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

journal contribution
posted on 2020-02-25, 22:48 authored by Jonathan L. Preston, Elaine R. Hitchcock, Megan C. Leece
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, ηp2 = .00). However, pretreatment auditory acuity was associated with treatment progress in both groups, with finer perceptual acuity corresponding to greater progress (p = .015, ηp2 = .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.


This study was supported in part by Syracuse University College of Arts and Sciences, Syracuse University Gerber Auditory Science Grant (PI: J. Preston), and National Institutes of Health Grants R03DC013152 (PI: J. Preston), R15DC016426 (PI: J. Preston), and R01DC013668 (PI: D. Whalen).