Auditory perception & biofeedback for /ɹ/ (Preston et al., 2020)

Purpose: This study evaluated whether outcomes from treatment, which includes ultrasound visual feedback (UVF), would be more or less effective when combined with auditory perception training for children with residual /ɹ/ errors.

Method: Children ages 8–16 years with /ɹ/ distortions participated in speech therapy that included real-time UVF of the tongue. Thirty-eight participants were randomized to speech therapy conditions that included a primary focus on articulation using UVF or a condition that included auditory perceptual training plus UVF (incorporating category goodness judgments and self-monitoring). Generalization of /ɹ/ production accuracy to untrained words was assessed before and after 14 hr of therapy. Additionally, the role of auditory perceptual acuity was explored using a synthetic /ɹ/–/w/ continuum.

Results: There was no difference between the treatment groups in rate of improvement of /ɹ/ accuracy (increase of 34% for each group; p = .95, η_p² = .00). However, pretreatment auditory acuity was associated with treatment progress in both groups, with finer perceptual acuity corresponding to greater progress (p = .015, η_p² = .182).

Conclusion: Similar gains in speech sound accuracy can be made with treatment that includes UVF with or without auditory perceptual training. Fine-grained perceptual acuity may be a prognostic indicator with treatment.

Supplemental Material S1. Individual performance data.

Supplemental Material S2. Correlation matrix for pretreatment variables and posttreatment /ɹ/ accuracy (N = 38).

Preston, J. L., Hitchcock, E. R., & Leece, M. C. (2020). Auditory perception and ultrasound biofeedback treatment outcomes for children with residual /ɹ/ distortions: A randomized controlled trial. Journal of Speech, Language, and Hearing Research. Advance online publication. https://doi.org/10.1044/2019_JSLHR-19-00060