Computer-assisted challenge point treatment (McAllister et al., 2020)

Purpose: This preliminary case series investigated the effects of biofeedback intervention for residual rhotic errors delivered within a modified challenge point framework. In the challenge point framework, practice difficulty is adaptively adjusted with the goal of enhancing generalization learning. This study more specifically evaluated the feasibility of a computer-mediated implementation of challenge point treatment for rhotic errors using a custom open-source software, the Challenge Point Program.

Method: Participants were five native English speakers, ages 7;3–15;5 (years;months), who had established but not generalized correct rhotic production in previous treatment; overall treatment duration was flexible. Treatment incorporated either electropalatographic or visual-acoustic biofeedback and was structured by challenge point principles implemented using the Challenge Point Program software.

Results: Participants were highly variable in the magnitude of generalization gains attained. However, the median overall effect size was 4.24, suggesting that participants' response in treatment tended to exceed the minimum value considered clinically significant.

Conclusion: These findings provide preliminary evidence that computer-mediated implementation of the challenge point framework can be effective in producing generalization in some participants.

Online Supplement A. Words and sentences elicited in baseline and maintenance probes. Words with * were also elicited in subset probe at the start of each treatment session.

Online Supplement B. Words used in treatment, with corresponding level descriptions. Shading is used to demarcate boundaries between different complexity levels.

McAllister, T., Hitchcock, E. R., & Ortiz, J. A. (2020). Computer-assisted challenge point intervention for residual speech errors. Perspectives of the ASHA Special Interest Groups. Advance online publication. https://doi.org/10.1044/2020_PERSP-20-00191