Intensive treatment for persisting rhotic distortions (Preston & Leece, 2017)

Purpose: The study explored changes in accuracy of American English rhotics as a result of an intensive 1-week therapy program for adolescents and young adults with residual speech sound errors that had not resolved with previous therapy.

Method: Four case reports are presented of individuals aged 13, 17, 21, and 22 years with residual /ɹ/ distortions. Each participant attended a 1-week intensive program consisting of pretreatment assessments, 14 hr of therapy, and posttreatment assessment. Treatment sessions included structured motor-based practice, ultrasound visual feedback of the tongue, and auditory speech perception training. To assess generalization, untreated words and sentences with rhotics were recorded before and after therapy; these were rated by listeners who were blind to when the recordings were taken.

Results: All participants showed measurable and statistically significant improvement in speech sound accuracy. Averaged across the 4 participants, rhotic accuracy at the word level improved from 35% to 83%. At the sentence level, rhotic accuracy increased from 11% pretreatment to 66% posttreatment in 1 week.

Conclusion: The promise of an intensive treatment program that includes motor-based practice, biofeedback, and auditory perception training is illustrated by the case presentations in which substantial improvements in speech sound accuracy were observed.

Supplemental Material S1. Video example of prepractice, the first phase of treatment, which involved eliciting 12 correct syllable-level targets.

Supplemental Material S2. Sample video of structured chaining practice with ultrasound feedback.

Supplemental Material S3. Sample video of structured chaining practice without ultrasound feedback.

Supplemental Material S4. Samples of pretreatment and posttreatment generalization probes.

Supplemental Material S5. Sample datasheet with the feedback schedule and sample stimuli.

Supplemental Material S6. Generalization probe lists, which were used to track progress.

Preston, J. L., & Leece, M. C. (2017). Intensive treatment for persisting rhotic distortions: A case series. American Journal of Speech-Language Pathology, 26, 1066–1079. https://doi.org/10.1044/2017_AJSLP-16-0232