data. In a multiple-baseline across-subjects design, 10 children with RSE will begin in a baseline phase probing perceptual acuity for /r/. Perceptual training with multiple types of stimuli will be initiated in a staggered fashion. Production probes elicited before and after treatment will assess the extent to which perception gains transfer to /r/ production.
Detailed description
Following the initial evaluation to determine eligibility, participants will be enrolled in a baseline phase in which perception and production abilities will be probed but not treated. In a multiple-baseline across-subjects design with randomization, the 10 participants will be randomly assigned to transition from the baseline to the treatment condition at one of 7 possible points, ranging from 3 to 9 baseline sessions. After baseline sessions, perceptual training will be delivered in twelve 30-minute sessions occurring 3 times per week for 4 weeks. The training is fully computerized and can be self-administered, but a study clinician will attend one session per participant per week to ensure attention to study tasks. Each session will feature three listening tasks of approximately equal duration. Following perceptual training, participants will receive 4 60-minute sessions of production training completed over two weeks.
Interventions
BEHAVIORALPerceptual training
Perceptual training involves self-paced presentation of auditory stimuli via a computerized software program. Stimuli are organized into three separate tasks: Tasks 1 and 3 will train category goodness judgment: Participants will hear 75 naturally produced speech tokens containing /r/ from various speakers, with a balance of correct and incorrect productions. They will classify each /r/ as correct or incorrect and receive feedback on the accuracy of their classification. Tasks 1 and 3 differ in that task 1 will feature a subset of items designed to provide focused practice on a specific context (e.g., initial /r/ as in red; /r/ as syllable nucleus as in sir), with increasing difficulty over time, whereas task 3 will feature randomly selected items representing all contexts and difficulty levels. Task 2: Participants will hear 75 items drawn from the synthetic rake-wake continuum used in the identification task administered at baseline.
BEHAVIORALProduction training
Instruction: Discuss tongue shapes for /r/. Pre-practice: relatively unstructured, highly interactive elicitation; provide models and placement cue and KP on every trial. Structured syllable practice: Practice will occur in blocks of 10 consecutive trials on the same syllable (e.g., 10 /ra/), after which a new syllable will be addressed (e.g., 10 /re/--but note that in the fully blocked condition, the same syllable should occur in two consecutive blocks of 10).
Sponsors
National Institute on Deafness and Other Communication Disorders (NIDCD)
Syracuse University
New York University
Montclair State University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
This study follows a multiple-baseline across-subjects design with random assignment of participants to different baseline durations. Following the initial evaluation to determine eligibility, participants will be enrolled in a baseline phase in which perception and production abilities will be probed but not treated. Perception will be measured using the online identification and category goodness tasks and production will be measured from standard probes containing /r/ in various phonetic contexts. Participants will be randomly assigned to transition from the baseline to the treatment condition at one of 7 possible points, ranging from 3 to 9 baseline sessions. All participants will receive 12 sessions of perceptual training over 4 weeks followed by 4 sessions of production training over 2 weeks.
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 HL * 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 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 |
|---|---|---|
| Averaged Perception Percent Accuracy Score | Participants' perception progress was tracked across all treatment phases. The averaged percent accuracy score reported here was collected during maintenance sessions (3 sessions across 1 week). | Averaged percent accuracy post-perception training. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Raw Change in Percent Accuracy Perception Task | Participants' progress was tracked across pre-treatment phase (averaged baselines) compared to post treatment phase (averaged three maintenance sessions which occurred over 1 week), up to 8 weeks, including baselines, treatment, and maintenance sessions. | Represents the raw change in percent accuracy on the perception task, calculated as the difference between the average pre-training accuracy score and the average post-training accuracy score. |
| Perceptually Rated Accuracy of /r/ Word Production | Participants' progress was tracked across pre-treatment phase (averaged baselines) compared to post treatment phase (averaged three maintenance sessions which occurred over 1 week), up to 8 weeks, including baselines, treatment, and maintenance sessions. | Perceptually rated accuracy of /r/ word production probes across an average of four expert listeners post perception and production training. |
Countries
United States
Participant flow
Recruitment details
All participants were enrolled between January 21, 2022 and July 30, 2024. All participants were assessed and treated online using standardized headphones which were mailed to them prior to the onset of the study.
Pre-assignment details
No significant events were encountered over the course of this study.
Participants by arm
| Arm | Count |
|---|---|
| Online Speech Perception Training Participants will be randomly assigned to transition from the baseline to the treatment condition. All participants will complete the assigned # of baselines sessions in which perception and production probes are elicited. All participants will then receive 12 sessions of perceptual training over 4 weeks, followed by 4 stimulability production training sessions. Participants will complete a 3-session maintenance phase in which perception and production are probed but not treated. | 10 |
| Total | 10 |
Baseline characteristics
| Characteristic | Online Speech Perception Training |
|---|---|
| Age, Categorical <=18 years | 10 Participants |
| Age, Categorical >=65 years | 0 Participants |
| Age, Categorical Between 18 and 65 years | 0 Participants |
| Percent Accuracy Perception Task | 1.84 percent accuracy STANDARD_DEVIATION 0.97 |
| Perceptually Rated Accuracy of /r/ Word Production | 5.87 percent accuracy STANDARD_DEVIATION 1.28 |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants |
| Race (NIH/OMB) Asian | 1 Participants |
| Race (NIH/OMB) Black or African American | 1 Participants |
| Race (NIH/OMB) More than one race | 1 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Race (NIH/OMB) White | 7 Participants |
| Sex: Female, Male Female | 5 Participants |
| Sex: Female, Male Male | 5 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 10 |
| other Total, other adverse events | 0 / 10 |
| serious Total, serious adverse events | 0 / 10 |
Outcome results
Primary
Averaged Perception Percent Accuracy Score
Averaged percent accuracy post-perception training.
Time frame: Participants' perception progress was tracked across all treatment phases. The averaged percent accuracy score reported here was collected during maintenance sessions (3 sessions across 1 week).
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Online Speech Perception Training | Averaged Perception Percent Accuracy Score | 84.74 percent accuracy | Standard Deviation 9.53 |
Secondary
Perceptually Rated Accuracy of /r/ Word Production
Perceptually rated accuracy of /r/ word production probes across an average of four expert listeners post perception and production training.
Time frame: Participants' progress was tracked across pre-treatment phase (averaged baselines) compared to post treatment phase (averaged three maintenance sessions which occurred over 1 week), up to 8 weeks, including baselines, treatment, and maintenance sessions.
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Online Speech Perception Training | Perceptually Rated Accuracy of /r/ Word Production | 23.45 percent accuracy |
Secondary
Raw Change in Percent Accuracy Perception Task
Represents the raw change in percent accuracy on the perception task, calculated as the difference between the average pre-training accuracy score and the average post-training accuracy score.
Time frame: Participants' progress was tracked across pre-treatment phase (averaged baselines) compared to post treatment phase (averaged three maintenance sessions which occurred over 1 week), up to 8 weeks, including baselines, treatment, and maintenance sessions.
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Online Speech Perception Training | Raw Change in Percent Accuracy Perception Task | 10.57 percent accuracy |