This project will foster the development of an intervention for children whose speech sound errors have been resistant to traditional articulation treatment. Ultrasound will be used to provide a visual display of the tongue shape in real time as the child speaks; these images will be used to teach children how to achieve more intelligible articulation. The project will refine the intervention procedures to achieve maximal benefit, determine if different profiles of children with speech sound disorders respond to the intervention, and compare the outcomes of this approach to outcomes achieved with traditional speech therapy.

Public Health Relevance

Speech sound disorders (articulation/phonological disorders) are communication impairments that involve reduced speech intelligibility and can impact social, academic, and occupational success. Current treatment options are limited for children whose errors do not respond to traditional speech therapy, and some children remain in therapy for many years with little progress. Recent case studies have shown that articulatory biofeedback (using ultrasound to provide a real-time visual display of the tongue) can improve outcomes for therapy-resistant clients. Experimental evaluation of the ultrasound biofeedback approach is needed to refine the intervention, to test the applicability to children with different clinical profiles, and to test whether the approach results in superior improvement over traditional treatment methods. Therefore, the current study pursues the goal of improving outcomes for children with therapy-resistant speech sound disorders using ultrasound biofeedback. Through a series of single-subject experimental designs with 11-14 year olds, we will use ultrasound to train the most common sound class in error (rhotics, the /r/ class of sounds). The project aims to refine the ultrasound biofeedback approach by determining if accuracy of a speech target can be improved by cues to vary prosody, allowing children to use the visual feedback to learn to coordinate tongue movement when varying other motor demands for speech. Additionally, the study will examine the utility of ultrasound biofeedback for children with Childhood Apraxia of Speech, a subtype of speech sound disorder that is often resistant to therapy. Finally, the study will explore whether adding ultrasound biofeedback to a treatment program can result in better speech sound accuracy and intelligibility outcomes than 'traditional' articulation therapy alone. The outcomes of the study could provide evidence of effective treatment options for children who do not respond well to traditional speech therapy.

National Institute of Health (NIH)
National Institute on Deafness and Other Communication Disorders (NIDCD)
Small Research Grants (R03)
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Communication Disorders Review Committee (CDRC)
Program Officer
Shekim, Lana O
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Syracuse University
Other Health Professions
Schools of Arts and Sciences
United States
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Preston, Jonathan L; McCabe, Patricia; Tiede, Mark et al. (2018) Tongue shapes for rhotics in school-age children with and without residual speech errors. Clin Linguist Phon :1-15
Preston, Jonathan L; McAllister Byun, Tara; Boyce, Suzanne E et al. (2017) Ultrasound Images of the Tongue: A Tutorial for Assessment and Remediation of Speech Sound Errors. J Vis Exp :
Preston, Jonathan L; Leece, Megan C (2017) Intensive Treatment for Persisting Rhotic Distortions: A Case Series. Am J Speech Lang Pathol 26:1066-1079
Preston, Jonathan L; Leece, Megan C; McNamara, Kerry et al. (2017) Variable Practice to Enhance Speech Learning in Ultrasound Biofeedback Treatment for Childhood Apraxia of Speech: A Single Case Experimental Study. Am J Speech Lang Pathol 26:840-852
Preston, Jonathan L; Leece, Megan C; Maas, Edwin (2017) Motor-based treatment with and without ultrasound feedback for residual speech-sound errors. Int J Lang Commun Disord 52:80-94
Preston, Jonathan L; Maas, Edwin; Whittle, Jessica et al. (2016) Limited acquisition and generalisation of rhotics with ultrasound visual feedback in childhood apraxia. Clin Linguist Phon 30:363-81
Preston, Jonathan L; Leece, Megan C; Maas, Edwin (2016) Intensive Treatment with Ultrasound Visual Feedback for Speech Sound Errors in Childhood Apraxia. Front Hum Neurosci 10:440
Heng, Qiwen; McCabe, Patricia; Clarke, Jillian et al. (2016) Using ultrasound visual feedback to remediate velar fronting in preschool children: A pilot study. Clin Linguist Phon 30:382-97
Sjolie, Greta M; Leece, Megan C; Preston, Jonathan L (2016) Acquisition, retention, and generalization of rhotics with and without ultrasound visual feedback. J Commun Disord 64:62-77
Preston, Jonathan L; Irwin, Julia R; Turcios, Jacqueline (2015) Perception of Speech Sounds in School-Aged Children with Speech Sound Disorders. Semin Speech Lang 36:224-33

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