xml: <clinical_study>
    <!-- This xml conforms to an XML Schema at:
      https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
    <required_header>
      <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
      <link_text>Link to the current ClinicalTrials.gov record.</link_text>
      <url>https://clinicaltrials.gov/ct2/show/NCT05988515</url>
    </required_header>
    <id_info>
      <org_study_id>22-426b</org_study_id>
      <secondary_id>1R01DC020959-01</secondary_id>
      <nct_id>NCT05988515</nct_id>
    </id_info>
    <brief_title>AI-Assisted Treatment for Residual Speech Sound Disorders</brief_title>
    <official_title>AI-Assisted Treatment for Residual Speech Sound Disorders</official_title>
    <sponsors>
      <lead_sponsor>
        <agency>Syracuse University</agency>
        <agency_class>Other</agency_class>
      </lead_sponsor>
      <collaborator>
        <agency>National Institutes of Health (NIH)</agency>
        <agency_class>NIH</agency_class>
      </collaborator>
      <collaborator>
        <agency>State University of New York - Upstate Medical University</agency>
        <agency_class>Other</agency_class>
      </collaborator>
      <collaborator>
        <agency>National Institute on Deafness and Other Communication Disorders (NIDCD)</agency>
        <agency_class>NIH</agency_class>
      </collaborator>
    </sponsors>
    <source>Syracuse University</source>
    <oversight_info>
      <has_dmc>Yes</has_dmc>
      <is_fda_regulated_drug>No</is_fda_regulated_drug>
      <is_fda_regulated_device>No</is_fda_regulated_device>
    </oversight_info>
    <brief_summary>
      <textblock>
        The goal of this randomized-controlled trial is to determine how artificial&#xD;
        intelligence-assisted home practice may enhance speech learning of the &quot;r&quot; sound in&#xD;
        school-age children with residual speech sound disorders. All child participants will receive&#xD;
        1 speech lesson per week, via telepractice, for 5 weeks with a human speech-language&#xD;
        clinician. Some participants will receive 3 speech sessions per week with an Artificial&#xD;
        Intelligence (AI)-clinician during the same 5 weeks as the human clinician sessions&#xD;
        (CONCURRENT treatment order group), whereas others will receive 3 speech sessions per week&#xD;
        with an AI-clinician after the human clinician sessions end (SEQUENTIAL treatment order&#xD;
        group.&#xD;
      </textblock>
    </brief_summary>
    <detailed_description>
      <textblock>
        Artificial Intelligence-assisted treatment that detects mispronunciations within an&#xD;
        evidence-based motor learning framework could increase access to sufficiently intense,&#xD;
        efficacious treatment despite provider shortages. A successful Artificial intelligencesystem&#xD;
        that can predict the clinical gold standard of trained listeners' perceptions could not only&#xD;
        improve access to clinical care but also mitigate known confounds to accurate clinical&#xD;
        feedback, including clinical experience and drift due to increasing familiarity between the&#xD;
        speaker and listener. The Artificial intelligence tool used in this study includes a speech&#xD;
        classifier trained to predict clinician judgment of American English &quot;r&quot; that is integrated&#xD;
        into an existing evidence-based treatment software called Speech Motor Chaining.&#xD;
      </textblock>
    </detailed_description>
    <overall_status>Not yet recruiting</overall_status>
    <start_date type="Anticipated">November 2023</start_date>
    <completion_date type="Anticipated">December 2027</completion_date>
    <primary_completion_date type="Anticipated">November 2027</primary_completion_date>
    <phase>N/A</phase>
    <study_type>Interventional</study_type>
    <has_expanded_access>No</has_expanded_access>
    <study_design_info>
      <allocation>Randomized</allocation>
      <intervention_model>Parallel Assignment</intervention_model>
      <intervention_model_description>Participants will be randomized across two conditions, CONCURRENT and SEQUENTIAL&#xD;
  Participants randomized to receive CONCURRENT treatment will receive speech lessons with a human clinician once per week for five weeks, along with 3 sessions per week of parent-supervised Chaining-AI (15 Chaining-AI sessions). Therefore, clinician-led and Chaining-AI are completed concurrently.&#xD;
  Participants randomized to receive SEQUENTIAL treatment will receive speech lessons with a human clinician once per week for five weeks, followed by three sessions per week of parent-supervised Chaining-AI for the NEXT five weeks. Therefore, clinician-led and Chaining-AI are completed sequentially.</intervention_model_description>
      <primary_purpose>Treatment</primary_purpose>
      <masking>Single (Outcomes Assessor)</masking>
      <masking_description>All perceptual ratings will be obtained from trained listeners who are blinded to treatment group and to timepoint. Binary rating of accuracy of the &quot;r&quot; sound (i.e., judgments of correct or incorrect) will be obtained from three listeners per token.</masking_description>
    </study_design_info>
    <primary_outcome>
      <measure>Change in percent correct for the /ɹ/ sound in untreated words, rated by blinded listeners.</measure>
      <time_frame>Before the initiation of treatment and again 5 weeks later.</time_frame>
      <description>To assess generalization of treatment gains to untreated words, participants will read a word list eliciting /ɹ/. Stimuli in each list will be presented individually in randomized order. Individual words will be isolated from the audio record of each word probe and presented in randomized order for perceptual rating by trained listeners who are blind to treatment condition and time point (but will see the written representation of each target word). We will use the change in percent correct as our primary measure of perceptually rated accuracy.</description>
    </primary_outcome>
    <secondary_outcome>
      <measure>Retention of percent correct for the /ɹ/ sound in untreated words, rated by blinded listeners.</measure>
      <time_frame>Before the initiation of treatment and again 10 weeks later.</time_frame>
      <description>To assess generalization of treatment gains to untreated words, participants will read a word list eliciting /ɹ/. Stimuli in each list will be presented individually in randomized order. Individual words will be isolated from the audio record of each word probe and presented in randomized order for perceptual rating by trained listeners who are blind to treatment condition and time point (but will see the written representation of each target word). We will use the change in percent correct as our primary measure of perceptually rated accuracy. The timeframe of 10 weeks differs from the primary outcome of 5 weeks, and assesses longer-term retention and captures the effects after both groups have received both interventions.</description>
    </secondary_outcome>
    <secondary_outcome>
      <measure>Change in percent correct for the /ɹ/ sound in untreated words, rated by blinded listeners.</measure>
      <time_frame>After 5 weeks of treatment and again 10 weeks later.</time_frame>
      <description>To assess generalization of treatment gains to untreated words, participants will read a word list eliciting /ɹ/. Stimuli in each list will be presented individually in randomized order. Individual words will be isolated from the audio record of each word probe and presented in randomized order for perceptual rating by trained listeners who are blind to treatment condition and time point (but will see the written representation of each target word). We will use the change in percent correct as our primary measure of perceptually rated accuracy. This timeframe compares the rate of improvement with Chaining-AI for the SEQUENTIAL group and the retention after a 5 week break for the CONCURRENT group.</description>
    </secondary_outcome>
    <secondary_outcome>
      <measure>Survey evaluating impacts of speech disorder on participants' social, emotional, and academic well-being.</measure>
      <time_frame>Before the initiation of treatment and again 5 weeks later.</time_frame>
      <description>This survey asks parents and participants to report the impact of speech disorder on their child's/their social, emotional, and academic well-being along a 5-point scale. A higher score indicates a greater degree of negative impact of speech disorder on social, emotional, or academic well-being.</description>
    </secondary_outcome>
    <secondary_outcome>
      <measure>Change in percent correct for the /ɹ/ sound in practiced words, rated by blinded listeners.</measure>
      <time_frame>Before the initiation of treatment and again 5 weeks later.</time_frame>
      <description>Participants will read word list eliciting /ɹ/ in practiced words to assess acquisition. Stimuli in each list will be presented individually in randomized order. Individual words will be isolated from the audio record of each word probe and presented in randomized order for perceptual rating by trained listeners who are blind to treatment condition and time point (but will see the written representation of each target word). We will use the change in percent correct as our primary measure of perceptually rated accuracy.</description>
    </secondary_outcome>
    <secondary_outcome>
      <measure>Change in percent correct for the /ɹ/ sound in practiced words, rated by blinded listeners.</measure>
      <time_frame>Before the initiation of treatment and again 10 weeks later.</time_frame>
      <description>Participants will read word list eliciting /ɹ/ in practiced words to assess acquisition. Stimuli in each list will be presented individually in randomized order. Individual words will be isolated from the audio record of each word probe and presented in randomized order for perceptual rating by trained listeners who are blind to treatment condition and time point (but will see the written representation of each target word). We will use the change in percent correct as our primary measure of perceptually rated accuracy. The timeframe of 10 weeks captures longer-term retention of practiced words and captures the effects after both groups have received both interventions.</description>
    </secondary_outcome>
    <secondary_outcome>
      <measure>Change in percent correct for the /ɹ/ sound in practiced words, rated by blinded listeners.</measure>
      <time_frame>After 5 weeks of treatment and again 10 weeks later.</time_frame>
      <description>Participants will read word list eliciting /ɹ/ in practiced words to assess acquisition. Stimuli in each list will be presented individually in randomized order. Individual words will be isolated from the audio record of each word probe and presented in randomized order for perceptual rating by trained listeners who are blind to treatment condition and time point (but will see the written representation of each target word). We will use the change in percent correct as our primary measure of perceptually rated accuracy. This timeframe compares the rate of improvement with Chaining-AI for the SEQUENTIAL group and the retention after a 5 week break for the CONCURRENT group.</description>
    </secondary_outcome>
    <number_of_arms>2</number_of_arms>
    <enrollment type="Anticipated">26</enrollment>
    <condition>Speech Sound Disorder</condition>
    <arm_group>
      <arm_group_label>CONCURRENT treatment order</arm_group_label>
      <arm_group_type>Experimental</arm_group_type>
      <description>5 speech lessons with a human speech-language clinician: 1 time per week for 5 weeks.&#xD;
  15 speech lessons with an AI clinician (supervised by the caregiver), 3 times per week DURING the same 5 weeks as the human clinician sessions.</description>
    </arm_group>
    <arm_group>
      <arm_group_label>SEQUENTIAL treatment order</arm_group_label>
      <arm_group_type>Experimental</arm_group_type>
      <description>5 speech lessons with a human speech-language clinician: 1 time per week for 5 weeks.&#xD;
  15 speech lessons with an AI clinician (supervised by the caregiver), 3 times per week for the 5 weeks AFTER the human clinician sessions end.</description>
    </arm_group>
    <intervention>
      <intervention_type>Behavioral</intervention_type>
      <intervention_name>Speech-Language Pathologist-led Speech Motor Chaining</intervention_name>
      <description>Sessions begin with Pre-practice to elicit the /r/ sound. During Structured Practice, the same utterance is practiced several times in a row (with systematic increases in difficulty based on performance). Our web-based software manipulates the principles of motor learning, including feedback prompts for the clinician, the complexity of the utterance, and the variability in the practice trial; the software will analyze the clinician's rating to increase the difficulty of practice when the child is more accurate. Randomized Practice will also be guided by the software and includes all linguistic levels that were produced correctly during Structured Practice, with items presented in random order. A trained speech-language pathologist is involved in all practice trials to provide feedback throughout the session.</description>
      <arm_group_label>CONCURRENT treatment order</arm_group_label>
      <arm_group_label>SEQUENTIAL treatment order</arm_group_label>
    </intervention>
    <intervention>
      <intervention_type>Behavioral</intervention_type>
      <intervention_name>Artificial Intelligence-led Speech Motor Chaining (CHAINING-AI)</intervention_name>
      <description>Sessions include Structured Practice and Randomized Practice using our web-based software with an Artificial Intelligence clinician to address the /r/ sound. Within a practice session, participants speak into a microphone, and the audio file is sent to a server to be analyzed by a classifier, which returns a binary accurate/inaccurate rating of productions in a fashion similar to SLP judgment. Our web-based software manipulates the principles of motor learning, including feedback prompts, the complexity of the utterance, and the variability in the practice trial. The software will analyze the child's accuracy as determined by the classifier to increase the difficulty of practice when the child is more accurate.</description>
      <arm_group_label>CONCURRENT treatment order</arm_group_label>
      <arm_group_label>SEQUENTIAL treatment order</arm_group_label>
    </intervention>
    <eligibility>
      <criteria>
        <textblock>
          Inclusion Criteria:&#xD;
  &#xD;
            -  Must speak a rhotic dialect of American English as a dominant language.&#xD;
  &#xD;
            -  Must have begun learning English by at least the age of 3 years.&#xD;
  &#xD;
            -  Must be between 9;0 to 17;11 years of age.&#xD;
  &#xD;
            -  Must have reported difficulty with /ɹ/ production.&#xD;
  &#xD;
            -  Must have reported hearing within normal limits.&#xD;
  &#xD;
            -  Must receive a Scaled Score of 5 or above on both the Listening Comprehension and&#xD;
               Story Retelling subtests from the Test of Integrated Language &amp; Literacy Skills&#xD;
               (TILLS).&#xD;
  &#xD;
            -  Must receive a percentile score of 8 or below on the Goldman-Fristoe Test of&#xD;
               Articulation-3 (GFTA-3) Sounds in Words subtest.&#xD;
  &#xD;
            -  Must have 1 scorable response with 5+ consecutive correct /pataka/ with &gt; 3.4&#xD;
               syllables per second in the MRR-Tri task of the Maximum Performance Tasks OR must&#xD;
               demonstrate no childhood apraxia of speech (CAS-only) features in BOTH articulatory&#xD;
               and rate/prosody domains of the ProCAD.&#xD;
  &#xD;
            -  Must score &lt;40% accurate based on word-level items from our /ɹ/ probe list.&#xD;
  &#xD;
            -  Must score &gt;=15% accuracy on /ɹ/ on 45 syllables following Dynamic Assessment.&#xD;
  &#xD;
            -  Must express interest in changing their /ɹ/ production.&#xD;
  &#xD;
            -  Must have oral structure and function that are appropriate for /ɹ/ production.&#xD;
  &#xD;
            -  Must have access to broadband internet with videoconferencing capabilities&#xD;
  &#xD;
          Exclusion Criteria:&#xD;
  &#xD;
            -  Must have no known history of autism spectrum disorder, Down Syndrome, cerebral palsy,&#xD;
               intellectual disability, permanent hearing loss, epilepsy/antiepileptic medication, or&#xD;
               brain injury/neurosurgery/stroke.&#xD;
  &#xD;
            -  Must not have diagnosis of attention deficit disorder, attention deficit hyperactivity&#xD;
               disorder, Tourette's, or Obsessive-compulsive disorder.&#xD;
  &#xD;
            -  Must have no orthodontic appliances that block the roof of the mouth (e.g., palate&#xD;
               expanders).&#xD;
  &#xD;
            -  Must not have current cleft palate, fluency disorder, or voice disorder.&#xD;
  &#xD;
            -  Must not demonstrate childhood apraxia of speech (CAS-only) features in BOTH&#xD;
               articulatory and rate/prosody domains of the ProCAD.&#xD;
        </textblock>
      </criteria>
      <gender>All</gender>
      <minimum_age>9 Years</minimum_age>
      <maximum_age>17 Years</maximum_age>
      <healthy_volunteers>Accepts Healthy Volunteers</healthy_volunteers>
    </eligibility>
    <overall_contact>
      <last_name>Jonathan Preston, PhD</last_name>
      <phone>315-443-1351</phone>
      <email>jopresto@syr.edu</email>
    </overall_contact>
    <overall_contact_backup>
      <last_name>Nina Benway, PhD</last_name>
      <email>nrbenway@syr.edu</email>
    </overall_contact_backup>
    <location>
      <facility>
        <name>Syracuse University</name>
        <address>
          <city>Syracuse</city>
          <state>New York</state>
          <zip>13244</zip>
          <country>United States</country>
        </address>
      </facility>
      <contact>
        <last_name>Jonathan Preston, PhD</last_name>
        <phone>315-443-3143</phone>
        <email>jopresto@syr.edu</email>
      </contact>
      <contact_backup>
        <last_name>Nicole Caballero, MS</last_name>
        <phone>315-443-1185</phone>
        <email>nfcaball@syr.edu</email>
      </contact_backup>
    </location>
    <location_countries>
      <country>United States</country>
    </location_countries>
    <link>
      <url>https://speechproductionlab.syr.edu/research/</url>
      <description>Lab website with recruitment information</description>
    </link>
    <verification_date>August 2023</verification_date>
    <study_first_submitted>August 4, 2023</study_first_submitted>
    <study_first_submitted_qc>August 4, 2023</study_first_submitted_qc>
    <study_first_posted type="Actual">August 14, 2023</study_first_posted>
    <last_update_submitted>August 4, 2023</last_update_submitted>
    <last_update_submitted_qc>August 4, 2023</last_update_submitted_qc>
    <last_update_posted type="Actual">August 14, 2023</last_update_posted>
    <responsible_party>
      <responsible_party_type>Sponsor</responsible_party_type>
    </responsible_party>
    <condition_browse>
      <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
      <mesh_term>Speech Sound Disorder</mesh_term>
    </condition_browse>
    <!-- Results have not yet been posted for this study                                          -->
  </clinical_study>
  
  
text: download date: ClinicalTrials.gov processed this data on September 20, 2023
  link text: Link to the current ClinicalTrials.gov record.
  url: https://clinicaltrials.gov/ct2/show/NCT05988515
  org study id: 22-426b
  secondary id: 1R01DC020959-01
  nct id: NCT05988515
  lead sponsor: 
  collaborator: 
  collaborator: 
  collaborator: 
  has dmc: Yes
  is fda regulated drug: No
  is fda regulated device: No
  The goal of this randomized-controlled trial is to determine how artificial
        intelligence-assisted home practice may enhance speech learning of the "r" sound in
        school-age children with residual speech sound disorders. All child participants will receive
        1 speech lesson per week, via telepractice, for 5 weeks with a human speech-language
        clinician. Some participants will receive 3 speech sessions per week with an Artificial
        Intelligence (AI)-clinician during the same 5 weeks as the human clinician sessions
        (CONCURRENT treatment order group), whereas others will receive 3 speech sessions per week
        with an AI-clinician after the human clinician sessions end (SEQUENTIAL treatment order
        group.
  Artificial Intelligence-assisted treatment that detects mispronunciations within an
        evidence-based motor learning framework could increase access to sufficiently intense,
        efficacious treatment despite provider shortages. A successful Artificial intelligencesystem
        that can predict the clinical gold standard of trained listeners' perceptions could not only
        improve access to clinical care but also mitigate known confounds to accurate clinical
        feedback, including clinical experience and drift due to increasing familiarity between the
        speaker and listener. The Artificial intelligence tool used in this study includes a speech
        classifier trained to predict clinician judgment of American English "r" that is integrated
        into an existing evidence-based treatment software called Speech Motor Chaining.
  allocation: Randomized
  intervention model: Parallel Assignment
  intervention model description: Participants will be randomized across two conditions, CONCURRENT and SEQUENTIAL
  Participants randomized to receive CONCURRENT treatment will receive speech lessons with a human clinician once per week for five weeks, along with 3 sessions per week of parent-supervised Chaining-AI (15 Chaining-AI sessions). Therefore, clinician-led and Chaining-AI are completed concurrently.
  Participants randomized to receive SEQUENTIAL treatment will receive speech lessons with a human clinician once per week for five weeks, followed by three sessions per week of parent-supervised Chaining-AI for the NEXT five weeks. Therefore, clinician-led and Chaining-AI are completed sequentially.
  primary purpose: Treatment
  masking: Single (Outcomes Assessor)
  masking description: All perceptual ratings will be obtained from trained listeners who are blinded to treatment group and to timepoint. Binary rating of accuracy of the "r" sound (i.e., judgments of correct or incorrect) will be obtained from three listeners per token.
  measure: Change in percent correct for the /ɹ/ sound in untreated words, rated by blinded listeners.
  time frame: Before the initiation of treatment and again 5 weeks later.
  description: To assess generalization of treatment gains to untreated words, participants will read a word list eliciting /ɹ/. Stimuli in each list will be presented individually in randomized order. Individual words will be isolated from the audio record of each word probe and presented in randomized order for perceptual rating by trained listeners who are blind to treatment condition and time point (but will see the written representation of each target word). We will use the change in percent correct as our primary measure of perceptually rated accuracy.
  measure: Retention of percent correct for the /ɹ/ sound in untreated words, rated by blinded listeners.
  time frame: Before the initiation of treatment and again 10 weeks later.
  description: To assess generalization of treatment gains to untreated words, participants will read a word list eliciting /ɹ/. Stimuli in each list will be presented individually in randomized order. Individual words will be isolated from the audio record of each word probe and presented in randomized order for perceptual rating by trained listeners who are blind to treatment condition and time point (but will see the written representation of each target word). We will use the change in percent correct as our primary measure of perceptually rated accuracy. The timeframe of 10 weeks differs from the primary outcome of 5 weeks, and assesses longer-term retention and captures the effects after both groups have received both interventions.
  measure: Change in percent correct for the /ɹ/ sound in untreated words, rated by blinded listeners.
  time frame: After 5 weeks of treatment and again 10 weeks later.
  description: To assess generalization of treatment gains to untreated words, participants will read a word list eliciting /ɹ/. Stimuli in each list will be presented individually in randomized order. Individual words will be isolated from the audio record of each word probe and presented in randomized order for perceptual rating by trained listeners who are blind to treatment condition and time point (but will see the written representation of each target word). We will use the change in percent correct as our primary measure of perceptually rated accuracy. This timeframe compares the rate of improvement with Chaining-AI for the SEQUENTIAL group and the retention after a 5 week break for the CONCURRENT group.
  measure: Survey evaluating impacts of speech disorder on participants' social, emotional, and academic well-being.
  time frame: Before the initiation of treatment and again 5 weeks later.
  description: This survey asks parents and participants to report the impact of speech disorder on their child's/their social, emotional, and academic well-being along a 5-point scale. A higher score indicates a greater degree of negative impact of speech disorder on social, emotional, or academic well-being.
  measure: Change in percent correct for the /ɹ/ sound in practiced words, rated by blinded listeners.
  time frame: Before the initiation of treatment and again 5 weeks later.
  description: Participants will read word list eliciting /ɹ/ in practiced words to assess acquisition. Stimuli in each list will be presented individually in randomized order. Individual words will be isolated from the audio record of each word probe and presented in randomized order for perceptual rating by trained listeners who are blind to treatment condition and time point (but will see the written representation of each target word). We will use the change in percent correct as our primary measure of perceptually rated accuracy.
  measure: Change in percent correct for the /ɹ/ sound in practiced words, rated by blinded listeners.
  time frame: Before the initiation of treatment and again 10 weeks later.
  description: Participants will read word list eliciting /ɹ/ in practiced words to assess acquisition. Stimuli in each list will be presented individually in randomized order. Individual words will be isolated from the audio record of each word probe and presented in randomized order for perceptual rating by trained listeners who are blind to treatment condition and time point (but will see the written representation of each target word). We will use the change in percent correct as our primary measure of perceptually rated accuracy. The timeframe of 10 weeks captures longer-term retention of practiced words and captures the effects after both groups have received both interventions.
  measure: Change in percent correct for the /ɹ/ sound in practiced words, rated by blinded listeners.
  time frame: After 5 weeks of treatment and again 10 weeks later.
  description: Participants will read word list eliciting /ɹ/ in practiced words to assess acquisition. Stimuli in each list will be presented individually in randomized order. Individual words will be isolated from the audio record of each word probe and presented in randomized order for perceptual rating by trained listeners who are blind to treatment condition and time point (but will see the written representation of each target word). We will use the change in percent correct as our primary measure of perceptually rated accuracy. This timeframe compares the rate of improvement with Chaining-AI for the SEQUENTIAL group and the retention after a 5 week break for the CONCURRENT group.
  arm group label: CONCURRENT treatment order
  arm group type: Experimental
  description: 5 speech lessons with a human speech-language clinician: 1 time per week for 5 weeks.
  15 speech lessons with an AI clinician (supervised by the caregiver), 3 times per week DURING the same 5 weeks as the human clinician sessions.
  arm group label: SEQUENTIAL treatment order
  arm group type: Experimental
  description: 5 speech lessons with a human speech-language clinician: 1 time per week for 5 weeks.
  15 speech lessons with an AI clinician (supervised by the caregiver), 3 times per week for the 5 weeks AFTER the human clinician sessions end.
  intervention type: Behavioral
  intervention name: Speech-Language Pathologist-led Speech Motor Chaining
  description: Sessions begin with Pre-practice to elicit the /r/ sound. During Structured Practice, the same utterance is practiced several times in a row (with systematic increases in difficulty based on performance). Our web-based software manipulates the principles of motor learning, including feedback prompts for the clinician, the complexity of the utterance, and the variability in the practice trial; the software will analyze the clinician's rating to increase the difficulty of practice when the child is more accurate. Randomized Practice will also be guided by the software and includes all linguistic levels that were produced correctly during Structured Practice, with items presented in random order. A trained speech-language pathologist is involved in all practice trials to provide feedback throughout the session.
  arm group label: CONCURRENT treatment order
  arm group label: SEQUENTIAL treatment order
  intervention type: Behavioral
  intervention name: Artificial Intelligence-led Speech Motor Chaining (CHAINING-AI)
  description: Sessions include Structured Practice and Randomized Practice using our web-based software with an Artificial Intelligence clinician to address the /r/ sound. Within a practice session, participants speak into a microphone, and the audio file is sent to a server to be analyzed by a classifier, which returns a binary accurate/inaccurate rating of productions in a fashion similar to SLP judgment. Our web-based software manipulates the principles of motor learning, including feedback prompts, the complexity of the utterance, and the variability in the practice trial. The software will analyze the child's accuracy as determined by the classifier to increase the difficulty of practice when the child is more accurate.
  arm group label: CONCURRENT treatment order
  arm group label: SEQUENTIAL treatment order
  criteria: 
  gender: All
  minimum age: 9 Years
  maximum age: 17 Years
  healthy volunteers: Accepts Healthy Volunteers
  last name: Jonathan Preston, PhD
  phone: 315-443-1351
  email: jopresto@syr.edu
  last name: Nina Benway, PhD
  email: nrbenway@syr.edu
  facility: 
  contact: 
  contact backup: 
  country: United States
  url: https://speechproductionlab.syr.edu/research/
  description: Lab website with recruitment information
  responsible party type: Sponsor
  mesh term: Speech Sound Disorder