Comparing Traditional and Biofeedback Telepractice Treatment for Residual Speech Errors

NCT04625062 | Completed Phase 1 Results DMC

• 2 other identifiers: C-RESULTS-TPTR01DC017476
• Study Type: interventional
• Target: 7
• Locations: 1 country
• Sites: 2

Brief Summary

This study aims to evaluate the relative efficacy of biofeedback and traditional treatment for residual speech errors when both are delivered via telepractice. In a single-case randomization design, up to eight children with RSE will receive both visual-acoustic biofeedback and traditional treatment via telepractice. Acoustic measures of within-session change will be compared across sessions randomly assigned to each condition. It is hypothesized that participants will exhibit a clinically significant overall treatment response and that short-term measures of change will indicate that biofeedback is associated with larger increments of progress than traditional treatment.

Conditions

Speech Sound Disorder

Keywords

speech; articulation; motor development

Outcome Measures

Primary Outcomes (1)

• Within-session Change in Percentage of "Correct" Ratings by Blinded Naive Listeners for /r/ Sounds Produced in Word Probes

  To assess /r/ production accuracy, participants read probe lists eliciting 25 utterances of /r/ in various phonetic contexts at the start and end of each treatment session. Recorded probe words are presented in randomized order for binary rating (correct/incorrect) by naive listeners who are blind to treatment condition and time point; the accuracy of each token is quantified as the percentage of "correct" ratings across 9 blinded listeners. We then compute the mean percent correct ratings for each probe; the change in this value from pre to post session ("within-session change") is our outcome measure of interest. Summary statistics report the mean and standard deviation of within-session change for each treatment condition, pooled across participants and sessions. This Outcome Measure is assessed using a two-tailed paired-samples t-test comparing mean change in percent correct for each treatment condition across subjects. Outcomes are evaluated relative to a superiority criterion.

  Change in word probe accuracy was measured in each treatment session, which were administered over ten weeks.

Study Arms (2)

Visual-acoustic biofeedback

EXPERIMENTAL

Visual- acoustic biofeedback treatment (behavioral) administered via telepractice

Behavioral: Visual-acoustic biofeedback

Motor-based treatment

EXPERIMENTAL

Motor-based articulation treatment administered via telepractice

Behavioral: Motor-based treatment

Interventions

Visual-acoustic biofeedback BEHAVIORAL

In visual-acoustic biofeedback treatment, participants view a dynamic display of the speech signal in the form of a 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 were cued to make their real-time LPC spectrum match a visual target characterized by a low F3 frequency.

Visual-acoustic biofeedback

Motor-based treatment BEHAVIORAL

Motor-based articulation treatment involves providing auditory models and verbal descriptions of correct articulator placement, then cueing repetitive motor practice. Images and diagrams of the vocal tract were used as visual aids; however, no real-time visual display of articulatory or acoustic information will be made available.

Motor-based treatment

Eligibility Criteria

• Age: 9 Years - 15 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• 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 brief examination of oral structure and function.
• Must exhibit less than thirty percent accuracy, based on trained listener ratings, on a probe list eliciting /r/ in various phonetic contexts at the word level.

You may not qualify if:

• Must not receive a T score more than 1.3 standard deviations (SD) below the mean on the Wechsler Abbreviated Scale of Intelligence-2 (WASI-2) Matrix Reasoning.
• Must not receive a scaled score below 6 on the CELF-5 Recalling Sentences or Formulated Sentences subtests.
• Must not have history of sensorineural hearing loss or failed infant hearing screening.
• Must not have an existing diagnosis of developmental disability, major neurobehavioral syndrome such as cerebral palsy, Down Syndrome, or Autism Spectrum Disorder, or major neural disorder (e.g., epilepsy, agenesis of the corpus callosum) or insult (e.g., traumatic brain injury, stroke, or tumor resection).
• Must not show clinically significant signs of apraxia of speech or dysarthria.
• Must not have major orthodontia that could interfere with tongue-palate contact.

Sponsors & Collaborators

• New York University: lead
• Syracuse University: collaborator
• Montclair State University: collaborator
• National Institute on Deafness and Other Communication Disorders (NIDCD): collaborator

Study Sites (2)

Montclair State University

Bloomfield, New Jersey, 07003, United States

Location

Syracuse University

Syracuse, New York, 13244, United States

Location

Related Publications (10)

• Dugan SH, Silbert N, McAllister T, Preston JL, Sotto C, Boyce SE. Modelling category goodness judgments in children with residual sound errors. Clin Linguist Phon. 2019;33(4):295-315. doi: 10.1080/02699206.2018.1477834. Epub 2018 May 24.

  PMID: 29792525 BACKGROUND

• Campbell H, Harel D, Hitchcock E, McAllister Byun T. Selecting an acoustic correlate for automated measurement of American English rhotic production in children. Int J Speech Lang Pathol. 2018 Nov;20(6):635-643. doi: 10.1080/17549507.2017.1359334. Epub 2017 Aug 10.

  PMID: 28795872 BACKGROUND

• Campbell H, McAllister Byun T. Deriving individualised /r/ targets from the acoustics of children's non-rhotic vowels. Clin Linguist Phon. 2018;32(1):70-87. doi: 10.1080/02699206.2017.1330898. Epub 2017 Jul 13.

  PMID: 28703653 BACKGROUND

• McAllister Byun T. Efficacy of Visual-Acoustic Biofeedback Intervention for Residual Rhotic Errors: A Single-Subject Randomization Study. J Speech Lang Hear Res. 2017 May 24;60(5):1175-1193. doi: 10.1044/2016_JSLHR-S-16-0038.

  PMID: 28389677 BACKGROUND

• McAllister Byun T, Tiede M. Perception-production relations in later development of American English rhotics. PLoS One. 2017 Feb 16;12(2):e0172022. doi: 10.1371/journal.pone.0172022. eCollection 2017.

  PMID: 28207800 BACKGROUND

• McAllister Byun T, Campbell H. Differential Effects of Visual-Acoustic Biofeedback Intervention for Residual Speech Errors. Front Hum Neurosci. 2016 Nov 11;10:567. doi: 10.3389/fnhum.2016.00567. eCollection 2016.

  PMID: 27891084 BACKGROUND

• McAllister Byun T, Halpin PF, Szeredi D. Online crowdsourcing for efficient rating of speech: a validation study. J Commun Disord. 2015 Jan-Feb;53:70-83. doi: 10.1016/j.jcomdis.2014.11.003. Epub 2014 Dec 15.

  PMID: 25578293 BACKGROUND

• Harel D, Hitchcock ER, Szeredi D, Ortiz J, McAllister Byun T. Finding the experts in the crowd: Validity and reliability of crowdsourced measures of children's gradient speech contrasts. Clin Linguist Phon. 2017;31(1):104-117. doi: 10.3109/02699206.2016.1174306. Epub 2016 Jun 7.

  PMID: 27267258 BACKGROUND

• Hitchcock ER, Harel D, Byun TM. Social, Emotional, and Academic Impact of Residual Speech Errors in School-Aged Children: A Survey Study. Semin Speech Lang. 2015 Nov;36(4):283-94. doi: 10.1055/s-0035-1562911. Epub 2015 Oct 12.

  PMID: 26458203 BACKGROUND

• Byun TM, Hitchcock ER. Investigating the use of traditional and spectral biofeedback approaches to intervention for /r/ misarticulation. Am J Speech Lang Pathol. 2012 Aug;21(3):207-21. doi: 10.1044/1058-0360(2012/11-0083). Epub 2012 Mar 21.

  PMID: 22442281 BACKGROUND

MeSH Terms

Conditions

Speech Sound Disorder; Speech

Condition Hierarchy (Ancestors)

Communication Disorders; Neurodevelopmental Disorders; Mental Disorders; Verbal Behavior; Communication; Behavior

Limitations and Caveats

Single-case randomization designs are limited in that gains from one treatment condition may carry over to the next.

Results Point of Contact

• Title: Dr. Tara McAllister
• Organization: New York University

tkm214@nyu.edu

212-992-9445

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: phase 1
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: All perceptual ratings will be obtained from blinded, naive listeners recruited through online crowdsourcing. Following protocols refined in previous published research, binary rating responses will be aggregated over at least 9 unique listeners per token.
• Purpose: TREATMENT
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: In this within-subjects single-case randomization design, each participant will receive an equal number of sessions of visual-acoustic biofeedback and traditional treatment (n = 10 each), with randomized allocation of treatment types to individual sessions. Randomization will be blocked, with each week of treatment serving as a block; within each week/block, one session will be randomly assigned to feature visual-acoustic and one to feature traditional treatment.

Study Record Dates

• First Submitted: September 8, 2020
• First Posted: November 12, 2020
• Study Start: September 1, 2020
• Primary Completion: March 18, 2021
• Study Completion: March 18, 2021
• Last Updated: February 13, 2023
• Results First Posted: February 13, 2023

Record last verified: 2020-11

Data Sharing

• IPD Sharing: Will not share

Locations

US (2)