Online assessment and enhancement of auditory perception for speech sound errors

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Project Summary/Abstract In developmental speech sound disorder, errors affecting the accuracy and intelligibility of speech can pose a barrier to participation in academic and social settings [1, 2], with potentially life-long consequences [3]. Between 2-5% of speakers exhibit residual speech errors (RSE) that persist through adolescence or even adulthood [4, 5, 6] and are considered particularly challenging to treat. Previous literature has established the importance of auditory-perceptual targets and feedback for speech-motor learning, including in RSE [7, 8], but there is a need for further research to measure auditory acuity and examine the effects of auditory-perceptual training in RSE. Furthermore, the COVID-19 pandemic has forced researchers to reassess certain practices, including what can be effectively accomplished online versus in person [9, 10]. Clinically, telepractice has proven essential for safe delivery of speech therapy services during social distancing [11]. Even after the pandemic subsides, we are likely to see a long-term shift toward online collection of research data and telepractice delivery of speech services. However, there is a pressing need for well-designed studies to support the validity of these remote approaches. The overall objective of this proposal is to expand our basic understanding of perception-production relations while evaluating whether tasks involving perceptual assessment and auditory-enhanced training are valid in the online modality. We focus on two auditory-enhanced treatment approaches readily adaptable to the telepractice context, visual-acoustic biofeedback [12, 13, 14] and auditory-perceptual training [15, 16, 8]. We will target children with errors affecting the American English /r/ sound, considered the most common form of RSE. Aim 1 will collect online normative data for two theoretically motivated measures of auditory perception for /r/ and will evaluate the validity of these measures by comparison with an existing dataset collected in the laboratory setting. We will administer the same measures to our participants with RSE, which will allow us to allocate them to our two proposed treatment studies in an evidence-based fashion. Individuals with typical perception will be assigned to the Aim 2 study, a randomized controlled trial (RCT) measuring the efficacy of online visual-acoustic biofeedback treatment relative to a waitlist comparison condition. Individuals with atypical perception will be allocated to the Aim 3 study, which will measure the effects of online auditory-perceptual training on outcomes in both perception and production domains. Our central hypothesis is that both forms of auditory-enhanced training will be associated with positive treatment effects in the context of telepractice service delivery. This research will advance the evidence base by contributing the first studies of the efficacy of biofeedback treatment and auditory-perceptual training in the telepractice context. The online tools for perceptual assessment and training developed in this project will be freely shared with clinicians and researchers. The proposed research will thus offer immediate benefit to clinicians and children affected by COVID-19 while also making a long-term contribution as new technologies reshape scientific research and treatment delivery in speech pathology.