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Speech Sound DisorderNCT04858035

Auditory-Perceptual Training Via Telepractice

A study testing Perceptual training and Production training in people with Speech Sound Disorder, run by Montclair State University at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

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. Read more about this study

Who is it for?
Ages 9 to 15 yearsHealthy volunteers can take part
Conditions the study is for
Speech Sound Disorder
What is being tested?
Perceptual training and Production training
Could I receive a placebo?
No, everyone receives an active treatment
How many people
10 participants
Where
1 siteUnited States
Study dates
21 Jan 2022to 30 Jun 2024
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 9 to 15 years
  • All sexes
  • Healthy volunteers accepted
  • Child

Who may be able to join

  • Must be between 9;0 and 15;11 years of age at the time of enrollment.
  • Must speak English as the dominant language (i.e., must have begun learning English by age 2, per parent report).
  • Must speak a rhotic dialect of English.
  • Must pass a pure-tone hearing screening at 20dB HL
  • Must pass a brief examination of oral structure and function.
  • Must exhibit less than 30% accuracy, based on consensus across 2 trained listeners, on a probe list eliciting rhotics in various phonetic contexts at the word level.
  • Must exhibit no more than 3 sounds other than /r/ in error on the GFTA-3

Who cannot join

  • Must not receive a T score more than 1.3 SD below the mean on the Wechsler Abbreviated Scale of Intelligence-2 (WASI-2) Matrix Reasoning
  • Must not receive a scaled score of 7 or higher on the Recalling Sentences and Formulated Sentences subtests of the Clinical Evaluation of Language Fundamentals-5 (CELF-5).
  • Must not have an existing diagnosis of developmental disability or major neurobehavioral syndrome such as cerebral palsy, Down Syndrome, or Autism Spectrum Disorder

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Montclair State University- Online Research Study

    Upper Montclair, New Jersey, 07043

Other trials in United States

About this study

Official title: Online Assessment and Enhancement of Auditory Perception for Speech Sound Errors: Online Perceptual Training for RSE

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.

Read the detailed description

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.

Being tested
Perceptual training, Production training
Keywords
speech sound disorder, auditory perception, articulation
Medical subject headings
Speech Sound Disorder

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Perceptual trainingBehavioural

    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.

  • Production trainingBehavioural

    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).

Study groups in NCT04858035
Study groupRoleWhat they receive
Online Speech TrainingExperimentalParticipants 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.
Receives: Behavioral: Perceptual training; Behavioral: Production training

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Averaged Perception Percent Accuracy Score

    Averaged percent accuracy post-perception training.

    Measured: 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).

Secondary outcomes (2)
  1. 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.

    Measured: 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.

  2. 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.

    Measured: 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.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted26 Apr 2021
  2. Study start21 Jan 2022
  3. Primary completion30 Jun 2024
  4. Study completion30 Jun 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Model description
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.
Masking
None (open label)
Enrolment
10 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04858035
Sponsor's protocol ID
20-21-2137-Study 3
Other IDs
R15DC019775-01
Status last verified
Sep 2025
First submitted
5 Apr 2021
Last updated
5 Sep 2025
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • 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.

    PubMed 32097058
  • 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.

    PubMed 22442281
  • 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.

    PubMed 28389677
  • 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.

    PubMed 27481555
  • 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.

    PubMed 27267258
  • 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.

    PubMed 32783706
  • 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.

    PubMed 25088034
  • 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.

    PubMed 29792525
  • 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.

    PubMed 28207800
  • 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.

    PubMed 32046671
  • 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.

    PubMed 25216375
  • 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.

    PubMed 26947142
  • 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.

  • 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.

    PubMed 30795023
  • 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.

    PubMed 28595354

Questions about this trial

What is this clinical trial studying?

A study testing Perceptual training and Production training in people with Speech Sound Disorder, run by Montclair State University at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 5 Sep 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 5 Sep 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Averaged Perception Percent Accuracy Score (time frame: 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).). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04858035, which also lists 16 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 5 Sep 2025.

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