# Biofeedback-Enhanced Treatment for Speech Sound Disorder:  Randomized Controlled Trial and Delineation of Sensorimotor Subtypes

> **NIH NIH R01** · NEW YORK UNIVERSITY · 2021 · $736,886

## Abstract

Children with speech sound disorder show diminished accuracy and intelligibility in spoken communication and
may thus be perceived as less capable or intelligent than peers, with negative consequences for both socioemo-
tional and socioeconomic outcomes. While most speech errors resolve by the late school-age years,
between 2-5% of speakers exhibit residual speech errors (RSE) that persist through adolescence or even adult-
hood, reﬂecting about 6 million cases in the US. Both affected children/families and speech-language
pathologists (SLPs) have highlighted the critical need for research to identify more effective forms of treatment for
children with RSE. In a series of single-case experimental studies, our research team has found that treatment
incorporating technologically enhanced sensory feedback (visual-acoustic biofeedback, ultrasound biofeedback)
can improve speech in individuals with RSE who have not responded to previous intervention.
A randomized controlled trial (RCT) comparing traditional vs biofeedback-enhanced intervention is the essential
next step to inform evidence-based decision-making for this prevalent population. Larger-scale research is also
needed to understand heterogeneity across individuals in the magnitude of response to biofeedback treatment.
 The overall objective of this proposal is to conduct clinical research that will guide the evidence-based man-
agement of RSE while also providing novel insights into the sensorimotor underpinnings of speech. Our central
hypothesis is that biofeedback will yield greater gains in speech accuracy than traditional treatment, and that
individual deﬁcit proﬁles will predict relative response to visual-acoustic vs ultrasound biofeedback. Building on
a robust history of recruiting and treating children with RSE, we will enroll n=118 children who misarticulate the
/r/ sound, the most common type of RSE. Aim 1 will evaluate the efﬁcacy of biofeedback relative to traditional
treatment in a well-powered randomized controlled trial (Correcting Residual Errors with Spectral, ULtrasound,
Traditional Speech therapy, or C-RESULTS). Ultrasound and visual-acoustic biofeedback, which have similar evi-
dence bases, will be represented equally; comparison between biofeedback types is deferred to Aim 3. Second,
we will measure auditory and somatosensory acuity in participants with RSE and a matched sample of 100 typical
children, allowing us to identify sensory deﬁcit proﬁles that could act as biomarkers to predict treatment response
in RSE. Finally, Aim 3 will select a subset of 8 children with RSE who show a deﬁcit in one domain (auditory or
somatosensory) and intact perception in the other. Single-case methods will be used to test the hypothesis that
sensory deﬁcit proﬁles differentially predict response to visual-acoustic vs ultrasound biofeedback.
 This research will be clinically signiﬁcant because Aim 1 will have immediate implications for the selection of
the most efﬁcient/effective therapy ...

## Key facts

- **NIH application ID:** 10098028
- **Project number:** 5R01DC017476-03
- **Recipient organization:** NEW YORK UNIVERSITY
- **Principal Investigator:** Tara McAllister
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $736,886
- **Award type:** 5
- **Project period:** 2019-01-01 → 2023-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10098028

## Citation

> US National Institutes of Health, RePORTER application 10098028, Biofeedback-Enhanced Treatment for Speech Sound Disorder:  Randomized Controlled Trial and Delineation of Sensorimotor Subtypes (5R01DC017476-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10098028. Licensed CC0.

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