Jessie O'Brian

Faculty Advisor

Julie Hanks

Document Type


Publication Date



The purpose of this intervention study is to answer the following clinical question: In school-aged children with residual rhotic speech sound errors, is visual biofeedback during speech motor chaining therapy more effective in improving speech sound accuracy than traditional articulation therapy? The researcher will be implementing speech motor chaining therapy with visual-acoustic biofeedback using the iOS app Speech Therapist’s App for /r/ Treatment (staRt). This biofeedback application provides a dynamic visual display of the formant or resonant frequencies of the tract. For children with speech sound disorders, biofeedback therapy provides a visual representation of articulatory movements during speech in order to modify speech sound errors. This topic was chosen due to the limited research available and the possibility that these visual supports could be useful for individuals with motor speech impairments to understand correct versus incorrect production of speech. Since /r/ is a speech sound that is visually difficult to see how it is produced, it may be beneficial for an individual to get visual-acoustic biofeedback in order to understand where they need to place their articulators and therefore what correct placement feels like. The desired outcomes include improvement in /r/ production accuracy and generalization to phonetically similar sequences. The progress of the intervention is currently in the transitional stage from traditional articulation therapy to biofeedback and speech motor chaining. Data has been collected for 16 sessions (2x/week for 45 minutes) with the use of traditional articulation therapy and now the research is beginning implementation of “staRt” with speech motor chaining therapy for an additional 14 sessions (2x/week for 45 minutes) for an 8-year-old female at the UNC Speech-Language Pathology and Audiology Clinic. The researcher will be targeting the phonemic productions of /rɑ/ and /ri/ for the purpose of the study.