Clinical trial NCT03623100: Neural Indices of Intervention Outcomes in Children With Speech Sound Disorders
Official title: Identification of Electrophysiological Indices of Speech Sound Perception and Change in Children With Speech Sound Disorders
Study type: INTERVENTIONAL
Overall status: ACTIVE_NOT_RECRUITING
Phase: NA
Conditions: Speech Sound Disorder
Keywords: Children
Phonology
EEG
ERP
ABR
FFR
Lead sponsor: Idaho State University
Sponsor class: OTHER
Collaborators: name: National Institute on Deafness and Other Communication Disorders (NIDCD)
First posted: 2018-08-09
Enrollment: 42
Sex: ALL
Minimum age (years): 4
Maximum age (years): 6
Standard ages: CHILD
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: A single-subject staggered multiple baseline design will be used in the speech treatment program. Following procedures for this design, the children with SSD will be randomly assigned to one of two treatment conditions. These groups will be evaluated independently and in combination. Every subject will be evaluated in a baseline period in which no treatment is provided. Every subject will first complete a full baseline assessment. Subsequent baselines will consist only of a shorter baseline probe that specifically targets the phonemes each child did not produce during the initial baseline session. Thus, the first subject in each condition will have 2 baselines and then begin treatment. Each subsequent subject within each condition will have 1 additional baseline before beginning treatment.
Primary purpose: TREATMENT

Brief summary: Children with speech sound disorders (SSD) are thought to be unable to detect subtle differences between sounds, though there is little understanding of the underlying perceptual mechanisms implicated in SSD. The investigators suggest that children with SSD may have difficulty creating phonological representations due to inaccurate perception and representation of speech sounds, which then directly impacts speech production abilities. Children will be randomly assigned to one of two treatment conditions in the present study: 1) Traditional speech treatment alone or 2) Traditional speech treatment in conjunction with speech perceptual training. By identifying an underlying mechanism of the disorder, the clinical approach to the treatment of SSD will be better informed and treatment approaches targeting all deficient areas can be utilized.

Detailed description: Five to eight percent of all children in the United States have a speech sound disorder (SSD). Children with SSD have difficulty producing sounds of their target language system. Some of these children also have difficulty perceiving and categorizing speech sounds. It is presently unknown what underlying mechanisms might account for the communication problems children with SSD encounter. One possible explanation is that children with SSD cannot produce speech sounds correctly because they have poorly specified phonological representations, which are the result of inaccurate speech sound perception. Thus, speech sound production errors may stem from imprecise speech perception and its resulting sparse phonological representations.

Most children with SSD make slow and steady gains in speech treatment. This is likely due to the fact that speech treatment typically targets just phonetics (i.e., speech production) and phonology (i.e., speech sound knowledge and use). However, it is possible that the underlying mechanisms of speech sound disorders are not specifically phonological in nature but may in fact be related to more general cognitive and/or linguistic impairments. Thus, children will be randomly assigned to one of two treatment conditions in the present study: 1) Traditional speech treatment alone or 2) Traditional speech treatment in conjunction with speech perceptual training.

One goal of the research program is to identify what components of treatment induce the greatest amount of phonological change in children with SSD. By comparing the treatment components, the investigators will be able to identify what treatment activities induce the greatest phonological change in children. This information should aid in developing more efficient and effective treatment programs for SSD.

A second goal of the research program to use electrophysiological measures (electroencephalogram, EEG; event-related potentials, ERP; frequency following responses, FFR) to examine how phonological representations and their associated auditory neural responses change in conjunction with the two traditional speech treatment approaches. A better understanding of phonological representations and the auditory sensory system in children with SSD will inform how speech evaluations and treatment are best conducted by speech-language pathologists.

Eligibility criteria: Inclusion criteria (all children):

* Between the ages of 4;0 and 6;0 years
* English monolingual speakers
* Typical hearing abilities
* Typical overall development
* No apparent organic anomalies of the speech mechanism
* No global cognitive delays
* No receptive language impairments

Inclusion criteria (children with speech sound disorders):

* Speech production abilities below the 10th percentile
* Exclude a minimum of 4 English consonants from sound repertoire
* No prior speech and/or language intervention services
* Prior diagnosis of speech sound disorder (SSD)

Inclusion criteria (typically developing children):

- All speech and language measures in the typical range

Exclusion Criteria:

* Speaking a language other than (or in addition to) English
* Being above the age of 6 years or under 4 years

Primary outcomes:
measure: Change from baseline treated sound production accuracy at four months
timeFrame: an average of 4 months
Secondary outcomes:
measure: Change from baseline Mismatch Negativity (MMN) mean amplitude at four months
timeFrame: an average of 4 months
measure: Change from baseline P1/P2 mean amplitude at four months
timeFrame: an average of 4 months
measure: Event-related spectral perturbation (ERSP) channel analyses
timeFrame: an average of 4 months
measure: Change from baseline frequency following responses (FFRs) at four months
timeFrame: an average of 4 months
measure: Event-related spectral perturbation (ERSP) independent component (IC) analyses
timeFrame: an average of 4 months
measure: Change from baseline Percent Consonants Correct (PCC) at four months
timeFrame: an average of 4 months
Other outcomes:
Locations:
city: Meridian
country: United States
facility: Idaho State University - Meridian
state: Idaho
Study officials:
affiliation: Idaho State University - Meridian
name: Alycia E Cummings, Ph.D.
role: PRINCIPAL_INVESTIGATOR
References: