Intensive treatment for persisting rhotic distortions (Preston & Leece, 2017)

<b>Purpose:</b> The study explored changes in accuracy of American English rhotics as a result of an intensive 1-week therapy program for adolescents and young adults with residual speech sound errors that had not resolved with previous therapy.<b>Method: </b>Four case reports are presented of individuals aged 13, 17, 21, and 22 years with residual /ɹ/ distortions. Each participant attended a 1-week intensive program consisting of pretreatment assessments, 14 hr of therapy, and posttreatment assessment. Treatment sessions included structured motor-based practice, ultrasound visual feedback of the tongue, and auditory speech perception training. To assess generalization, untreated words and sentences with rhotics were recorded before and after therapy; these were rated by listeners who were blind to when the recordings were taken.<b>Results: </b>All participants showed measurable and statistically significant improvement in speech sound accuracy. Averaged across the 4 participants, rhotic accuracy at the word level improved from 35% to 83%. At the sentence level, rhotic accuracy increased from 11% pretreatment to 66% posttreatment in 1 week.<b>Conclusion: </b>The promise of an intensive treatment program that includes motor-based practice, biofeedback, and auditory perception training is illustrated by the case presentations in which substantial improvements in speech sound accuracy were observed.<b><br></b><b>Supplemental Material S1.</b> Video example of prepractice, the first phase of treatment, which involved eliciting 12 correct syllable-level targets. <br><b>Supplemental Material S2. </b>Sample video of structured chaining practice with ultrasound feedback.<b><br></b><b>Supplemental Material S3.</b> Sample video of structured chaining practice without ultrasound feedback.<br><b>Supplemental Material S4. </b>Samples of pretreatment and posttreatment generalization probes.<br> <b>Supplemental Material S5. </b>Sample datasheet with the feedback schedule and sample stimuli.<br> <b>Supplemental Material S6. </b>Generalization probe lists, which were used to track progress. <br>Preston, J. L., &amp; Leece, M. C. (2017). Intensive treatment for persisting rhotic distortions: A case series. <i>American Journal of Speech-Language Pathology, 26, </i>1066–1079<i>.</i> https://doi.org/10.1044/2017_AJSLP-16-0232