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Cited by 16Voice and Speech DisordersLanguage Development and DisordersPhonetics and Phonology Research

Telepractice Treatment of Residual Rhotic Errors Using App-Based Biofeedback: A Pilot Study

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Peterson, Laura, Savarese, Christian, Campbell, Twylah, Ma, Zhigong, Simpson, Kenneth O., McAllister, Tara·2022·Language, Speech, and Hearing Services in Schools
DOI 10.1044/2021_lshss-21-00084PMC PMC9549922
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Abstract

Purpose: Although mobile apps are used extensively by speech-language pathologists, evidence for app-based treatments remains limited in quantity and quality. This study investigated the efficacy of app-based visual–acoustic biofeedback relative to nonbiofeedback treatment using a single-case randomization design. Because of COVID-19, all intervention was delivered via telepractice. Method: Participants were four children aged 9–10 years with residual errors affecting American English /ɹ/. Using a randomization design, individual sessions were randomly assigned to feature practice with or without biofeedback, all delivered using the speech app Speech Therapist's App for /r/ Treatment . Progress was assessed using blinded listener ratings of word probes administered at baseline, posttreatment, and immediately before and after each treatment session. Results: All participants showed a clinically significant response to the overall treatment package, with effect sizes ranging from moderate to very large. One participant showed a significant advantage for biofeedback over nonbiofeedback treatment, although the order of treatment delivery poses a potential confound for interpretation in this case. Conclusions: While larger scale studies are needed, these results suggest that app-based treatment for residual errors can be effective when delivered via telepractice. These results are compatible with previous findings in the motor learning literature regarding the importance of treatment dose and the timing of feedback conditions. Supplemental Material: https://doi.org/10.23641/asha.18461576

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  • Pop2TalkNordic offers more auditory exposure to target words than opportunities to production compared to both staRt and SayBananas!.

    “It should be noted, however, that there is a critical difference between these speech‐training tools, where Pop2TalkNordic offers more auditory exposure to target words than opportunities to production compared to both staRt and SayBananas!.”

    From Self‐Supervised App‐Based Speech Training for Children With Speech Sound Disorder—A Single‐Case Experimental Design Study (2026) · cites this paper as Peterson et al. 2022

    The Treatment section describes staRt as a production-practice tool: participants produced a syllable or word on each trial, with 200 structured trials per session. Our copy does not describe Pop2TalkNordic or SayBananas!, or compare their auditory exposure and production opportunities with staRt, so it supports only the staRt portion of the comparison. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

  • Peterson et al. (2022) found that four children increased speech target accuracy during a clinician-led telepractice intervention using staRt across 16 training sessions.

    “Here, too, the participating children increased their speech target accuracy during intervention.”

    From Self‐Supervised App‐Based Speech Training for Children With Speech Sound Disorder—A Single‐Case Experimental Design Study (2026) · cites this paper as Peterson et al. 2022

  • The results that intervention with Pop2TalkNordic was not successful for the participating children runs counter to the positive results reported in previous studies of app-based speech intervention for children with SSD.

    “The results that intervention with Pop2TalkNordic was not successful for the participating children runs counter to the positive results reported in previous studies of app‐based speech intervention for children with SSD (Hair et al. 2021; McLeod et al. 2023; Peterson et al. 2022).”

    From Self‐Supervised App‐Based Speech Training for Children With Speech Sound Disorder—A Single‐Case Experimental Design Study (2026) · cites this paper as Peterson et al. 2022

  • The current study employed a shorter and less supervised form of intervention as compared to previous investigations.

    “In terms of intervention delivery, the current study employed a shorter and less supervised form of intervention as compared to previous investigations.”

    From Self‐Supervised App‐Based Speech Training for Children With Speech Sound Disorder—A Single‐Case Experimental Design Study (2026) · cites this paper as Peterson et al. 2022

  • The observed dose frequency ranging between four and seven sessions per week in the present study is comparable to the frequency of four sessions per week in Hair et al. (2021) and McLeod et al. (2023), and higher than the frequency of 2-3 sessions per week in Peterson et al. (2022).

    “Regarding dose frequency, on the other hand, the observed frequency ranging between four and seven sessions per week in the present study, is comparable to the frequency of four sessions per week in Hair et al. (2021) and McLeod et al. (2023), and higher than the frequency of 2–3 sessions per week in Peterson et al. (2022).”

    From Self‐Supervised App‐Based Speech Training for Children With Speech Sound Disorder—A Single‐Case Experimental Design Study (2026) · cites this paper as Peterson et al. 2022

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Cited by

Sorted by citations

Authors
Peterson, L., Savarese, C., Campbell, T., Ma, Z., Simpson, K. O., & McAllister, T.
Affiliations
  • Rocky Mountain University of Health Professions (US)
  • Harvard University (US)
  • New York University (US)
ORCID
Venue
Language, Speech, and Hearing Services in Schools
Publisher
American Speech Language Hearing Association
Published
2022-04-11
Volume
53
Issue
2
Pages
256-274
ISSN
  • 0161-1461 (ISSN-L)
  • 1558-9129
DOI
10.1044/2021_lshss-21-00084
PMC
PMC9549922
OpenAlex
W4205461269
Cited by
16
References
4
Citations by year
2026: 1 · 2025: 2 · 2024: 4 · 2023: 7 · 2022: 2
FWCI
2.26
Type
journal article
Language
en
Open access
Locations
  • Language Speech and Hearing Services in Schools (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute on Deafness and Other Communication Disorders (R41DC016778, R01DC017476)
Topics
  • Health Sciences › Medicine › Physiology › Voice and Speech Disorders
  • Social Sciences › Psychology › Developmental and Educational Psychology › Language Development and Disorders
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Phonetics and Phonology Research
Keywords
rhoticity, telepractice, speech-language pathology, children, speech sound disorders, treatment dose, feedback timing, motor learning
MeSH terms
COVID-19, Biofeedback, Psychology, Child, Humans, Pilot Projects, Speech Therapy, Mobile Applications

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