AI-Assisted Treatment for Residual Speech Sound Disorders

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

26 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-09-05

Study Completion Date

2027-12-31

Brief Summary

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The goal of this randomized-controlled trial is to determine how artificial intelligence-assisted home practice may enhance speech learning of the "r" sound in school-age children with residual speech sound disorders. All child participants will receive 1 speech lesson per week, via telepractice, for 5 weeks with a human speech-language clinician. Some participants will receive 3 speech sessions per week with an Artificial Intelligence (AI)-clinician during the same 5 weeks as the human clinician sessions (CONCURRENT treatment order group), whereas others will receive 3 speech sessions per week with an AI-clinician after the human clinician sessions end (SEQUENTIAL treatment order group.

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Detailed Description

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Artificial Intelligence-assisted treatment that detects mispronunciations within an evidence-based motor learning framework could increase access to sufficiently intense, efficacious treatment despite provider shortages. A successful Artificial intelligencesystem that can predict the clinical gold standard of trained listeners' perceptions could not only improve access to clinical care but also mitigate known confounds to accurate clinical feedback, including clinical experience and drift due to increasing familiarity between the speaker and listener. The Artificial intelligence tool used in this study includes a speech classifier trained to predict clinician judgment of American English "r" that is integrated into an existing evidence-based treatment software called Speech Motor Chaining.

Conditions

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Speech Sound Disorder

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participants will be randomized across two conditions, CONCURRENT and SEQUENTIAL

Participants randomized to receive CONCURRENT treatment will receive speech lessons with a human clinician once per week for five weeks, along with 3 sessions per week of parent-supervised Chaining-AI (15 Chaining-AI sessions). Therefore, clinician-led and Chaining-AI are completed concurrently.

Participants randomized to receive SEQUENTIAL treatment will receive speech lessons with a human clinician once per week for five weeks, followed by three sessions per week of parent-supervised Chaining-AI for the NEXT five weeks. Therefore, clinician-led and Chaining-AI are completed sequentially.

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

All perceptual ratings will be obtained from trained listeners who are blinded to treatment group and to timepoint. Binary rating of accuracy of the "r" sound (i.e., judgments of correct or incorrect) will be obtained from three listeners per token.

Study Groups

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CONCURRENT treatment order

* 5 speech lessons with a human speech-language clinician: 1 time per week for 5 weeks.
* 15 speech lessons with an AI clinician (supervised by the caregiver), 3 times per week DURING the same 5 weeks as the human clinician sessions.

Group Type EXPERIMENTAL

Speech-Language Pathologist-led Speech Motor Chaining

Intervention Type BEHAVIORAL

Sessions begin with Pre-practice to elicit the /r/ sound. During Structured Practice, the same utterance is practiced several times in a row (with systematic increases in difficulty based on performance). Our web-based software manipulates the principles of motor learning, including feedback prompts for the clinician, the complexity of the utterance, and the variability in the practice trial; the software will analyze the clinician's rating to increase the difficulty of practice when the child is more accurate. Randomized Practice will also be guided by the software and includes all linguistic levels that were produced correctly during Structured Practice, with items presented in random order. A trained speech-language pathologist is involved in all practice trials to provide feedback throughout the session.

Artificial Intelligence-led Speech Motor Chaining (CHAINING-AI)

Intervention Type BEHAVIORAL

Sessions include Structured Practice and Randomized Practice using our web-based software with an Artificial Intelligence clinician to address the /r/ sound. Within a practice session, participants speak into a microphone, and the audio file is sent to a server to be analyzed by a classifier, which returns a binary accurate/inaccurate rating of productions in a fashion similar to SLP judgment. Our web-based software manipulates the principles of motor learning, including feedback prompts, the complexity of the utterance, and the variability in the practice trial. The software will analyze the child's accuracy as determined by the classifier to increase the difficulty of practice when the child is more accurate.

SEQUENTIAL treatment order

* 5 speech lessons with a human speech-language clinician: 1 time per week for 5 weeks.
* 15 speech lessons with an AI clinician (supervised by the caregiver), 3 times per week for the 5 weeks AFTER the human clinician sessions end.

Group Type EXPERIMENTAL

Speech-Language Pathologist-led Speech Motor Chaining

Intervention Type BEHAVIORAL

Sessions begin with Pre-practice to elicit the /r/ sound. During Structured Practice, the same utterance is practiced several times in a row (with systematic increases in difficulty based on performance). Our web-based software manipulates the principles of motor learning, including feedback prompts for the clinician, the complexity of the utterance, and the variability in the practice trial; the software will analyze the clinician's rating to increase the difficulty of practice when the child is more accurate. Randomized Practice will also be guided by the software and includes all linguistic levels that were produced correctly during Structured Practice, with items presented in random order. A trained speech-language pathologist is involved in all practice trials to provide feedback throughout the session.

Artificial Intelligence-led Speech Motor Chaining (CHAINING-AI)

Intervention Type BEHAVIORAL

Sessions include Structured Practice and Randomized Practice using our web-based software with an Artificial Intelligence clinician to address the /r/ sound. Within a practice session, participants speak into a microphone, and the audio file is sent to a server to be analyzed by a classifier, which returns a binary accurate/inaccurate rating of productions in a fashion similar to SLP judgment. Our web-based software manipulates the principles of motor learning, including feedback prompts, the complexity of the utterance, and the variability in the practice trial. The software will analyze the child's accuracy as determined by the classifier to increase the difficulty of practice when the child is more accurate.

Interventions

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Speech-Language Pathologist-led Speech Motor Chaining

Sessions begin with Pre-practice to elicit the /r/ sound. During Structured Practice, the same utterance is practiced several times in a row (with systematic increases in difficulty based on performance). Our web-based software manipulates the principles of motor learning, including feedback prompts for the clinician, the complexity of the utterance, and the variability in the practice trial; the software will analyze the clinician's rating to increase the difficulty of practice when the child is more accurate. Randomized Practice will also be guided by the software and includes all linguistic levels that were produced correctly during Structured Practice, with items presented in random order. A trained speech-language pathologist is involved in all practice trials to provide feedback throughout the session.

Intervention Type BEHAVIORAL

Artificial Intelligence-led Speech Motor Chaining (CHAINING-AI)

Sessions include Structured Practice and Randomized Practice using our web-based software with an Artificial Intelligence clinician to address the /r/ sound. Within a practice session, participants speak into a microphone, and the audio file is sent to a server to be analyzed by a classifier, which returns a binary accurate/inaccurate rating of productions in a fashion similar to SLP judgment. Our web-based software manipulates the principles of motor learning, including feedback prompts, the complexity of the utterance, and the variability in the practice trial. The software will analyze the child's accuracy as determined by the classifier to increase the difficulty of practice when the child is more accurate.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Must speak a rhotic dialect of American English as a dominant language.
* Must have begun learning English by at least the age of 3 years.
* Must be between 9;0 to 17;11 years of age.
* Must have reported difficulty with /ɹ/ production.
* Must have reported hearing within normal limits.
* Must receive a Scaled Score of 5 or above on both the Listening Comprehension and Story Retelling subtests from the Test of Integrated Language \& Literacy Skills (TILLS).
* Must receive a percentile score of 8 or below on the Goldman-Fristoe Test of Articulation-3 (GFTA-3) Sounds in Words subtest.
* Must have 1 scorable response with 5+ consecutive correct /pataka/ with \> 3.4 syllables per second in the MRR-Tri task of the Maximum Performance Tasks OR must demonstrate no childhood apraxia of speech (CAS-only) features in BOTH articulatory and rate/prosody domains of the ProCAD.
* Must score \<40% accurate based on word-level items from our /ɹ/ probe list.
* Must score \>=15% accuracy on /ɹ/ on 45 syllables following Dynamic Assessment.
* Must express interest in changing their /ɹ/ production.
* Must have oral structure and function that are appropriate for /ɹ/ production.
* Must have access to broadband internet with videoconferencing capabilities

Exclusion Criteria

* Must have no known history of autism spectrum disorder, Down Syndrome, cerebral palsy, intellectual disability, permanent hearing loss, epilepsy/antiepileptic medication, or brain injury/neurosurgery/stroke.
* Must not have diagnosis of attention deficit disorder, attention deficit hyperactivity disorder, Tourette's, or Obsessive-compulsive disorder.
* Must have no orthodontic appliances that block the roof of the mouth (e.g., palate expanders).
* Must not have current cleft palate, fluency disorder, or voice disorder.
* Must not demonstrate childhood apraxia of speech (CAS-only) features in BOTH articulatory and rate/prosody domains of the ProCAD.

Minimum Eligible Age

9 Years

Maximum Eligible Age

17 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes