Rhotic Acquisition Is More Rapid in Biofeedback Than Motor-Based Treatment for Residual Speech Sound Disorder: Primary Outcome of a Randomizeeech Research Articlesd Controlled Trial.
Tara McAllister, Jonathan L Preston, Nina R Benway, Jennifer Hill, Marcela P Lara, Megan C Leece, Wendy Liang, Elaine R Hitchcock
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引用次数: 0
Abstract
Purpose: Residual speech sound disorder (RSSD) is a high-prevalence condition that can limit children's academic and social participation, with negative consequences for overall well-being. Previous studies have described visual biofeedback as a promising option for RSSD, but results have been inconclusive due to study design limitations and small sample sizes.
Method: In a preregistered randomized controlled trial, 108 children aged 9-15 years with RSSD affecting American English /ɹ/ were randomly assigned to receive treatment incorporating visual biofeedback (subdivided into ultrasound and visual-acoustic types) or a comparison condition of motor-based treatment consistent with current best practices in speech therapy. An acoustic measure (the distance between the second and third formants, which is smaller in perceptually accurate /ɹ/) was used to quantify progress in the first three sessions of treatment in participants' assigned condition. The focus on the early stages of treatment was grounded in principles of motor learning: As a type of knowledge of performance feedback, biofeedback is expected to have its greatest impact during initial acquisition of a new speech-motor plan.
Results: A linear mixed-effects regression model revealed a statistically significant interaction between treatment type and session: While both groups made progress over time, the rate of progress was significantly faster in the biofeedback condition compared to motor-based treatment. No statistically significant difference was observed between the ultrasound and visual-acoustic types of biofeedback.
Discussion: This large-scale randomized controlled trial supports previous small-scale research in finding that biofeedback can help children with RSSD acquire American English /ɹ/. A companion study will compare participants' generalization learning after the end of all treatment.
目的：残余言语障碍（RSSD）是一种高患病率的疾病，可以限制儿童的学业和社会参与，对整体健康产生负面影响。先前的研究已经将视觉生物反馈描述为RSSD的一个有希望的选择，但由于研究设计的限制和小样本量，结果一直不确定。方法：在一项预先注册的随机对照试验中，108名9-15岁的RSSD影响美式英语/音标/随机分配到视觉生物反馈治疗（细分为超声和视声两种类型）或与当前语言治疗最佳实践一致的基于运动的治疗比较条件。声学测量（第二个和第三个共振峰之间的距离，在感知上准确/ r /中较小）用于量化参与者指定条件下前三个疗程的治疗进展。对早期治疗阶段的关注是基于运动学习的原则：作为表现反馈的一种知识，生物反馈在新语言-运动计划的初始习得过程中预计会产生最大的影响。结果：线性混合效应回归模型显示，治疗类型和疗程之间存在统计学上显著的相互作用：虽然两组随着时间的推移都取得了进展，但与基于运动的治疗相比，生物反馈条件下的进展速度明显更快。超声与视声两种生物反馈方式差异无统计学意义。讨论：这项大规模的随机对照试验支持了之前的小规模研究，发现生物反馈可以帮助RSSD儿童习得美式英语。一项伴随研究将比较所有治疗结束后参与者的泛化学习情况。补充资料：https://doi.org/10.23641/asha.29971501。
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