Comparing biofeedback types for residual /ɹ/ errors (Benway et al., 2021)
Creators: name: Benway, Nina R.
name: Hitchcock, Elaine
name: McAllister, Tara
name: Feeny, Graham Tomkins
name: Hill, Jennifer
name: Preston, Jonathan L.
Publisher: name: ASHA journals
Year: 2021
Subjects: subject: 170204 Linguistic Processes (incl. Speech Production and Comprehension)
subject: FOS: Psychology
subject: 200404 Laboratory Phonetics and Speech Science
subject: FOS: Languages and literature

description: <b>Purpose:</b> Research comparing different biofeedback types could lead to individualized treatments for those with residual speech errors. This study examines within-treatment response to ultrasound and visual-acoustic biofeedback, as well as generalization to untrained words, for errors affecting the American English rhotic /ɹ/. We investigated whether some children demonstrated greater improvement in /ɹ/ during ultrasound or visual-acoustic biofeedback. Each participant received both biofeedback types. Individual predictors of treatment response (i.e., age, auditory-perceptual skill, oral somatosensory skill, and growth mindset) were also explored.<b>Method: </b>Seven children ages 9–16 years with residual rhotic errors participated in 10 treatment visits. Each visit consisted of two conditions: 45 min of ultrasound biofeedback and 45 min of visual-acoustic biofeedback. The order of biofeedback conditions was randomized within a single-case experimental design. Acquisition of /ɹ/ was evaluated through acoustic measurements (normalized F3–F2 difference) of selected nonbiofeedback productions during practice. Generalization of /ɹ/ was evaluated through acoustic measurements and perceptual ratings of pretreatment/posttreatment probes.<b>Results: </b>Five participants demonstrated acquisition of practiced words during the combined treatment package. Three participants demonstrated a clinically significant degree of generalization to untreated words on posttreatment probes. Randomization tests indicated one participant demonstrated a significant advantage for visual-acoustic over ultrasound biofeedback. Participants’ auditory-perceptual acuity on an /ɹ/−/w/ identification task was identified as a possible correlate of generalization following treatment.<b>Conclusions: </b>Most participants did not demonstrate a statistically significant difference in acoustic productions between the ultrasound and visual-acoustic conditions, but one participant showed greater improvement in /ɹ/ during visual-acoustic biofeedback.<br><b>Supplemental Material S1.</b> Video example of a structured practice during the dynamic assessment visit. <b><br></b><b>Supplemental Material S2. </b>Video example of biofeedback treatment.<br><b>Supplemental Material S3. </b>A second video example of biofeedback treatment.<br><b>Supplemental Material S4. </b>Randomization sequence for each participant<br><b>Supplemental Material S5. </b>Screening of automated formant values and the procedure for manual remeasurement. <br><b>Supplemental Material S6. </b>Exploring preferential response to treatment. <br><b>Supplemental Material S7. </b>Exploring magnitude of generalization.<br>Benway, N. R., Hitchcock, E. R., McAllister, T., Feeny, G. T., Hill, J., &amp; Preston, J. L. (2021). Comparing biofeedback types for children with residual /ɹ/ errors in American English: A single-case randomization design.<i> American Journal of Speech-Language Pathology</i>. Advance online publication. https://doi.org/10.1044/2021_AJSLP-20-00216