Evaluating the Effectiveness of Hybrid and Traditional Speech Therapy for /ɹ/ and /s/ Sound Production

Genesis: Clinical Trial of Better Speech's Artificial Intelligence Helper for Speech Therapy

The purpose of this research study is to evaluate the effectiveness of a hybrid Artificial Intelligence-assisted speech therapy model, which combines the use of an AI speech therapist (Jessica) with traditional speech therapy sessions led by a Speech-Language Pathologist (SLP). This study aims to determine whether the hybrid model improves articulation in children more effectively than traditional SLP-only therapy. Over the course of 8 weeks, participants will receive weekly therapy sessions, and those in the hybrid therapy group will also practice with Jessica between sessions. The study will also gather feedback from parents and speech therapists to assess their experiences and satisfaction with treatment.

The RCT compares two intervention conditions over eight weeks: (1) a hybrid treatment group, where children receive one weekly "treatment as usual" clinician-led tele-practice session PLUS an additional 60 minutes of home practice with Jessica, and (2) a traditional treatment group, where children receive one weekly "treatment as usual" clinician-led tele-practice session.

Children from both groups will be assigned to work on either the /ɹ/ or /s/ sound for the duration of the study, depending on their clinical needs. Children are randomized to conditions and stratified by clinicians. The investigators expect to enroll 100 children, 50 in each condition, aged 5-17 from the following states where study-trained SLPs hold valid clinical licenses: CO, NC, WA, KS, MS, IN, MN, MT, AK, NV, OH, VA, FL, GA, AZ, LA, NY, NJ, MI. Participants must be children aged 5;0 to 17;11 who speak American English as a primary language, have no significant cognitive, neurological, or structural speech impairments, score at or below the 10th percentile on the Goldman-Fristoe Test of Articulation-3 (GFTA 3), have a desire to change their production of /ɹ/ or /s/, and have access to broadband internet for telepractice. Participants with autism, Down syndrome, cerebral palsy, intellectual disabilities, epilepsy, significant hearing loss, ADHD, Tourette's, OCD, or orthodontic appliances that block the roof of the mouth are excluded from this clinical trial phase.

The investigators hypothesize that the hybrid treatment group will show greater improvement in speech sound learning compared to the traditional group, as measured by expert perceptual ratings of unpracticed words. Additionally, it is expected that children in the hybrid group will achieve mastery of targeted speech sounds in fewer sessions, making speech therapy more efficient and cost-effective. If successful, this study could provide strong evidence supporting the integration of AI-driven home practice into standard speech therapy protocols, leading to broader accessibility and improved outcomes for children with SSDs. Furthermore, an analysis of treatment fidelity and participant engagement with Jessica will offer insights into the practical implementation of AI-assisted speech therapy in real-world clinical settings.

Inclusion Criteria:

- Response to be filled out by the Parent after sign up.

• Does the child speak American English as one of their primary languages: Yes
• At what age did the child first begin to learn English? Age 4 or younger
• Child's current age: > 5 years or < 17 years 8 months
• Does the child have any known history of any of the following: autism spectrum disorder, Down Syndrome, cerebral palsy, intellectual disability, permanent hearing loss, epilepsy/antiepileptic medication, or brain injury/neurosurgery/stroke: NO
• Does the child have a diagnosis of ADD/ADHD, Tourette's Syndrome, or OCD? NO
• Does the child currently have orthodontic appliances that block the roof of the mouth (e.g., palate expanders)? NO
• Does the child currently have a cleft palate, fluency disorder (e.g., stuttering), or voice disorder? NO
• Is one of your goals for your child to work on saying the "r" or "s" sounds? YES

Exclusion Criteria:

• EXCLUSIONARY Response to be filled out by the Parent after sign up.
• Does the child speak American English as one of their primary languages: No
• At what age did the child first begin to learn English? Age 4 or older
• Child's current age: <5 years or > 17 years 8 months
• Does the child have any known history of any of the following: autism spectrum disorder, Down Syndrome, cerebral palsy, intellectual disability, permanent hearing loss, epilepsy/antiepileptic medication, or brain injury/neurosurgery/stroke: YES
• Does the child have a diagnosis of ADD/ADHD, Tourette's Syndrome, or OCD? YES
• Does the child currently have orthodontic appliances that block the roof of the mouth (e.g., palate expanders)? YES
• Does the child currently have a cleft palate, fluency disorder (e.g., stuttering), or voice disorder? YES
• Is one of your goals for your child to work on saying the "r" or "s" sounds? NO