Efficacy of Visual–Acoustic Biofeedback Intervention for Residual Rhotic Errors: A Single-Subject Randomization Study Purpose This study documented the efficacy of visual–acoustic biofeedback intervention for residual rhotic errors, relative to a comparison condition involving traditional articulatory treatment. All participants received both treatments in a single-subject experimental design featuring alternating treatments with blocked randomization of sessions to treatment conditions. Method Seven child and ... Research Article
Research Article  |   May 24, 2017
Efficacy of Visual–Acoustic Biofeedback Intervention for Residual Rhotic Errors: A Single-Subject Randomization Study
 
Author Affiliations & Notes
  • Tara McAllister Byun
    Department of Communicative Sciences and Disorders, New York University
  • Disclosure: The author has declared that no competing interests existed at the time of publication.
    Disclosure: The author has declared that no competing interests existed at the time of publication. ×
  • Correspondence to Tara McAllister Byun: tara.byun@nyu.edu
  • Editor: Julie Liss
    Editor: Julie Liss×
  • Associate Editor: Tanya Eadie
    Associate Editor: Tanya Eadie×
Article Information
Hearing & Speech Perception / Acoustics / Speech / Research Articles
Research Article   |   May 24, 2017
Efficacy of Visual–Acoustic Biofeedback Intervention for Residual Rhotic Errors: A Single-Subject Randomization Study
Journal of Speech, Language, and Hearing Research, May 2017, Vol. 60, 1175-1193. doi:10.1044/2016_JSLHR-S-16-0038
History: Received January 31, 2016 , Revised May 20, 2016 , Accepted August 28, 2016
 
Journal of Speech, Language, and Hearing Research, May 2017, Vol. 60, 1175-1193. doi:10.1044/2016_JSLHR-S-16-0038
History: Received January 31, 2016; Revised May 20, 2016; Accepted August 28, 2016

Purpose This study documented the efficacy of visual–acoustic biofeedback intervention for residual rhotic errors, relative to a comparison condition involving traditional articulatory treatment. All participants received both treatments in a single-subject experimental design featuring alternating treatments with blocked randomization of sessions to treatment conditions.

Method Seven child and adolescent participants received 20 half-hour sessions of individual treatment over 10 weeks. Within each week, sessions were randomly assigned to feature traditional or biofeedback intervention. Perceptual accuracy of rhotic production was assessed in a blinded, randomized fashion. Each participant's response to the combined treatment package was evaluated by using effect sizes and visual inspection. Differences in the magnitude of response to traditional versus biofeedback intervention were measured with individual randomization tests.

Results Four of 7 participants demonstrated a clinically meaningful response to the combined treatment package. Three of 7 participants showed a statistically significant difference between treatment conditions. In all 3 cases, the magnitude of within-session gains associated with biofeedback exceeded the gains associated with traditional treatment.

Conclusions These results suggest that the inclusion of visual–acoustic biofeedback can enhance the efficacy of intervention for some individuals with residual rhotic errors. Further research is needed to understand which participants represent better or poorer candidates for biofeedback treatment.

Acknowledgments
The author acknowledges support for this research by the National Institutes of Health Grant NIH R03DC 012883 and also by a travel fellowship to attend the Institute of Education Sciences Single-Case Design and Analysis Institute 2014. The author gratefully acknowledges the contributions of the following individuals: for treatment delivery, Heather Campbell; for developing the Challenge-R software, José Ortiz and Elaine Hitchcock; for programming support, Daniel Szeredi; for statistical consultation, Daphna Harel; for data collection and management, numerous student assistants at New York University, notably Laine Cialdella, Tala Ginsberg, Deanna Kawitzky, and Christopher Nightingale. Many thanks also to all participants and their families for their cooperation throughout the study.
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