Recruiting

Perception/Production Enhanced Treatment

Sponsor:

Montclair State University

Code:

NCT06969521

Conditions

Speech Sound Disorder

Eligibility Criteria

Sex: All

Age: 8 - 17

Healthy Volunteers: Not accepted

Interventions

Visual acoustic biofeedback: ORDER

Perception Training: ORDER

Study Details

Brief summary:

The goal of this clinical trial is to determine whether perceptual training enhances speech perception and production outcomes in children with Residual Speech Sound Disorders (RSSD). The main questions it aims to answer are:

Does pre-treatment speech production accuracy predict treatment response?

Does perceptual acuity influence the effectiveness of perception-first versus production-first interventions?

Researchers will compare TAU+Perception-first and TAU-first treatment conditions to see if the order of intervention affects speech improvement outcomes, particularly based on participants' initial perception and production accuracy.

Participants will:

Complete pre-treatment evaluations to assess /r/ production and speech perception.

Be grouped into high or low production and perception accuracy categories based on established thresholds.

Be randomly assigned (using a blocked randomization procedure) to one of two treatment arms via telepractice.

Participate in the assigned treatment condition designed to target speech sound accuracy.

Randomization is stratified to ensure treatment groups are balanced based on pre-treatment severity in both the perception and production domains.

Conditions

Speech Sound Disorder

Study ID

NCT06969521

Start date

May 10, 2025

Status verified date

Aug, 2026

Completion date

Jul 1, 2027

Anticipated

Primary completion date

Jul 1, 2027

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 8 - 17

Healthy Volunteers: Not accepted

Inclusion Criteria:

Must be between 8;0 and 17;11 years of age at the time of enrollment. Must speak English as the dominant language (i.e., must have begun learning English by age 2, per parent report).

Must speak a rhotic dialect of English. Must pass a pure-tone hearing screening at 20dB hearing level. Must pass a brief examination of oral structure and function. Must exhibit less than 30% accuracy, based on consensus across 2 trained listeners, on a probe list eliciting rhotics in various phonetic contexts at the word level.

Must exhibit no more than 3 sounds other than /r/ in error on the Goldman-Fristoe Test of Articulation-3 (GFTA-3).

Exclusion Criteria:

Must not receive a T score more than 1.3 SD below the mean on the Wechsler Abbreviated Scale of Intelligence-2 (WASI-2) Matrix Reasoning Must not receive a scaled score of 7 or higher on the Recalling Sentences and Formulated Sentences subtests of the Clinical Evaluation of Language Fundamentals-5 (CELF-5).

Must not have an existing diagnosis of developmental disability or major neurobehavioral syndrome such as cerebral palsy, Down Syndrome, or Autism Spectrum Disorder

Study Design

Enrollment

60 participants

Anticipated

Allocation

Randomized

Intervention Model

Crossover

Primary purpose

Treatment

Interventions and Outcome Measures

Arms

active comparator: ORDER: Visual acoustic biofeedback training

The investigators will use the following approach, adopted successfully for the RCT in the previous funding cycle:

(1) Participants will be randomized after providing informed consent, meeting eligibility requirements, and completing the tasks and clinician-rated baselines that determine response group (High, Low). (2) For each perception accuracy group, the statistician will develop 2 batches of 10 concealed envelopes for assignment, one for high production accuracy participants and one for low production accuracy participants. Each will contain 10 participant assignments in random order: 5 TAU+ Perception-first, 5 TAU-first. Thus, once the investigators have recruited the first 10 participants for one subgroup (e.g., Low Perceptual Accuracy, Low Production Accuracy), another batch of 10 envelopes will be generated to allocate the next 10 children recruited in that subgroup.

experimental: ORDER: Perceptual training

The investigators will use the following approach, adopted successfully for the RCT in the previous funding cycle: (1) Participants will be randomized after providing informed consent, meeting eligibility requirements, and completing the tasks and clinician-rated baselines that determine response group (High, Low). (2) For each perception accuracy group, the statistician will develop 2 batches of 10 concealed envelopes for assignment, one for high production accuracy participants and one for low production accuracy participants. Each will contain 10 participant assignments in random order: 5 TAU+ Perception-first, 5 TAU-first. Thus, once we have recruited the first 10 participants for one subgroup (e.g., Low Perceptual Accuracy, Low Production Accuracy), another batch of 10 envelopes will be generated to allocate the next 10 children recruited in that subgroup.

no intervention: ORDER: No treatment

No treatment, 4-week period of no treatment

Interventions

Visual acoustic biofeedback: ORDER

In visual-acoustic biofeedback treatment, elements of traditional articulation treatment are used, including auditory models, verbal descriptions of correct articulator placement, cues for repetitive motor practice via images and diagrams of the vocal tract as visual aids. These strategies are supplemented with a dynamic display of the speech signal in the form of the real-time LPC (Linear Predictive Coding) spectrum (Sona-Match module of PENTAX Sona- Speech software). Because correct vs incorrect productions of /r/ contrast acoustically in the frequency of the third formant (F3), participants will be cued to make their real-time LPC spectrum match a visual target characterized by a low F3 frequency. They will be encouraged to attend to the visual display while adjusting the placement of their articulators and observing how those adjustments impact F3. Knowledge of performance feedback will typically involve reference to the location of the third peak on the visual display.

Perception Training: ORDER

Description: Perceptual training involves self-paced presentation of auditory stimuli via a computerized software program (Gorilla). Stimuli are organized into three separate tasks. In tasks 1 and 3, which train category goodness judgment, participants will hear 75 naturally produced speech tokens containing /r/ from various speakers, with a balance of correct and incorrect productions. They will classify each /r/ as correct or incorrect and receive feedback on the accuracy of their classification. Tasks 1 and 3 differ in that task 1 will feature a subset of items designed to provide focused practice on a specific context (e.g., initial /r/ as in red; /r/ as syllable nucleus as in sir), with increasing difficulty over time, whereas task 3 will feature randomly selected items representing all contexts and difficulty levels. In task 2, participants will hear 75 items drawn from the synthetic rake-wake continuum used in the identification task administered at baseline, but they will recei

Primary outcome measure

  • Change in perceptually rated accuracy of /r/ [ Time Frame: The timepoints for comparison will be from baseline to after both groups have completed 4 weeks of VAB and when both groups have completed the target 12 weeks of treatment (all types interventions: VAB, Perception training and no treatment). ]

Central Contacts and Locations

Central contacts

Elaine R. Hitchcock, PhD

973-229-3797hitchcocke@montclair.edu

Locations

Montclair State University

Recruiting

Montclair, New Jersey, United States, 07403

Contacts

Laura Ochs, Project Manager, MA

908 334-4140ochsl@montclair.edu

More Information

Sponsor

Montclair State University

Last update posted

Aug 28, 2026

Last verified

Aug, 2026

Keywords

  • speech sound disorder
  • auditory perception
  • articulation

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-10. This information was provided to ClinicalTrials.gov by Montclair State University on 2026-08-28.