Speech Production Enhancement Using Augmentative Communication for Kids

NCT ID: NCT07173049

Last Updated: 2025-12-17

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2026-01-31

Study Completion Date

2029-06-30

Brief Summary

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The goal of this clinical trial is to learn if speech supplementation can improve speech intelligibility in children ages 7 to 17 years with cerebral palsy. The main questions it aims to answer are:

* To what extent can speech supplementation improve intelligibility in children with CP compared with habitual speech produced without speech supplementation?
* How much intelligibility change is necessary for meaningful improvement when children use speech supplementation strategies?

Participants will:

* complete speech and language assessments
* complete a speech pre-test using habitual speech
* learn a speech supplementation strategy with training from a speech-language pathologist
* complete a speech post-test using the speech supplementation strategy

Detailed Description

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This study uses a pre-/post- test design to test the effects of a one-session intervention to improve speech intelligibility in 100 children with cerebral palsy and dysarthria. The intervention involves the augmentative and alternative communication (AAC) strategy known as speech supplementation. Specifically, children will learn how to simultaneously speak and point to the first letter of each word on a communication board, or to speak and point to a topical picture on a communication board. The strategy serves to provide listeners with context cues for spoken words, and it also serves to impact temporo-acoustic features of speech by reducing rate of speech and making word boundaries clear.

In this study, children will first participate in a set of baseline assessment measures, which will include the production of a corpus of 60 sentences (referred to as "habitual speech"). Then, children will learn to use the speech supplementation strategy through one-on-one clinician modeling, teaching, and practice. When children have mastered the strategy on a set of practice sentences, they will complete a post-test in which they produce the same set of elicited sentences a second time using speech supplementation.

Pre-test and post-test speech samples will then be played to two groups of listeners. One group will orthographically transcribe the words produced by children in both conditions (habitual and supplemented). Listener transcriptions in each condition will be scored as correct or incorrect based on whether they matched the intended word. Average percent of words identified correctly will be obtained from 2 listener for each child and each speaking condition as measures of speech intelligibility. The difference between habitual speech (pre-test) and supplemented speech (post-test) will be examined to quantify the effects of the speech supplementation on intelligibility.

The second set of listeners will hear the same speech samples as the first set (habitual speech and supplemented speech), but they will make ratings of whether one of the conditions seems more understandable than the other, and if so, they will rate how much better using a 7-point Likert scale.

These two sets of data from listeners will enable us to measure the minimum detectable difference in speech intelligibility and then the minimal clinically important difference based on listener ratings. Together these measures will enable us to determine how much change in intelligibility is necessary in order for clinically meaningful improvement. The hypotheses are as follows:

1. speech supplementation will result in increased speech intelligibility relative to habitual speech.
2. the minimal clinically important difference in intelligibility scores to consider the speech supplementation strategy "successful" will vary depending on child severity, with more severely speech impaired children requiring a larger improvement to achieve a clinically meaningful change.

Conditions

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Cerebral Palsy (CP) Intelligibility, Speech Augmentative and Alternative Communication

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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speech supplementation

Children will complete a pre-test on their speech prior to learning speech supplementation strategy use, and will be taught to use speech supplementation through one-on-one teaching. They will then complete a post test on their speech while using speech supplementation.

Group Type EXPERIMENTAL

AAC Speech supplementation

Intervention Type BEHAVIORAL

The speech supplementation intervention involves learning to point to pictures, words, or letters on a communication board while simultaneously producing speech. Children will spend up to 30 minutes learning to use the strategy in one- on-one interaction with a speech therapist and demonstrate mastery by using the strategy successfully on a series of test stimuli.

Interventions

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AAC Speech supplementation

The speech supplementation intervention involves learning to point to pictures, words, or letters on a communication board while simultaneously producing speech. Children will spend up to 30 minutes learning to use the strategy in one- on-one interaction with a speech therapist and demonstrate mastery by using the strategy successfully on a series of test stimuli.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Medical diagnosis of cerebral palsy, or a similar, related condition that affects early motor development and presents as a chronic motor disability
* Age between 7 and 17 years
* Clinical dysarthria with speech intelligibility between 10-85 percent
* Able to produce connected speech in English, with a minimum utterance length of 3 words
* Able to use hands to point to items on a communication board
* Cognitive/language skills that enable basic picture identification on a communication board
* Pass pure tone hearing screening

* Vision impairment that precludes being able to see items on a communication board.
* Not suitable for participation due to other reasons at the discretion of the investigators.
Minimum Eligible Age

7 Years

Maximum Eligible Age

17 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute on Deafness and Other Communication Disorders (NIDCD)

NIH

Sponsor Role collaborator

University of Wisconsin, Madison

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Katherine C Hustad, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Wisconsin, Madison

Locations

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University of Wisconsin-Madison Waisman Center

Madison, Wisconsin, United States

Site Status

Countries

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United States

Central Contacts

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WISC Lab

Role: CONTACT

608-263-5822

Heather Mabie

Role: CONTACT

608-263-5822

References

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Korkalainen J, McCabe P, Smidt A, Morgan C. Motor Speech Interventions for Children With Cerebral Palsy: A Systematic Review. J Speech Lang Hear Res. 2023 Jan 12;66(1):110-125. doi: 10.1044/2022_JSLHR-22-00375. Epub 2023 Jan 9.

Reference Type BACKGROUND
PMID: 36623233 (View on PubMed)

Levy ES, Chang YM, Ancelle JA, McAuliffe MJ. Acoustic and Perceptual Consequences of Speech Cues for Children With Dysarthria. J Speech Lang Hear Res. 2017 Jun 22;60(6S):1766-1779. doi: 10.1044/2017_JSLHR-S-16-0274.

Reference Type BACKGROUND
PMID: 28655046 (View on PubMed)

Hustad KC, Lee J. Changes in speech production associated with alphabet supplementation. J Speech Lang Hear Res. 2008 Dec;51(6):1438-50. doi: 10.1044/1092-4388(2008/07-0185). Epub 2008 Jul 29.

Reference Type BACKGROUND
PMID: 18664687 (View on PubMed)

Hustad KC, Jones T, Dailey S. Implementing speech supplementation strategies: effects on intelligibility and speech rate of individuals with chronic severe dysarthria. J Speech Lang Hear Res. 2003 Apr;46(2):462-74.

Reference Type BACKGROUND
PMID: 14700386 (View on PubMed)

Stipancic KL, Yunusova Y, Berry JD, Green JR. Minimally Detectable Change and Minimal Clinically Important Difference of a Decline in Sentence Intelligibility and Speaking Rate for Individuals With Amyotrophic Lateral Sclerosis. J Speech Lang Hear Res. 2018 Nov 8;61(11):2757-2771. doi: 10.1044/2018_JSLHR-S-17-0366.

Reference Type BACKGROUND
PMID: 30383220 (View on PubMed)

Sakash A, Mahr TJ, Natzke PEM, Hustad KC. Effects of Rate Manipulation on Intelligibility in Children With Cerebral Palsy. Am J Speech Lang Pathol. 2020 Feb 7;29(1):127-141. doi: 10.1044/2019_AJSLP-19-0047. Epub 2019 Dec 23.

Reference Type BACKGROUND
PMID: 31869242 (View on PubMed)

Other Identifiers

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2R01DC009411-16

Identifier Type: NIH

Identifier Source: secondary_id

View Link

A481800

Identifier Type: OTHER

Identifier Source: secondary_id

L&S/COMMUN SCI & DISORDERS

Identifier Type: OTHER

Identifier Source: secondary_id

Protocol Version 7/21/2025

Identifier Type: OTHER

Identifier Source: secondary_id

2025-0885

Identifier Type: -

Identifier Source: org_study_id