Auditory-Perceptual Training Via Telepractice

NCT ID: NCT04858035

Last Updated: 2025-09-05

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

10 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-01-21

Study Completion Date

2024-06-30

Brief Summary

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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.

Detailed Description

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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.

Conditions

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Speech Sound Disorder

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

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.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Online Speech Training

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. 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.

Group Type EXPERIMENTAL

Perceptual training

Intervention Type BEHAVIORAL

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 training

Intervention Type BEHAVIORAL

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).

Interventions

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Perceptual training

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.

Intervention Type BEHAVIORAL

Production training

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).

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* 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

Exclusion Criteria

* 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
Minimum Eligible Age

9 Years

Maximum Eligible Age

15 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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National Institute on Deafness and Other Communication Disorders (NIDCD)

NIH

Sponsor Role collaborator

Syracuse University

OTHER

Sponsor Role collaborator

New York University

OTHER

Sponsor Role collaborator

Montclair State University

OTHER

Sponsor Role lead

Responsible Party

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Elaine Hitchcock

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Elaine R. Hitchcock, PhD

Role: PRINCIPAL_INVESTIGATOR

Montclair State University

Locations

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Montclair State University- Online Research Study

Upper Montclair, New Jersey, United States

Site Status

Countries

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United States

References

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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.

Reference Type BACKGROUND
PMID: 32097058 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 22442281 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 28389677 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 27481555 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 27267258 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 32783706 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 25088034 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 29792525 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 28207800 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 32046671 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 25216375 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 26947142 (View on PubMed)

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.

Reference Type BACKGROUND

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.

Reference Type BACKGROUND
PMID: 30795023 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 28595354 (View on PubMed)

Hitchcock ER, Harel D, Byun TM. Social, Emotional, and Academic Impact of Residual Speech Errors in School-Aged Children: A Survey Study. Semin Speech Lang. 2015 Nov;36(4):283-94. doi: 10.1055/s-0035-1562911. Epub 2015 Oct 12.

Reference Type BACKGROUND
PMID: 26458203 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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R15DC019775-01

Identifier Type: NIH

Identifier Source: secondary_id

View Link

20-21-2137-Study 3

Identifier Type: -

Identifier Source: org_study_id

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