Comparing Traditional and Biofeedback Telepractice Treatment for Residual Speech Errors

Comparing Traditional and Biofeedback Treatment for Residual Speech Errors Via Telepractice

Sponsors

Lead Sponsor: New York University

Collaborator: Syracuse University
Montclair State University
National Institutes of Health (NIH)

Source New York University
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.

Detailed Description

The COVID-19 crisis has forced speech-language pathologists to migrate from in-person delivery of speech treatment services to remote delivery via telepractice. This study will compare the efficacy of visual-acoustic biofeedback treatment versus non-biofeedback treatment in this setting. Specifically, participants will receive both visual-acoustic biofeedback treatment and non-biofeedback treatment via telepractice (Zoom call with screen-sharing) in a single-case randomization design. The hypothesis of interest is that sessions featuring visual-acoustic biofeedback will be associated with larger short-term gains than sessions featuring non-biofeedback treatment. To test this hypothesis, the study team will recruit up to 8 participants who will receive an initial treatment orientation followed by an equal dose of both types of treatment (10 sessions of visual-acoustic biofeedback and 10 sessions of non-biofeedback treatment). Participants will complete approximately two sessions per week via telepractice; each week will feature one session of each type, randomly ordered. They will also complete 4 pre-treatment baseline sessions and 3 post-treatment maintenance sessions to evaluate the overall magnitude of change over the course of treatment.

Overall Status Recruiting
Start Date 2020-09-01
Completion Date 2023-09-01
Primary Completion Date 2022-09-01
Phase Phase 1
Study Type Interventional
Primary Outcome
Measure Time Frame
Acoustically measured accuracy of /r/ in words Immediately before each of 20 treatment sessions over 10 weeks
Acoustically measured accuracy of /r/ in words Immediately after each of 20 treatment sessions over 10 weeks
Acoustically measured accuracy of /r/ in words In three separate sessions within two weeks of the start of all treatment
Acoustically measured accuracy of /r/ in words In three separate sessions within two weeks after the end of all treatment
Secondary Outcome
Measure Time Frame
Proportion of "correct" (vs "incorrect") ratings by blinded naive listeners, a measure of perceptually rated accuracy of /r/ production, for /r/ sounds produced in word or syllable probes. In three separate sessions within two weeks of the start of all treatment
Proportion of "correct" (vs "incorrect") ratings by blinded naive listeners, a measure of perceptually rated accuracy of /r/ production, for /r/ sounds produced in word or syllable probes. In three separate sessions within two weeks after the end of all treatment
Enrollment 8
Condition
Intervention

Intervention Type: Behavioral

Intervention Name: Visual-acoustic biofeedback

Description: In visual-acoustic biofeedback treatment, the elements of motor-based 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. All treatment will be provided over video calls.

Arm Group Label: Condition 1: Visual-acoustic biofeedback

Intervention Type: Behavioral

Intervention Name: Motor-based treatment

Description: 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 will be used as visual aids; however, no real-time visual display of articulatory or acoustic information will be made available. All treatment will be provided over video calls.

Arm Group Label: Condition 2: Motor-based treatment

Other Name: Traditional treatment

Eligibility

Criteria:

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 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. Exclusion Criteria: - 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.

Gender:

All

Minimum Age:

9 Years

Maximum Age:

15 Years

Healthy Volunteers:

No

Overall Contact

Last Name: Tara McAllister, PhD

Phone: 2129929445

Email: [email protected]

Location
Facility: Status: Contact: Contact Backup:
Montclair State University | Bloomfield, New Jersey, 07003, United States Recruiting Elaine R Hitchcock, PhD 973-229-3797 [email protected]
Syracuse University | Syracuse, New York, 13244, United States Recruiting Jonathan L Preston, PhD 315-443-3143 [email protected]
Location Countries

United States

Verification Date

2020-11-01

Responsible Party

Type: Sponsor

Keywords
Has Expanded Access No
Condition Browse
Number Of Arms 2
Arm Group

Label: Condition 1: Visual-acoustic biofeedback

Type: Experimental

Description: Visual-acoustic biofeedback treatment (behavioral) administered via telepractice

Label: Condition 2: Motor-based treatment

Type: Experimental

Description: Motor-based articulation treatment administered via telepractice

Acronym C-RESULTS TPT
Patient Data No
Study Design Info

Allocation: Randomized

Intervention Model: Factorial Assignment

Intervention Model Description: In this 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.

Primary Purpose: Treatment

Masking: Single (Outcomes Assessor)

Masking Description: 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. Acoustic measures will be obtained by trained research assistants who are blinded to the time point and treatment condition of each sample.

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact [email protected]. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Clinical Research News