Project PAIR: Parent-implemented Articulation Intervention With Recast

Purpose

Using a single-case multiple baseline across participants design, this study aims to explore the effectiveness of parent-implemented Broad Treatment Speech Recast supplemented with traditional clinician-led articulation therapy on speech production in elementary-aged deaf and hard of hearing children. To address these objectives, the following research questions will be investigated: 1. Does drill-based articulation therapy, administered by a speech-language pathologist, improve speech sound production in DHH children when parent-implemented BTSR is concurrently utilized at home? 2. Does the combination of parent-implemented BTSR and clinician-led traditional articulation therapy result in generalization of speech sound accuracy at the conversation level?

Condition

  • Hearing Impaired Children

Eligibility

Eligible Ages
Between 4 Years and 10 Years
Eligible Sex
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • Age 4;0-9;11 - Permanent, prelingual sensorineural hearing loss - Uses spoken English as their primary home language (≥ 51% of the time) - Standard score ≥70 on the Leiter - Standard score ≥70 on the OWLS-II Listening Comprehension - At least two speech sound errors appropriate to target based on speech norms and general stimulability

Exclusion Criteria

  • Motor speech disorder (e.g., childhood apraxia of speech) - Oral structural functional disorder (e.g., cleft palate) - Diagnosis of autism spectrum disorder - Diagnosis of ADHD - Uncorrected vision impairment (i.e., identified vision loss without the use of corrective lenses)

Study Design

Phase
N/A
Study Type
Interventional
Allocation
N/A
Intervention Model
Single Group Assignment
Intervention Model Description
Single case multiple baseline across participants
Primary Purpose
Treatment
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Articulation Therapy 		Participants engage in two conditions: (1) Parent-implemented Broad Target Speech Recast (BTSR), (2) Parent-implemented BTSR combined with clinician-implemented speech therapy This is a nonconcurrent multiple probe single-case experimental design with staggered introduction of conditions across participants. All participants receive both interventions, but the interventions are introduced in separate phases and evaluated independently and in combination. This is not a crossover or parallel group design. Rather than having separate arms or randomization, each participant serves as their own control over time, allowing for individualized evaluation of intervention effects.
  • Behavioral: Broad Target Speech Recast
    Broad Target Speech Recasts (BTSR) is a speech intervention technique in which an adult immediately recasts a child's incorrect articulation by providing a corrected version of the word in a naturalistic, meaningful context. Unlike traditional articulation therapy, which focuses on isolated sound drills, BTSR integrates correction seamlessly into conversation without requiring the child to repeat or imitate the model. This approach is rooted in principles of implicit learning, where repeated exposure to accurate speech models facilitates phonological development over time. BTSR differs from traditional minimal pair or phonetic placement techniques in that it does not involve explicit instruction or direct prompts for self-correction. Instead, it provides high-frequency, naturalistic exposure to correct phoneme production within functional language use.
    Other names:
    • BTSR
  • Behavioral: Traditional Speech Therapy
    Traditional Speech Therapy is clinician-led and includes structured, drill-based approaches. Techniques such as placement cues, direct feedback, and reinforcement are used to help children achieve correct articulation. The structured nature of this approach is often more effective in remediating persistent speech errors than parent-implemented strategies alone. This study examines whether the combination of parent-implemented BTSR and clinician-led traditional articulation therapy leads to improved speech sound production and long-term maintenance of correct articulation in elementary-aged DHH children.

Recruiting Locations

Vanderbilt University Medical Center
Nashville, Tennessee 37232
Contact:
Jena McDaniel, PhD
(615) 936-5114
jena.mcdaniel@vumc.org

More Details

Status
Recruiting
Sponsor
Vanderbilt University

Study Contact

Meganne Muir
330-814-1748
meganne.muir@vanderbilt.edu

For general questions about clinical trials, contact Research Support Services at (615) 322-7343 or research.support.services@vumc.org