AI-Assisted Treatment for Residual Speech Sound Disorders

NCT05988515 | Recruiting DMC

• 2 other identifiers: 22-426b1R01DC020959-01
• Study Type: interventional
• Target: 26
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this randomized-controlled trial is to determine how artificial intelligence-assisted home practice may enhance speech learning of the "r" sound in school-age children with residual speech sound disorders. All child participants will receive 1 speech lesson per week, via telepractice, for 5 weeks with a human speech-language clinician. Some participants will receive 3 speech sessions per week with an Artificial Intelligence (AI)-clinician during the same 5 weeks as the human clinician sessions (CONCURRENT treatment order group), whereas others will receive 3 speech sessions per week with an AI-clinician after the human clinician sessions end (SEQUENTIAL treatment order group.

Conditions

Speech Sound Disorder

Outcome Measures

Primary Outcomes (1)

• Change in percent correct for the /ɹ/ sound in untreated words, rated by blinded listeners.

  To assess generalization of treatment gains to untreated words, participants will read a word list eliciting /ɹ/. Stimuli in each list will be presented individually in randomized order. Individual words will be isolated from the audio record of each word probe and presented in randomized order for perceptual rating by trained listeners who are blind to treatment condition and time point (but will see the written representation of each target word). We will use the change in percent correct as our primary measure of perceptually rated accuracy.

  Before the initiation of treatment and again 5 weeks later.

Secondary Outcomes (6)

• Retention of percent correct for the /ɹ/ sound in untreated words, rated by blinded listeners.

  Before the initiation of treatment and again 10 weeks later.

• Change in percent correct for the /ɹ/ sound in untreated words, rated by blinded listeners.

  After 5 weeks of treatment and again 10 weeks later.

• Survey evaluating impacts of speech disorder on participants' social, emotional, and academic well-being.

  Before the initiation of treatment and again 5 weeks later.

• Change in percent correct for the /ɹ/ sound in practiced words, rated by blinded listeners.

  Before the initiation of treatment and again 5 weeks later.

• Change in percent correct for the /ɹ/ sound in practiced words, rated by blinded listeners.

  Before the initiation of treatment and again 10 weeks later.

Study Arms (2)

CONCURRENT treatment order

EXPERIMENTAL

* 5 speech lessons with a human speech-language clinician: 1 time per week for 5 weeks. * 15 speech lessons with an AI clinician (supervised by the caregiver), 3 times per week DURING the same 5 weeks as the human clinician sessions.

Behavioral: Speech-Language Pathologist-led Speech Motor Chaining; Behavioral: Artificial Intelligence-led Speech Motor Chaining (CHAINING-AI)

SEQUENTIAL treatment order

EXPERIMENTAL

* 5 speech lessons with a human speech-language clinician: 1 time per week for 5 weeks. * 15 speech lessons with an AI clinician (supervised by the caregiver), 3 times per week for the 5 weeks AFTER the human clinician sessions end.

Behavioral: Speech-Language Pathologist-led Speech Motor Chaining; Behavioral: Artificial Intelligence-led Speech Motor Chaining (CHAINING-AI)

Interventions

Artificial Intelligence-led Speech Motor Chaining (CHAINING-AI) BEHAVIORAL

Sessions include Structured Practice and Randomized Practice using our web-based software with an Artificial Intelligence clinician to address the /r/ sound. Within a practice session, participants speak into a microphone, and the audio file is sent to a server to be analyzed by a classifier, which returns a binary accurate/inaccurate rating of productions in a fashion similar to SLP judgment. Our web-based software manipulates the principles of motor learning, including feedback prompts, the complexity of the utterance, and the variability in the practice trial. The software will analyze the child's accuracy as determined by the classifier to increase the difficulty of practice when the child is more accurate.

CONCURRENT treatment order; SEQUENTIAL treatment order

Speech-Language Pathologist-led Speech Motor Chaining BEHAVIORAL

Sessions begin with Pre-practice to elicit the /r/ sound. During Structured Practice, the same utterance is practiced several times in a row (with systematic increases in difficulty based on performance). Our web-based software manipulates the principles of motor learning, including feedback prompts for the clinician, the complexity of the utterance, and the variability in the practice trial; the software will analyze the clinician's rating to increase the difficulty of practice when the child is more accurate. Randomized Practice will also be guided by the software and includes all linguistic levels that were produced correctly during Structured Practice, with items presented in random order. A trained speech-language pathologist is involved in all practice trials to provide feedback throughout the session.

CONCURRENT treatment order; SEQUENTIAL treatment order

Eligibility Criteria

• Age: 9 Years - 17 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)

You may qualify if:

• Must speak a rhotic dialect of American English as a dominant language.
• Must have begun learning English by at least the age of 3 years.
• Must be between 9;0 to 17;11 years of age.
• Must have reported difficulty with /ɹ/ production.
• Must have reported hearing within normal limits.
• Must receive a Scaled Score of 5 or above on both the Listening Comprehension and Story Retelling subtests from the Test of Integrated Language \& Literacy Skills (TILLS).
• Must receive a percentile score of 8 or below on the Goldman-Fristoe Test of Articulation-3 (GFTA-3) Sounds in Words subtest.
• Must have 1 scorable response with 5+ consecutive correct /pataka/ with \> 3.4 syllables per second in the MRR-Tri task of the Maximum Performance Tasks OR must demonstrate no childhood apraxia of speech (CAS-only) features in BOTH articulatory and rate/prosody domains of the ProCAD.
• Must score \<40% accurate based on word-level items from our /ɹ/ probe list.
• Must score \>=15% accuracy on /ɹ/ on 45 syllables following Dynamic Assessment.
• Must express interest in changing their /ɹ/ production.
• Must have oral structure and function that are appropriate for /ɹ/ production.
• Must have access to broadband internet with videoconferencing capabilities

You may not qualify if:

• Must have no known history of autism spectrum disorder, Down Syndrome, cerebral palsy, intellectual disability, permanent hearing loss, epilepsy/antiepileptic medication, or brain injury/neurosurgery/stroke.
• Must not have diagnosis of attention deficit disorder, attention deficit hyperactivity disorder, Tourette's, or Obsessive-compulsive disorder.
• Must have no orthodontic appliances that block the roof of the mouth (e.g., palate expanders).
• Must not have current cleft palate, fluency disorder, or voice disorder.
• Must not demonstrate childhood apraxia of speech (CAS-only) features in BOTH articulatory and rate/prosody domains of the ProCAD.

Sponsors & Collaborators

• Syracuse University: lead
• State University of New York - Upstate Medical University: collaborator
• National Institute on Deafness and Other Communication Disorders (NIDCD): collaborator
• National Institutes of Health (NIH): collaborator

Study Sites (1)

Syracuse University

Syracuse, New York, 13244, United States

RECRUITING

Related Links

• Lab website with recruitment information

MeSH Terms

Conditions

Speech Sound Disorder

Condition Hierarchy (Ancestors)

Communication Disorders; Neurodevelopmental Disorders; Mental Disorders

Central Study Contacts

Jonathan Preston, PhD

CONTACT

315-443-1351; jopresto@syr.edu

Nina Benway, PhD

CONTACT

nrbenway@syr.edu

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: All perceptual ratings will be obtained from trained listeners who are blinded to treatment group and to timepoint. Binary rating of accuracy of the "r" sound (i.e., judgments of correct or incorrect) will be obtained from three listeners per token.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Participants will be randomized across two conditions, CONCURRENT and SEQUENTIAL Participants randomized to receive CONCURRENT treatment will receive speech lessons with a human clinician once per week for five weeks, along with 3 sessions per week of parent-supervised Chaining-AI (15 Chaining-AI sessions). Therefore, clinician-led and Chaining-AI are completed concurrently. Participants randomized to receive SEQUENTIAL treatment will receive speech lessons with a human clinician once per week for five weeks, followed by three sessions per week of parent-supervised Chaining-AI for the NEXT five weeks. Therefore, clinician-led and Chaining-AI are completed sequentially.

Study Record Dates

• First Submitted: August 4, 2023
• First Posted: August 14, 2023
• Study Start: September 5, 2024
• Primary Completion (Estimated): December 31, 2027
• Study Completion (Estimated): December 31, 2027
• Last Updated: January 8, 2026

Record last verified: 2026-01

Locations

US (1)