In the literature, /r/ is well documented as the most difficult sound to treat (Byun & Hitchcock, 2012), yet the research devoted to the remediation of this sound is limited. Surveys of school-based clinicians reveal /r/ treatment to be eclectic (Lancaster, Keusch, Levin, Pring, & Martin, 2010), even though Ehern (2010) reports less efficacy using an eclectic approach versus a programed approach. The most recent research for /r/ focuses on the use of ultrasound and biofeedback, but the cost of these technologies prohibits their mainstream use for nearly all clinicians, especially in the schools. The purpose of this study was to evaluate the efficacy of using anticipatory coarticulation with augmented feedback to increase accuracy of final /r/ words in people with speech sound disorders (SSDs). Anticipatory coarticulation in this study involved the addition of the word red after every final /r/ word and then specific augmented feedback was given for the participant to correct their production. A single-subject ABAB withdrawal design was implemented to assess the accuracy of productions of final /r/ words with red in four participants, ranging in age from 8;0 to 13;6 with a diagnosis of SSD. The accuracy of anticipatory coarticulation paired with augmented feedback was assessed in real time by the clinician and two interobservers (IOs) who listened to the audio recordings of the participants’ productions. According to the results, the participants improved their final /r/ productions during intervention phases as a function of anticipatory coarticulation and augmented feedback while returning to baseline level during the withdrawal phase. The data offer preliminary support for the use of anticipatory coarticulation in therapy for final /r/ words. The need for continued research is discussed as are the benefits and limitations encountered using telepractice.
Keywords: articulation disorder, speech sound disorder, persistent speech sound disorder, rhotics, anticipatory coarticulation, telepractice
