Traditional and Visual–Acoustic Biofeedback Treatment via Telepractice for Residual Speech Sound Disorders Affecting /ɹ/: Pilot Study

Purpose: This study aimed to examine the feasibility of telepractice delivery of a treatment package including visual–acoustic biofeedback (VAB) and motor-based treatment for residual speech sound disorder affecting /ɹ/ in school-age children. The overall study used a single-case randomization design; however, this preliminary report will simply quantify changes in accuracy before and after completion of the treatment package. The present analysis did not differentiate between the relative contributions of biofeedback and motor-based treatments. Method: Seven children aged 9–14 years received speech therapy for /ɹ/ distortions via telepractice. The study design consisted of three phases: baseline (four sessions), treatment (20 sessions), and posttreatment (three sessions). Treatment included two sessions weekly for a duration of 10 weeks. The participants received one motor-based/nonbiofeedback session and one VAB session per week. The order of treatment within each week was randomly determined prior to the start of therapy. Overall progress was assessed using untrained listeners' ratings of word probes administered in the baseline and posttreatment phases. Results: Findings revealed that six of the seven participants showed a clinically significant response to the overall treatment package, although the magnitude of individual responses varied across speech contexts (consonantal and vocalic) and participants. Conclusions: The present results suggest that an intervention combining VAB and motor-based treatment for residual /ɹ/ errors can be effectively delivered via telepractice. Considerations for technology setup and treatment protocols are provided.