Beatboxing and Residual Speech Errors

Study Overview
=================
Brief Summary
-----------------
This project will study the effect of practicing speech sounds via beatboxing on speech accuracy, engagement in therapy, and functional outcomes for older children and adolescents with speech sound disorders (SSDs). Though SSDs exhibited by young children are often considered, SSDs are among the most frequent communication disorders in school-aged and adolescent children. SSDs can persist until adulthood. Individuals exhibit residual speech errors (RSE) when speech sounds are produced incorrectly after the age of eight, the age at which speech production is expected to be error-free. Common RSE include /r/, /s/, and /z/, all of which have high frequency in American English. Beatboxing is a unique manipulation of the speech mechanism in which the individual creates repetitive, percussive and other instrumental sounds by actually being the instrument. Beatboxing is engaging and increasingly found in a variety of musical contexts and mainstream culture. The broad objective of this investigation is to explore the impact of beatboxing as an intervention tool on the speech produced and the functional outcomes attained by children with RSE compared to a traditional articulation therapy approach.The effect of a beatboxing intervention approach (BEAT-Speech) will be compared to traditional articulation therapy and employs a two-group pretest-posttest design. Specifically, the research aims to 1) assess the impact of beatboxing on speech sound production accuracy and amount of targets produced during therapy; 2) examine the relative level of client engagement of individuals exposed to beatboxing intervention; and 3) explore influences of beatboxing experiences on communication, activities, and participation in social and daily interactions.

Official Title
-----------------
The Impact of Beatboxing on the Management of Individuals With Residual Speech Errors

Conditions
-----------------
Speech Sound Disorder

Intervention / Treatment
-----------------
* Behavioral: BEAT-Speech
* Behavioral: Traditional Articulation Approach


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: • diagnosed with a speech sound disorder due to residual speech sound errors Exclusion Criteria: out of age range history of hearing, neurogenic, behavioral diagnoses that can contribute to speech disorder English is not first or preferred language concurrent treatment for speech goals

Ages Eligible for Study
-----------------
Minimum Age: 8 Years
Maximum Age: 16 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Beatboxing: BEAT-Speech<br> | Behavioral: BEAT-Speech<br>* BEAT-Speech integrates beatboxing techniques within speech-therapy services for individuals with speech sound disorders.<br>|
| Experimental: Traditional Articulation Approach<br> | Behavioral: Traditional Articulation Approach<br>* The traditional approach to treating speech sound disorders focus on one or two sounds at a time until they are mastered by the client. Perceptual and production training are used with target starting at simple (isolation) and moving to more complex (sentences). A variety of cues such as shaping and phonetic placement cues are used.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Speech sound accuracy: dichotomous ratings | rated by naive, blinded raters | within two years | 
| Speech sound accuracy: visual analog scale ratings | rated by naive, blinded raters, will mark accuracy on a scale from 0-100 mm (not at all accurate to completely accurate). There is no formal name to this scale at this time given that it is novel to the study. | within two years | 
| Phonetic accuracy | % of consonants correct determined by phonetic transcription completed by trained transcribers | within two years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| therapeutic engagement level | measured via clinician ratings and naive, blinded raters who will code nonverbal behaviors associated with engagement/disengagement | within two years | 
| Hopkins Rehabilitation Engagement Rating | five item quantitative questionnaire completed by instructors only after final session | within two years | 
| Pittsburgh Rehabilitation Rating Scale | single item questionnaire completed by instructors after each treatment session | within two years | 
| PROMIS (Patient-Reported Outcomes Measurement Information System) Pediatric Peer Relationship Scale | questionnaire completed by participants to assess impact of treatment on social activities and participation. Scale is from 0-4 which is from worse to best outcome. | within two years | 
| Adolescent Communication Questionnaire | assesses self-efficacy/individual's belief in their ability to make change and succeed in therapy. Scale is fro 1 to 5 with the lowest number being associated with the greatest amount of negative impact to the highest number being associated with no impact. | within two years | 
| Qualitative interview regarding functional outcomes | phenomenological approach to better understanding themes associated with this novel therapy approach and traditional therapy approach | within two years |