Online assessment and enhancement of auditory perception for speech sound errors

Project Summary/Abstract Children diagnosed with speech sound disorder (SSD) demonstrate atypical speech patterns that impact speech intelligibility, creating obstacles to their engagement in both social and academic environments [1]. Delayed speech development typically resolves by the age of 8-9; however, approximately 2-5% of individuals exhibit residual speech sound disorder (RSSD), which can persist into adolescence or adulthood despite years of intervention. RSSD primarily affects late-developing sounds such as the American English rhotic /ɹ/ and sibilants /s/. Previous research, including our work in the past funding cycle, indicates that children with RSSD typically exhibit reduced auditory-perceptual acuity for the sounds they produce in error. This implies that interventions designed to enhance auditory targets and provide feedback on error sounds could improve treatment outcomes for RSSD. One such intervention is biofeedback, in which learners view a real-time display of the acoustic signal of their speech compared to a target representing the desired output. Biofeedback has shown promising results in individuals with RSSD who have not responded to previous treatments [2, 3]. Another well-studied approach seeks to enhance the auditory target for error sounds by presenting a wide range of productions and training the child to classify them as correct or incorrect [4-6]. The present proposal is centered on exploring the relationship between these two auditory-enhanced treatment methods for American English /ɹ/ while also extending the use of biofeedback to another frequently misarticulated sound category, the sibilants. The overall objective of this proposal is to expand our basic understanding of perception-production relations in child speech while evaluating whether tasks involving perceptual training and visual-acoustic biofeedback are valid in the online modality. In Aim 1, we will evaluate the extent to which a period of perceptual training can enhance response to biofeedback treatment via telepractice. Aim 2 will use a single-case experimental design to test the hypothesis that biofeedback treatment via telepractice can be successfully expanded to include the sibilant /s/, a common target for children with RSSD that presents novel technological challenges for remote service delivery. Our central hypothesis is that gains associated with biofeedback treatment will be enhanced when perception training precedes production training and that biofeedback intervention for sibilants will yield statistically and clinically significant treatment effects in the telepractice context. This research will continue to advance the evidence base by contributing the first studies investigating the efficacy of integrated auditory-perceptual training and biofeedback treatment in the telepractice context. This research is also pioneering as it represents the first systematic effort to measure the efficacy of biofeedback using a Fast Fourier Transform (FFT) spectrum to display sibilant sounds. Overall, the proposed research is optimally positioned to make a high-impact contribution as new technologies reshape the nature of scientific research and treatment delivery in speech pathology.