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.
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.
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