Efficacy of Electropalatography for Treating Misarticulation of /r/.

Purpose: The purpose of the present study was to document the efficacy of electropalatography (EPG) for the treatment of rhotic errors in school-age children. Despite a growing body of literature using EPG for the treatment of speech sound errors, there is little systematic evidence about the relative efficacy of EPG for rhotic errors.

Method: Participants were 5 English-speaking children aged 6;10 to 9;10, who produced /r/ at the word level with < 30% accuracy but otherwise showed typical speech, language, and hearing abilities.

Selecting an acoustic correlate for automated measurement of American English rhotic production in children.

: A current need in the field of speech-language pathology is the development of reliable and efficient techniques to evaluate accuracy of speech targets over the course of treatment. As acoustic measurement techniques improve, it should become possible to use automated scoring in lieu of ratings from a trained clinician in some contexts. This study asks which acoustic measures correspond most closely with expert ratings of children's productions of American English /ɹ/ in an effort to develop an automated scoring algorithm for use in treatment targeting rhotics.

Deriving individualised /r/ targets from the acoustics of children's non-rhotic vowels.

In visual-acoustic biofeedback for rhotic errors, learners are guided to match the third formant (F3) location to a visual target on a real-time acoustic spectrum. As the acoustic properties of correct English /r/differ across speakers, this study aimed to improve target selection by investigating the validity of individualised targets derived from children's non-rhotic vowels. A previously proposed prediction formula was adjusted using data from a child normative sample and tested in two groups of children.

Enhancing Intervention for Residual Rhotic Errors Via App-Delivered Biofeedback: A Case Study.

Purpose: Recent research suggests that visual-acoustic biofeedback can be an effective treatment for residual speech errors, but adoption remains limited due to barriers including high cost and lack of familiarity with the technology. This case study reports results from the first participant to complete a course of visual-acoustic biofeedback using a not-for-profit iOS app, Speech Therapist's App for /r/ Treatment.

Method: App-based biofeedback treatment for rhotic misarticulation was provided in weekly 30-min sessions for 20 weeks.

Masked Visual Analysis: Minimizing Type I Error in Visually Guided Single-Case Design for Communication Disorders.

Purpose: Single-case experimental designs are widely used to study interventions for communication disorders. Traditionally, single-case experiments follow a response-guided approach, where design decisions during the study are based on participants' observed patterns of behavior. However, this approach has been criticized for its high rate of Type I error.

Efficacy of Visual-Acoustic Biofeedback Intervention for Residual Rhotic Errors: A Single-Subject Randomization Study.

Purpose: This study documented the efficacy of visual-acoustic biofeedback intervention for residual rhotic errors, relative to a comparison condition involving traditional articulatory treatment. All participants received both treatments in a single-subject experimental design featuring alternating treatments with blocked randomization of sessions to treatment conditions.

Method: Seven child and adolescent participants received 20 half-hour sessions of individual treatment over 10 weeks.

Perception-production relations in later development of American English rhotics.

It is known that some adult listeners have more sharply defined perceptual categories than others, and listeners with more precise auditory targets are also more precise in their production of contrasts. There is additionally evidence that children who have not yet mastered production of a contrast show diminished performance on perceptual measures of the same contrast. To date, however, few studies have investigated developmental perception-production relations using the fine-grained measures typical of adult studies.

Ultrasound Images of the Tongue: A Tutorial for Assessment and Remediation of Speech Sound Errors.

Diagnostic ultrasound imaging has been a common tool in medical practice for several decades. It provides a safe and effective method for imaging structures internal to the body. There has been a recent increase in the use of ultrasound technology to visualize the shape and movements of the tongue during speech, both in typical speakers and in clinical populations.

Differential Effects of Visual-Acoustic Biofeedback Intervention for Residual Speech Errors.

Recent evidence suggests that the incorporation of visual biofeedback technologies may enhance response to treatment in individuals with residual speech errors. However, there is a need for controlled research systematically comparing biofeedback versus non-biofeedback intervention approaches. This study implemented a single-subject experimental design with a crossover component to investigate the relative efficacy of visual-acoustic biofeedback and traditional articulatory treatment for residual rhotic errors.

Deriving gradient measures of child speech from crowdsourced ratings.

Recent research has demonstrated that perceptual ratings aggregated across multiple non-expert listeners can reveal gradient degrees of contrast between sounds that listeners might transcribe identically. Aggregated ratings have been found to correlate strongly with acoustic gold standard measures both when individual raters use a continuous rating scale such as visual analog scaling (Munson et al., 2012) and when individual raters provide binary ratings (McAllister Byun, Halpin, & Szeredi, 2015).

Finding the experts in the crowd: Validity and reliability of crowdsourced measures of children's gradient speech contrasts.

Perceptual ratings aggregated across multiple nonexpert listeners can be used to measure covert contrast in child speech. Online crowdsourcing provides access to a large pool of raters, but for practical purposes, researchers may wish to use smaller samples. The ratings obtained from these smaller samples may not maintain the high levels of validity seen in larger samples.

Analyzing Clinical Phonological Data Using Phon.

In this article, we describe how Phon, an open-source software program for the transcription and analysis of phonological data, can be applied to facilitate clinical phonological analyses. We begin with a summary of the types of analyses that are frequently used in the assessment and management of speech sound disorders. We then discuss challenges inherent to the transcription and analysis of clinical phonological data.

Direction of attentional focus in biofeedback treatment for /r/ misarticulation.

Background: Maintaining an external direction of focus during practice is reported to facilitate acquisition of non-speech motor skills, but it is not known whether these findings also apply to treatment for speech errors. This question has particular relevance for treatment incorporating visual biofeedback, where clinician cueing can direct the learner's attention either internally (i.e.

Functional Segregation of Cortical Regions Underlying Speech Timing and Articulation.

Spoken language is a central part of our everyday lives, but the precise roles that individual cortical regions play in the production of speech are often poorly understood. To address this issue, we focally lowered the temperature of distinct cortical regions in awake neurosurgical patients, and we relate this perturbation to changes in produced speech sequences. Using this method, we confirm that speech is highly lateralized, with the vast majority of behavioral effects seen on the left hemisphere.

Social, Emotional, and Academic Impact of Residual Speech Errors in School-Aged Children: A Survey Study.

Children with residual speech errors face an increased risk of social, emotional, and/or academic challenges relative to their peers with typical speech. Previous research has shown that the effects of speech sound disorder may persist into adulthood and span multiple domains of activity limitations and/or participation restrictions, as defined by the World Health Organization's International Classification of Functioning, Disability and Health model. However, the nature and extent of these influences varies widely across children.

Covert contrast in velar fronting: An acoustic and ultrasound study.

There is growing evidence that speech sound acquisition is a gradual process, with instrumental measures frequently revealing covert contrast in errors perceived to involve phonemic substitution. Ultrasound imaging has the potential to expand our understanding of covert contrast by showing whether a child uses different tongue shapes while producing sounds that are perceived as neutralised. This study used an ultrasound measure (Dorsum Excursion Index) and acoustic measures (VOT and spectral moments of the burst) to investigate overt and covert contrast between velar and alveolar stops in child speech.

Perceptual discrimination across contexts and contrasts in preschool-aged children.

This paper investigates a proposed phonetically-based account of developmental phonological patterns that lack counterparts in adult typology. Adult listeners perceive some phonemic contrasts more accurately than others, and these differences in perceptual recoverability are posited to represent one influence on phonological typology. One hypothesis suggests that children and adults could differ in their patterns of relative perceptual sensitivity, and these differences could form the basis for some child-specific phonological patterns in production.

Online crowdsourcing for efficient rating of speech: a validation study.

Unlabelled: Blinded listener ratings are essential for valid assessment of interventions for speech disorders, but collecting these ratings can be time-intensive and costly. This study evaluated the validity of speech ratings obtained through online crowdsourcing, a potentially more efficient approach. 100 words from children with /r/ misarticulation were electronically presented for binary rating by 35 phonetically trained listeners and 205 naïve listeners recruited through the Amazon Mechanical Turk (AMT) crowdsourcing platform.

Enhancing generalisation in biofeedback intervention using the challenge point framework: a case study.

Biofeedback intervention can help children achieve correct production of a treatment-resistant error sound, but generalisation is often limited. This case study suggests that generalisation can be enhanced when biofeedback intervention is structured in accordance with a "challenge point" framework for speech-motor learning. The participant was an 11-year-old with residual /r/ misarticulation who had previously attained correct /r/ production through a structured course of ultrasound biofeedback treatment but did not generalise these gains beyond the word level.

Retroflex versus bunched in treatment for rhotic misarticulation: evidence from ultrasound biofeedback intervention.

Purpose: To document the efficacy of ultrasound biofeedback treatment for misarticulation of the North American English rhotic in children. Because of limited progress in the first cohort, a series of two closely related studies was conducted in place of a single study. The studies differed primarily in the nature of tongue-shape targets (e.

A multidimensional investigation of children's /r/ productions: perceptual, ultrasound, and acoustic measures.

Purpose: This study explored relationships among perceptual, ultrasound, and acoustic measurements of children's correct and misarticulated /r/ sounds. Longitudinal data documenting changes across these parameters were collected from 2 children who acquired /r/ over a period of intervention and were compared with data from children with typical speech.

Method: Participants were 3 children with typical speech, recorded once, and 2 children with /r/ misarticulation, recorded over 7-8 months.

The relationship between inexperienced listeners' perceptions and acoustic correlates of children's /r/ productions.

This study examined inexperienced listeners' perceptions of children's naturally produced /r/ sounds with reference to levels of accuracy determined by consensus between two expert clinicians. Participants rated /r/ sounds as fully correct, distorted or incorrect/non-rhotic. Second and third formant heights were measured to explore the relationship between acoustic cues and perceptual judgments.

Bidirectional perception-production relations in phonological development: evidence from positional neutralization.

Many children who neutralize phonemic contrasts in production exhibit diminished perception of the same contrasts. It is usually difficult to determine whether the perception deficit caused the production error, or vice versa; however, the direction of causation has implications for treatment planning. This study examines perception-production relationships in the phenomenon of neutralization in strong position, where children neutralize only in perceptually salient contexts.

Investigating the use of traditional and spectral biofeedback approaches to intervention for /r/ misarticulation.

Purpose: Misarticulation of /r/ is among the most challenging developmental speech errors to remediate. Case studies suggest that visual biofeedback treatment can establish perceptually accurate /r/ in clients who have not responded to traditional treatments. This investigation studied the response of children with persistent /r/ misarticulation to a course of traditional treatment and a course of biofeedback treatment.