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| ID | Type | Description | Link |
|---|---|---|---|
| R15DC019775-01 | U.S. NIH Grant/Contract | View source |
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| Name | Class |
|---|---|
| National Institute on Deafness and Other Communication Disorders (NIDCD) | NIH |
| Syracuse University | OTHER |
| New York University | OTHER |
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The objective of this study is to measure the effects of online perceptual training on perception and production in children with RSE who exhibit atypical perception relative to norms from our lab-based pilot data. In a multiple-baseline across-subjects design, 10 children with RSE will begin in a baseline phase probing perceptual acuity for /r/. Perceptual training with multiple types of stimuli will be initiated in a staggered fashion. Production probes elicited before and after treatment will assess the extent to which perception gains transfer to /r/ production.
Following the initial evaluation to determine eligibility, participants will be enrolled in a baseline phase in which perception and production abilities will be probed but not treated. In a multiple-baseline across-subjects design with randomization, the 10 participants will be randomly assigned to transition from the baseline to the treatment condition at one of 7 possible points, ranging from 3 to 9 baseline sessions. After baseline sessions, perceptual training will be delivered in twelve 30-minute sessions occurring 3 times per week for 4 weeks. The training is fully computerized and can be self-administered, but a study clinician will attend one session per participant per week to ensure attention to study tasks. Each session will feature three listening tasks of approximately equal duration. Following perceptual training, participants will receive 4 60-minute sessions of production training completed over two weeks.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Online Speech Training | Experimental | Participants will be randomly assigned to transition from the baseline to the treatment condition at one of 7 possible points, ranging from 3 to 9 baseline sessions. All participants will receive 12 sessions of perceptual training over 4 weeks. Finally, participants will complete a 3-session maintenance phase in which perception and production are probed but not treated. Perception will be measured using the identification and category goodness judgment. Following completion of perception training all participants will complete two weeks of production training. The production training will consists of 4, 60-minute sessions. Each session will provide instruction and practice trials. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Perceptual training | Behavioral | Perceptual training involves self-paced presentation of auditory stimuli via a computerized software program. Stimuli are organized into three separate tasks: Tasks 1 and 3 will train category goodness judgment: Participants will hear 75 naturally produced speech tokens containing /r/ from various speakers, with a balance of correct and incorrect productions. They will classify each /r/ as correct or incorrect and receive feedback on the accuracy of their classification. Tasks 1 and 3 differ in that task 1 will feature a subset of items designed to provide focused practice on a specific context (e.g., initial /r/ as in red; /r/ as syllable nucleus as in sir), with increasing difficulty over time, whereas task 3 will feature randomly selected items representing all contexts and difficulty levels. Task 2: Participants will hear 75 items drawn from the synthetic rake-wake continuum used in the identification task administered at baseline. |
| Measure | Description | Time Frame |
|---|---|---|
| Averaged Perception Percent Accuracy Score | Averaged percent accuracy post-perception training. | Participants' perception progress was tracked across all treatment phases. The averaged percent accuracy score reported here was collected during maintenance sessions (3 sessions across 1 week). |
| Measure | Description | Time Frame |
|---|---|---|
| Raw Change in Percent Accuracy Perception Task | Represents the raw change in percent accuracy on the perception task, calculated as the difference between the average pre-training accuracy score and the average post-training accuracy score. | Participants' progress was tracked across pre-treatment phase (averaged baselines) compared to post treatment phase (averaged three maintenance sessions which occurred over 1 week), up to 8 weeks, including baselines, treatment, and maintenance sessions. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Elaine R. Hitchcock, PhD | Montclair State University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Montclair State University- Online Research Study | Upper Montclair | New Jersey | 07043 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 32097058 | Background | Preston JL, Hitchcock ER, Leece MC. Auditory Perception and Ultrasound Biofeedback Treatment Outcomes for Children With Residual /ɹ/ Distortions: A Randomized Controlled Trial. J Speech Lang Hear Res. 2020 Feb 26;63(2):444-455. doi: 10.1044/2019_JSLHR-19-00060. Epub 2020 Feb 26. | |
| 22442281 | Background | Byun TM, Hitchcock ER. Investigating the use of traditional and spectral biofeedback approaches to intervention for /r/ misarticulation. Am J Speech Lang Pathol. 2012 Aug;21(3):207-21. doi: 10.1044/1058-0360(2012/11-0083). Epub 2012 Mar 21. |
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No significant events were encountered over the course of this study.
All participants were enrolled between January 21, 2022 and July 30, 2024. All participants were assessed and treated online using standardized headphones which were mailed to them prior to the onset of the study.
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| ID | Title | Description |
|---|---|---|
| FG000 | Online Speech Perception Training | Participants will be randomly assigned to transition from the baseline to the treatment condition at one of 7 possible points, ranging from 3 to 9 baseline sessions. All participants will receive 12 sessions of perceptual training over 4 weeks. Finally, participants will complete a 3-session maintenance phase in which perception and production are probed but not treated. Perception will be measured using the identification and category goodness judgment. Following completion of perception training all participants will complete two weeks of production training. The production training will consists of 4, 60-minute sessions. Each session will provide instruction and practice trials. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
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| ID | Title | Description |
|---|---|---|
| BG000 | Online Speech Perception Training | Participants will be randomly assigned to transition from the baseline to the treatment condition. All participants will complete the assigned # of baselines sessions in which perception and production probes are elicited. All participants will then receive 12 sessions of perceptual training over 4 weeks, followed by 4 stimulability production training sessions. Participants will complete a 3-session maintenance phase in which perception and production are probed but not treated. |
| Units | Counts |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Averaged Perception Percent Accuracy Score | Averaged percent accuracy post-perception training. | Posted | Mean | Standard Deviation | percent accuracy | Participants' perception progress was tracked across all treatment phases. The averaged percent accuracy score reported here was collected during maintenance sessions (3 sessions across 1 week). |
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4 months
Participants were surveyed in post treatment assessment sessions where they asked if they experienced any discomfort or side effects from the treatment.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Online Speech Perception Training | Participants will be randomly assigned to transition from the baseline to the treatment condition at one of 7 possible points, ranging from 4 to 10 baseline sessions. All participants will receive 12 sessions of perceptual training over 4 weeks. Finally, participants will complete a 3-session maintenance phase in which perception and production are probed but not treated. Perception will be measured using the identification and category goodness judgment. Following completion of perception training all participants will complete two weeks of production training. The production training will consists of 4, 60-minute sessions. Each session will provide instruction and practice trials. |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Elaine R. Hitchcock | Montclair State University | 9732293797 | hitchcocke@montclair.edu |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Oct 21, 2020 | Sep 3, 2025 | Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Mar 17, 2021 | May 23, 2025 | SAP_001.pdf |
| ICF | No | No | Yes | Informed Consent Form | Feb 9, 2022 | Aug 7, 2025 | ICF_002.pdf |
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| ID | Term |
|---|---|
| D066229 | Speech Sound Disorder |
| ID | Term |
|---|---|
| D003147 | Communication Disorders |
| D065886 | Neurodevelopmental Disorders |
| D001523 | Mental Disorders |
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This study follows a multiple-baseline across-subjects design with random assignment of participants to different baseline durations. Following the initial evaluation to determine eligibility, participants will be enrolled in a baseline phase in which perception and production abilities will be probed but not treated. Perception will be measured using the online identification and category goodness tasks and production will be measured from standard probes containing /r/ in various phonetic contexts. Participants will be randomly assigned to transition from the baseline to the treatment condition at one of 7 possible points, ranging from 3 to 9 baseline sessions. All participants will receive 12 sessions of perceptual training over 4 weeks followed by 4 sessions of production training over 2 weeks.
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| Production training | Behavioral | Instruction: Discuss tongue shapes for /r/. Pre-practice: relatively unstructured, highly interactive elicitation; provide models and placement cue and KP on every trial. Structured syllable practice: Practice will occur in blocks of 10 consecutive trials on the same syllable (e.g., 10 /ra/), after which a new syllable will be addressed (e.g., 10 /re/--but note that in the fully blocked condition, the same syllable should occur in two consecutive blocks of 10). |
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| Perceptually Rated Accuracy of /r/ Word Production | Perceptually rated accuracy of /r/ word production probes across an average of four expert listeners post perception and production training. | Participants' progress was tracked across pre-treatment phase (averaged baselines) compared to post treatment phase (averaged three maintenance sessions which occurred over 1 week), up to 8 weeks, including baselines, treatment, and maintenance sessions. |
| 28389677 | Background | McAllister Byun T. Efficacy of Visual-Acoustic Biofeedback Intervention for Residual Rhotic Errors: A Single-Subject Randomization Study. J Speech Lang Hear Res. 2017 May 24;60(5):1175-1193. doi: 10.1044/2016_JSLHR-S-16-0038. |
| 27481555 | Background | McAllister Byun T, Harel D, Halpin PF, Szeredi D. Deriving gradient measures of child speech from crowdsourced ratings. J Commun Disord. 2016 Nov-Dec;64:91-102. doi: 10.1016/j.jcomdis.2016.07.001. Epub 2016 Jul 6. |
| 27267258 | Background | Harel D, Hitchcock ER, Szeredi D, Ortiz J, McAllister Byun T. Finding the experts in the crowd: Validity and reliability of crowdsourced measures of children's gradient speech contrasts. Clin Linguist Phon. 2017;31(1):104-117. doi: 10.3109/02699206.2016.1174306. Epub 2016 Jun 7. |
| 32783706 | Background | Preston JL, Benway NR, Leece MC, Hitchcock ER, McAllister T. Tutorial: Motor-Based Treatment Strategies for /r/ Distortions. Lang Speech Hear Serv Sch. 2020 Oct 2;51(4):966-980. doi: 10.1044/2020_LSHSS-20-00012. Epub 2020 Aug 12. |
| 25088034 | Background | Byun TM, Hitchcock ER, Swartz MT. Retroflex versus bunched in treatment for rhotic misarticulation: evidence from ultrasound biofeedback intervention. J Speech Lang Hear Res. 2014 Dec;57(6):2116-30. doi: 10.1044/2014_JSLHR-S-14-0034. |
| 29792525 | Background | Dugan SH, Silbert N, McAllister T, Preston JL, Sotto C, Boyce SE. Modelling category goodness judgments in children with residual sound errors. Clin Linguist Phon. 2019;33(4):295-315. doi: 10.1080/02699206.2018.1477834. Epub 2018 May 24. |
| 28207800 | Background | McAllister Byun T, Tiede M. Perception-production relations in later development of American English rhotics. PLoS One. 2017 Feb 16;12(2):e0172022. doi: 10.1371/journal.pone.0172022. eCollection 2017. |
| 32046671 | Background | McAllister T, Preston JL, Hitchcock ER, Hill J. Protocol for Correcting Residual Errors with Spectral, ULtrasound, Traditional Speech therapy Randomized Controlled Trial (C-RESULTS RCT). BMC Pediatr. 2020 Feb 11;20(1):66. doi: 10.1186/s12887-020-1941-5. |
| 25216375 | Background | Hitchcock ER, Byun TM. Enhancing generalisation in biofeedback intervention using the challenge point framework: a case study. Clin Linguist Phon. 2015 Jan;29(1):59-75. doi: 10.3109/02699206.2014.956232. Epub 2014 Sep 12. |
| 26947142 | Background | McAllister Byun T, Swartz MT, Halpin PF, Szeredi D, Maas E. Direction of attentional focus in biofeedback treatment for /r/ misarticulation. Int J Lang Commun Disord. 2016 Jul;51(4):384-401. doi: 10.1111/1460-6984.12215. Epub 2016 Mar 6. |
| Background | Hitchcock, ER, Cabbage, KL, Swartz, M, Carrell, T. Measuring Speech Perception Using the Wide-Range Acoustic Accuracy Scale: Preliminary Findings. Perspectives of the ASHA Special Interest Groups, 5(4):1098-1112, 2020. |
| 30795023 | Background | Hitchcock ER, Swartz MT, Lopez M. Speech Sound Disorder and Visual Biofeedback Intervention: A Preliminary Investigation of Treatment Intensity. Semin Speech Lang. 2019 Mar;40(2):124-137. doi: 10.1055/s-0039-1677763. Epub 2019 Feb 22. |
| 28595354 | Background | Byun TM, Hitchcock ER, Ferron J. Masked Visual Analysis: Minimizing Type I Error in Visually Guided Single-Case Design for Communication Disorders. J Speech Lang Hear Res. 2017 Jun 10;60(6):1455-1466. doi: 10.1044/2017_JSLHR-S-16-0344. |
| 26458203 | Background | Hitchcock ER, Harel D, Byun TM. Social, Emotional, and Academic Impact of Residual Speech Errors in School-Aged Children: A Survey Study. Semin Speech Lang. 2015 Nov;36(4):283-94. doi: 10.1055/s-0035-1562911. Epub 2015 Oct 12. |
| Participants |
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| Sex: Female, Male | Count of Participants | Participants |
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| Race (NIH/OMB) | Count of Participants | Participants |
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| Percent Accuracy Perception Task | Prior to any perception training, participants will listen recordings of single words containing /r/ in various word positions one at a time and will be cued to rate the /r/ in each production as correct or incorrect. Performance will be quantified as percent agreement with expert listeners and reported here as an average baseline level of function prior to any perceptual training tasks.. | Mean | Standard Deviation | percent accuracy |
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| Perceptually Rated Accuracy of /r/ Word Production | Prior to any perception or speech production training, participants will complete standard word probes containing /r/ in various phonetic context. | Mean | Standard Deviation | percent accuracy |
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| Secondary | Raw Change in Percent Accuracy Perception Task | Represents the raw change in percent accuracy on the perception task, calculated as the difference between the average pre-training accuracy score and the average post-training accuracy score. | Posted | Mean | Full Range | percent accuracy | Participants' progress was tracked across pre-treatment phase (averaged baselines) compared to post treatment phase (averaged three maintenance sessions which occurred over 1 week), up to 8 weeks, including baselines, treatment, and maintenance sessions. |
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| Secondary | Perceptually Rated Accuracy of /r/ Word Production | Perceptually rated accuracy of /r/ word production probes across an average of four expert listeners post perception and production training. | Posted | Mean | Full Range | percent accuracy | Participants' progress was tracked across pre-treatment phase (averaged baselines) compared to post treatment phase (averaged three maintenance sessions which occurred over 1 week), up to 8 weeks, including baselines, treatment, and maintenance sessions. |
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