staRt: Enhancing Speech Treatment With Smartphone-delivered Biofeedback

Not Applicable

Completed

Interventions: Behavioral: Traditional articulation treatment
Behavioral: Visual-acoustic biofeedback

Brief Summary: Previous research suggests that biofeedback can outperform traditional interventions for RSE, but no controlled studies have tested this hypothesis in the context of app-delivered biofeedback. The objective of this aim is to use the staRt app to test our working hypothesis that speakers will make larger gains in /r/ accuracy when app-based treatment incorporates biofeedback, compared to a non-biofeedback condition. With a network of cooperating SLPs, this project will recruit 15 children with /r/ misarticulation to receive 8 weeks of intervention using staRt. Individual sessions will be randomly assigned to include or exclude the visual biofeedback display. Randomization tests will be used to evaluate, for each individual, whether larger increments of change are associated with biofeedback and non-biofeedback sessions.

Recruitment & Eligibility

Inclusion Criteria

Normal performance on a pure-tone hearing screening at 20 dB HL, a screening examination of oral-motor structure and function, and a test of receptive language.

Exclusion Criteria

History of major behavioral, neurological, or hearing impairment, per parent and/or SLP report.

Arm && Interventions

Group	Intervention	Description
Traditional articulation treatment	Traditional articulation treatment	-
Visual-acoustic biofeedback	Visual-acoustic biofeedback	-

Primary Outcome Measures

Name	Time	Method
F3-F2 Distance, an Acoustic Measure That Correlates With Perceptual Accuracy of /r/, Measured From /r/ Sounds Produced in Treatment Sessions.	F3-F2 distance was measured in all 16 treatment sessions (eight of each type), which were administered over eight weeks.	From recordings of words containing /r/ produced during treatment sessions, the sound /r/ was flagged for measurement and the first three formants (F1, F2, F3) were extracted from the center of the /r/ interval. The distance between the second and third formants (F3-F2) was used as the index of rhoticity. F3-F2 is small in perceptually accurate /r/, larger values indicate lower accuracy. Summary statistics report the mean and standard deviation of normalized F3-F2 distance for each treatment condition, pooled across participants and sessions. A two-tailed paired-samples t-test (superiority criterion) was used to compare mean F3-F2 distance for each treatment condition across subjects.

Secondary Outcome Measures