Doctor of Philosophy, Case Western Reserve University, 2018, Communication Sciences

Purpose: Although most children with speech sound disorders are able to remediate their errors, some individuals have errors that persist into late childhood and even adulthood. These individuals are considered to have residual speech sound errors (RSSEs), and they are at risk for social, academic, and employment difficulties. Most individuals with RSSEs have participated in years of traditional speech therapy with little success. Visual biofeedback provides an alternative method of treatment that may be what finally allows these individuals to remediate their errors. This study utilized Opti-Speech, a visual biofeedback software that uses electromagnetic articulography to create a threedimensional rendering of the tongue that moves in real time with the participant's own tongue, for the remediation of RSSEs. Method: This single subject multiple baseline design included 18 participants (11 males and 7 females) who ranged from 8 -22 years of age. Speech sounds addressed in treatment included "r", "s", "sh", "ch", and "l". Participants attended an average of three baseline sessions and ten treatment sessions that utilized Opti-Speech visual biofeedback, and returned for a two-month follow-up. Results: Perceptual measures were based on generalization to untreated words. Eleven of the 18 participants were able to make clinically significant improvements for their target sound by their final treatment session, and 11 of 16 participants who returned for follow19 up measures had made clinically significant improvement on their target sound. When final session perceptual ratings were compared to follow-up, eight of the nine participants who presented with clinically significant improvement for their target sound were able to maintain their progress or presented with significantly improved speech sound skills. However, generalization was not seen at the sentence level. When considered as a group, clinically significant improvements were seen overal (open full item for complete abstract)

Committee: Jennell Vick Ph.D. (Committee Chair); Barbara Lewis Ph.D. (Committee Member); Elizabeth Short Ph.D. (Committee Member); Gregory Lee Ph.D. (Committee Member); Parrill Fey Ph.D. (Committee Member) Subjects: Speech Therapy

PhD, University of Cincinnati, 2016, Allied Health Sciences: Communication Sciences and Disorders

Listeners' speech perception abilities appear to relate to their production abilities, but in investigations of older children with speech disorders, there is a surprising lack of consensus about perceptual difficulties that correspond to production. In this investigation, I focus on the American English rhotic /r/, which is one of the later-developing sounds in the language, with some children acquiring automatic production of the sound as late as age 9. It is also one of the most common errors in children and one of the most resistant to remediation. It is possible that, given that children with RSE have deficits in phonological processing skills, speech perception skills may also show deficits. To investigate this, three category goodness judgment experiments were devised. These tasks all required listeners to judge /r/ sounds along a distribution of natural speech words, where endpoints are “very good” and “very bad” productions. The distribution of productions was created using an acoustic parameter (the third formant) normalized to account for vocal tract differences. The three tasks demonstrated that the distribution of natural speech /r/ productions formed by normalized third formants was strongly associated with category goodness judgments of /r/ in adult listeners, but children with RSEs and age-matched controls made significantly different judgments. Children with RSE make more accurate category goodness judgments when listening to speech from other children versus their own speech. Category goodness judgments also did not correlate with /r/ production abilities after a course of ultrasound biofeedback therapy. Taken together, these results suggest that category goodness judgments (especially judgments of sounds like /r/) may be difficult for children regardless of disorder status, where they do not achieve adultlike performance even into the second decade of life. In addition, due to the significant interaction between effect of talker identity a (open full item for complete abstract)

Committee: Suzanne Boyce Ph.D. (Committee Chair); Noah H. Silbert Ph.D. (Committee Member); Tara McAllister Byun Ph.D. (Committee Member); Carolyn Sotto Ph.D. (Committee Member) Subjects: Speech Therapy