Project PAIR: Parent-implemented Articulation Intervention With Recast

NCT06936696 | Recruiting

• 1 other identifier: 240777
• Study Type: interventional
• Target: 10
• Locations: 1 country
• Sites: 1

Brief Summary

Using a single-case multiple baseline across participants design, this study aims to explore the effectiveness of parent-implemented Broad Treatment Speech Recast supplemented with traditional clinician-led articulation therapy on speech production in elementary-aged deaf and hard of hearing children. To address these objectives, the following research questions will be investigated:

1. 1.Does drill-based articulation therapy, administered by a speech-language pathologist, improve speech sound production in DHH children when parent-implemented BTSR is concurrently utilized at home?
2. 2.Does the combination of parent-implemented BTSR and clinician-led traditional articulation therapy result in generalization of speech sound accuracy at the conversation level?

Conditions

Hearing Impaired Children

Keywords

deaf and hard of hearing; articulation; speech sound production; parent training; children

Outcome Measures

Primary Outcomes (1)

• Target phoneme production accuracy

  The percent of accurate phoneme productions per target, which is derived by dividing the number of correct productions by the total possible points for each target and then multiplying by 100. Accurate phoneme production is defined by a speech-language pathologist's judgment of perceptual accuracy through the lens of broad transcription.

  From baseline until end of treatment (when intervention criteria have been reached or 6 weeks of no progress / regression)

Secondary Outcomes (2)

• Goldman Fristoe Test of Articulation - Third Edition (GFTA-3)

  Collected during eligibility (before the intervention) and at the end of the intervention (when intervention criteria have been reached or 6 weeks of no progress / regression)

• Generalization to Conversation

  From enrollment to the end of treatment (when child meets criteria or exhibits no progress/regression for three consecutive sessions).

Study Arms (1)

Articulation Therapy

EXPERIMENTAL

Participants engage in two conditions: (1) Parent-implemented Broad Target Speech Recast (BTSR), (2) Parent-implemented BTSR combined with clinician-implemented speech therapy This is a nonconcurrent multiple probe single-case experimental design with staggered introduction of conditions across participants. All participants receive both interventions, but the interventions are introduced in separate phases and evaluated independently and in combination. This is not a crossover or parallel group design. Rather than having separate arms or randomization, each participant serves as their own control over time, allowing for individualized evaluation of intervention effects.

Behavioral: Broad Target Speech Recast; Behavioral: Traditional Speech Therapy

Interventions

Broad Target Speech Recast BEHAVIORAL

Broad Target Speech Recasts (BTSR) is a speech intervention technique in which an adult immediately recasts a child's incorrect articulation by providing a corrected version of the word in a naturalistic, meaningful context. Unlike traditional articulation therapy, which focuses on isolated sound drills, BTSR integrates correction seamlessly into conversation without requiring the child to repeat or imitate the model. This approach is rooted in principles of implicit learning, where repeated exposure to accurate speech models facilitates phonological development over time. BTSR differs from traditional minimal pair or phonetic placement techniques in that it does not involve explicit instruction or direct prompts for self-correction. Instead, it provides high-frequency, naturalistic exposure to correct phoneme production within functional language use.

Also known as: BTSR

Articulation Therapy

Traditional Speech Therapy BEHAVIORAL

Traditional Speech Therapy is clinician-led and includes structured, drill-based approaches. Techniques such as placement cues, direct feedback, and reinforcement are used to help children achieve correct articulation. The structured nature of this approach is often more effective in remediating persistent speech errors than parent-implemented strategies alone. This study examines whether the combination of parent-implemented BTSR and clinician-led traditional articulation therapy leads to improved speech sound production and long-term maintenance of correct articulation in elementary-aged DHH children.

Articulation Therapy

Eligibility Criteria

• Age: 4 Years - 10 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• Age 4;0-9;11
• Permanent, prelingual sensorineural hearing loss
• Uses spoken English as their primary home language (≥ 51% of the time)
• Standard score ≥70 on the Leiter
• Standard score ≥70 on the OWLS-II Listening Comprehension
• At least two speech sound errors appropriate to target based on speech norms and general stimulability

You may not qualify if:

• Motor speech disorder (e.g., childhood apraxia of speech)
• Oral structural functional disorder (e.g., cleft palate)
• Diagnosis of autism spectrum disorder
• Diagnosis of ADHD
• Uncorrected vision impairment (i.e., identified vision loss without the use of corrective lenses)

Sponsors & Collaborators

• Vanderbilt University: lead

Study Sites (1)

Vanderbilt University Medical Center

Nashville, Tennessee, 37232, United States

RECRUITING

MeSH Terms

Conditions

Hearing Loss

Condition Hierarchy (Ancestors)

Hearing Disorders; Ear Diseases; Otorhinolaryngologic Diseases; Sensation Disorders; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Central Study Contacts

Meganne Muir

CONTACT

330-814-1748; meganne.muir@vanderbilt.edu

Jena McDaniel

CONTACT

615-936-5114; jena.mcdaniel@vumc.org

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: PhD Student and Certified Speech-Language Pathologist

Model Details: Single case multiple baseline across participants

Study Record Dates

• First Submitted: April 13, 2025
• First Posted: April 20, 2025
• Study Start: June 10, 2025
• Primary Completion (Estimated): August 1, 2026
• Study Completion (Estimated): August 1, 2026
• Last Updated: June 29, 2025

Record last verified: 2025-06

Locations

US (1)