View in EDS PDF Full Text

Rhotic Acquisition Is More Rapid in Biofeedback than Motor-Based Treatment for Residual Speech Sound Disorder: Primary Outcome of a Randomized Controlled Trial

Saved in:
Bibliographic Details
Title: Rhotic Acquisition Is More Rapid in Biofeedback than Motor-Based Treatment for Residual Speech Sound Disorder: Primary Outcome of a Randomized Controlled Trial
Language: English
Authors: Tara McAllister (ORCID 0000-0003-2230-2897), Jonathan L. Preston (ORCID 0000-0001-9971-6321), Nina R. Benway, Jennifer Hill (ORCID 0000-0003-4983-2206), Marcela P. Lara, Megan C. Leece (ORCID 0000-0003-3792-2992), Wendy Liang, Elaine R. Hitchcock (ORCID 0000-0003-1835-0976)
Source: Journal of Speech, Language, and Hearing Research. 2026 69(4):1342-1361.
Availability: American Speech-Language-Hearing Association. 2200 Research Blvd #250, Rockville, MD 20850. Tel: 301-296-5700; Fax: 301-296-8580; e-mail: slhr@asha.org; Web site: http://jslhr.pubs.asha.org
Peer Reviewed: Y
Page Count: 20
Publication Date: 2026
Sponsoring Agency: National Institutes of Health (NIH) (DHHS)
Contract Number: R01DC017476
Document Type: Journal Articles
Reports - Research
Descriptors: Speech Impairments, Biofeedback, Speech Therapy, North American English, Language Acquisition, Children, Adolescents, Outcomes of Treatment, Motor Development
Geographic Terms: New York, New Jersey
DOI: 10.1044/2025_JSLHR-24-00909
ISSN: 1092-4388
1558-9102
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.
Abstractor: As Provided
Notes: https://osf.io/vdh93
Entry Date: 2026
Accession Number: EJ1505635
Database: ERIC
FullText Links:
  – Type: pdflink
    Url: https://content.ebscohost.com/cds/retrieve?content=AQICAHj0k_4E0hTGH8RJwT4gCJyBsGNe_WN95AvKlDbXJGqwxwHekf10RXxKTr7yWfN21FMYAAAA4jCB3wYJKoZIhvcNAQcGoIHRMIHOAgEAMIHIBgkqhkiG9w0BBwEwHgYJYIZIAWUDBAEuMBEEDIqiTfEsnlzDa7wpagIBEICBmqnzFahppisBfMqJTt3FsEWtZwphtsYpfUK2gi_Np6NK78NoEm8LG2tb8OGgqmOvRYAIMGUOWZAIa0_y3pDWNCPLksI8CUm_nqVYnl1sJ2Ibqdq9slnqWeRtE54_3J2HKRiphzaaXe6GoU7cvKQCP6FR3zQ4_G-TWd5m1sLHgSkDFR-SYEQDsOyd692nPU1faeTTX5ptrMdX3hc=
Text:
  Availability: 0
Header DbId: eric
DbLabel: ERIC
An: EJ1505635
AccessLevel: 3
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Rhotic Acquisition Is More Rapid in Biofeedback than Motor-Based Treatment for Residual Speech Sound Disorder: Primary Outcome of a Randomized Controlled Trial
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Tara+McAllister%22">Tara McAllister</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0003-2230-2897">0000-0003-2230-2897</externalLink>)<br /><searchLink fieldCode="AR" term="%22Jonathan+L%2E+Preston%22">Jonathan L. Preston</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0001-9971-6321">0000-0001-9971-6321</externalLink>)<br /><searchLink fieldCode="AR" term="%22Nina+R%2E+Benway%22">Nina R. Benway</searchLink><br /><searchLink fieldCode="AR" term="%22Jennifer+Hill%22">Jennifer Hill</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0003-4983-2206">0000-0003-4983-2206</externalLink>)<br /><searchLink fieldCode="AR" term="%22Marcela+P%2E+Lara%22">Marcela P. Lara</searchLink><br /><searchLink fieldCode="AR" term="%22Megan+C%2E+Leece%22">Megan C. Leece</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0003-3792-2992">0000-0003-3792-2992</externalLink>)<br /><searchLink fieldCode="AR" term="%22Wendy+Liang%22">Wendy Liang</searchLink><br /><searchLink fieldCode="AR" term="%22Elaine+R%2E+Hitchcock%22">Elaine R. Hitchcock</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0003-1835-0976">0000-0003-1835-0976</externalLink>)
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="SO" term="%22Journal+of+Speech%2C+Language%2C+and+Hearing+Research%22"><i>Journal of Speech, Language, and Hearing Research</i></searchLink>. 2026 69(4):1342-1361.
– Name: Avail
  Label: Availability
  Group: Avail
  Data: American Speech-Language-Hearing Association. 2200 Research Blvd #250, Rockville, MD 20850. Tel: 301-296-5700; Fax: 301-296-8580; e-mail: slhr@asha.org; Web site: http://jslhr.pubs.asha.org
– Name: PeerReviewed
  Label: Peer Reviewed
  Group: SrcInfo
  Data: Y
– Name: Pages
  Label: Page Count
  Group: Src
  Data: 20
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2026
– Name: SourceSuprt
  Label: Sponsoring Agency
  Group: SrcSuprt
  Data: National Institutes of Health (NIH) (DHHS)
– Name: NumberContract
  Label: Contract Number
  Group: NumCntrct
  Data: R01DC017476
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: Journal Articles<br />Reports - Research
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Speech+Impairments%22">Speech Impairments</searchLink><br /><searchLink fieldCode="DE" term="%22Biofeedback%22">Biofeedback</searchLink><br /><searchLink fieldCode="DE" term="%22Speech+Therapy%22">Speech Therapy</searchLink><br /><searchLink fieldCode="DE" term="%22North+American+English%22">North American English</searchLink><br /><searchLink fieldCode="DE" term="%22Language+Acquisition%22">Language Acquisition</searchLink><br /><searchLink fieldCode="DE" term="%22Children%22">Children</searchLink><br /><searchLink fieldCode="DE" term="%22Adolescents%22">Adolescents</searchLink><br /><searchLink fieldCode="DE" term="%22Outcomes+of+Treatment%22">Outcomes of Treatment</searchLink><br /><searchLink fieldCode="DE" term="%22Motor+Development%22">Motor Development</searchLink>
– Name: Subject
  Label: Geographic Terms
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22New+York%22">New York</searchLink><br /><searchLink fieldCode="DE" term="%22New+Jersey%22">New Jersey</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1044/2025_JSLHR-24-00909
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 1092-4388<br />1558-9102
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: 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.
– Name: AbstractInfo
  Label: Abstractor
  Group: Ab
  Data: As Provided
– Name: Note
  Label: Notes
  Group: Note
  Data: https://osf.io/vdh93
– Name: DateEntry
  Label: Entry Date
  Group: Date
  Data: 2026
– Name: AN
  Label: Accession Number
  Group: ID
  Data: EJ1505635
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1505635
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1044/2025_JSLHR-24-00909
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 20
        StartPage: 1342
    Subjects:
      – SubjectFull: Speech Impairments
        Type: general
      – SubjectFull: Biofeedback
        Type: general
      – SubjectFull: Speech Therapy
        Type: general
      – SubjectFull: North American English
        Type: general
      – SubjectFull: Language Acquisition
        Type: general
      – SubjectFull: Children
        Type: general
      – SubjectFull: Adolescents
        Type: general
      – SubjectFull: Outcomes of Treatment
        Type: general
      – SubjectFull: Motor Development
        Type: general
      – SubjectFull: New York
        Type: general
      – SubjectFull: New Jersey
        Type: general
    Titles:
      – TitleFull: Rhotic Acquisition Is More Rapid in Biofeedback than Motor-Based Treatment for Residual Speech Sound Disorder: Primary Outcome of a Randomized Controlled Trial
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Tara McAllister
      – PersonEntity:
          Name:
            NameFull: Jonathan L. Preston
      – PersonEntity:
          Name:
            NameFull: Nina R. Benway
      – PersonEntity:
          Name:
            NameFull: Jennifer Hill
      – PersonEntity:
          Name:
            NameFull: Marcela P. Lara
      – PersonEntity:
          Name:
            NameFull: Megan C. Leece
      – PersonEntity:
          Name:
            NameFull: Wendy Liang
      – PersonEntity:
          Name:
            NameFull: Elaine R. Hitchcock
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 01
              Type: published
              Y: 2026
          Identifiers:
            – Type: issn-print
              Value: 1092-4388
            – Type: issn-electronic
              Value: 1558-9102
          Numbering:
            – Type: volume
              Value: 69
            – Type: issue
              Value: 4
          Titles:
            – TitleFull: Journal of Speech, Language, and Hearing Research
              Type: main
ResultId 1