Visual Acoustic Biofeedback for RSE Via Telepractice

Online Assessment and Enhancement of Auditory Perception for Speech Sound Errors: Visual Acoustic Biofeedback for RSE Via Telepractice


Lead Sponsor: Montclair State University

Collaborator: National Institute on Deafness and Other Communication Disorders (NIDCD)
New York University
Syracuse University

Source Montclair State University
Brief Summary

This research will meet a public health need by evaluating the efficacy of speech intervention supplemented with real-time visual-acoustic biofeedback when delivered using remote technologies.

Detailed Description

In a crossover design, participants will be randomly assigned to receive 10 weeks/20 sessions of visual-acoustic biofeedback treatment via telepractice followed by a 10-week period of no treatment, or the same two conditions in the reverse order. Production accuracy will be assessed with standard probes (20 syllables, 30 words, and 10 sentences containing /r/ in various phonetic contexts) administered prior to the beginning of treatment (baseline), after the first 10-week phase, and again at the end of the study.

Overall Status Not yet recruiting
Start Date 2021-08-01
Completion Date 2023-08-30
Primary Completion Date 2023-08-30
Phase Phase 2
Study Type Interventional
Primary Outcome
Measure Time Frame
Change in perceptually rated accuracy of /r/ Pre-, mid- (after 10 weeks), and 1 week post-treatment
Secondary Outcome
Measure Time Frame
Change in social-emotional well-being Pre- and 1 week post-treatment
Enrollment 40

Intervention Type: Behavioral

Intervention Name: Visual Acoustic Biofeedback

Description: In visual-acoustic biofeedback treatment, the elements of traditional articulatory 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.

Arm Group Label: Visual Acoustic Biofeedback for RSE via Telepractice-Treatment

Intervention Type: Other

Intervention Name: No treatment - waitlist

Description: 10-week period of no treatment

Arm Group Label: Visual Acoustic Biofeedback for RSE via Telepractice-Wait



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 hearing level. - 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 Goldman-Fristoe Test of Articulation-3 (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



Minimum Age:

9 Years

Maximum Age:

15 Years

Healthy Volunteers:

Accepts Healthy Volunteers

Overall Contact

Last Name: Elaine R Hitchcock, PhD

Phone: 973-229-3797

Email: [email protected]

Verification Date


Responsible Party

Type: Principal Investigator

Investigator Affiliation: Montclair State University

Investigator Full Name: Elaine Hitchcock

Investigator Title: Associate Professor

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

Label: Visual Acoustic Biofeedback for RSE via Telepractice-Treatment

Type: Experimental

Description: Condition1: Treatment-first Children with RSE and typical perception will be allocated to a randomized controlled trial measuring the efficacy of online visual-acoustic biofeedback treatment. Ten children with RSE will receive 10 weeks of visual-acoustic biofeedback training via video call.

Label: Visual Acoustic Biofeedback for RSE via Telepractice-Wait

Type: Experimental

Description: Condition 2: Waitlist-first Following the initial evaluation, 10 children with RSE will be allocated to a 10 week no treatment condition.

Patient Data No
Study Design Info

Allocation: Randomized

Intervention Model: Factorial Assignment

Intervention Model Description: Children with residual speech errors (RSE) and typical perception will assigned to a randomized controlled trial measuring the efficacy of online visual-acoustic biofeedback treatment relative to a waitlist comparison condition. Treatment will last a total of 20 weeks. The investigators will randomly assign 20 children to receive 10 weeks of biofeedback training via video call followed by 10 weeks in a no-treatment phase; 20 children will receive the same phases in reverse order. Children with RSE may vary in pre-treatment severity, and the extent to which they can approximate /r/ may be an important indicator of subsequent treatment response. Therefore, a blocked randomization procedure will be used to protect against a situation where treatment groups are unbalanced with respect to pre-treatment severity.

Primary Purpose: Treatment

Masking: Single (Outcomes Assessor)

Masking Description: All perceptual ratings will be obtained from blinded, skilled clinician listeners recruited through online crowdsourcing. Following protocols refined in previous published research, binary rating responses (1=correct; 0=incorrect) will be aggregated over at least 9 unique listeners per token.

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