Speech Sound DisorderNCT05988515
AI-Assisted Treatment for Residual Speech Sound Disorders
A study testing Speech-Language Pathologist-led Speech Motor Chaining and Artificial Intelligence-led Speech Motor Chaining (CHAINING-AI) in people with Speech Sound Disorder, run by Syracuse University at 1 site in United States.
Trial summary
The goal of this randomized-controlled trial is to determine how artificial intelligence-assisted home practice may enhance speech learning of the "r" sound in school-age children with residual speech sound disorders. Read more about this study
- Who is it for?
- Ages 9 to 17 yearsHealthy volunteers can take part
- Conditions the study is for
- Speech Sound Disorder
- What is being tested?
- Speech-Language Pathologist-led Speech Motor Chaining and Artificial Intelligence-led Speech Motor Chaining (CHAINING-AI)
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 26 participants
- Where
- 1 siteUnited States
- Study dates
- 5 Sep 2024to 31 Dec 2027
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 9 to 17 years
- All sexes
- Healthy volunteers accepted
- Child
Who may be able to join
- Must speak a rhotic dialect of American English as a dominant language.
- Must have begun learning English by at least the age of 3 years.
- Must be between 9;0 to 17;11 years of age.
- Must have reported difficulty with /ɹ/ production.
- Must have reported hearing within normal limits.
- Must receive a Scaled Score of 5 or above on both the Listening Comprehension and Story Retelling subtests from the Test of Integrated Language \& Literacy Skills (TILLS).
Show all 13Show fewer
- Must receive a percentile score of 8 or below on the Goldman-Fristoe Test of Articulation-3 (GFTA-3) Sounds in Words subtest.
- Must have 1 scorable response with 5+ consecutive correct /pataka/ with > 3.4 syllables per second in the MRR-Tri task of the Maximum Performance Tasks OR must demonstrate no childhood apraxia of speech (CAS-only) features in BOTH articulatory and rate/prosody domains of the ProCAD.
- Must score <40% accurate based on word-level items from our /ɹ/ probe list.
- Must score >=15% accuracy on /ɹ/ on 45 syllables following Dynamic Assessment.
- Must express interest in changing their /ɹ/ production.
- Must have oral structure and function that are appropriate for /ɹ/ production.
- Must have access to broadband internet with videoconferencing capabilities
Who cannot join
- Must have no known history of autism spectrum disorder, Down Syndrome, cerebral palsy, intellectual disability, permanent hearing loss, epilepsy/antiepileptic medication, or brain injury/neurosurgery/stroke.
- Must not have diagnosis of attention deficit disorder, attention deficit hyperactivity disorder, Tourette's, or Obsessive-compulsive disorder.
- Must have no orthodontic appliances that block the roof of the mouth (e.g., palate expanders).
- Must not have current cleft palate, fluency disorder, or voice disorder.
- Must not demonstrate childhood apraxia of speech (CAS-only) features in BOTH articulatory and rate/prosody domains of the ProCAD.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Nina Benway, PhD contact
United States1 site, 1 recruiting
- Recruiting
Syracuse University
Syracuse, New York, 13244
Jonathan Preston, PhD, 315-443-3143, jopresto@syr.edu
Nicole Caballero, MS, 315-443-1185, nfcaball@syr.edu
About this study
The goal of this randomized-controlled trial is to determine how artificial intelligence-assisted home practice may enhance speech learning of the "r" sound in school-age children with residual speech sound disorders. All child participants will receive 1 speech lesson per week, via telepractice, for 5 weeks with a human speech-language clinician. Some participants will receive 3 speech sessions per week with an Artificial Intelligence (AI)-clinician during the same 5 weeks as the human clinician sessions (CONCURRENT treatment order group), whereas others will receive 3 speech sessions per week with an AI-clinician after the human clinician sessions end (SEQUENTIAL treatment order group.
Read the detailed description
Artificial Intelligence-assisted treatment that detects mispronunciations within an evidence-based motor learning framework could increase access to sufficiently intense, efficacious treatment despite provider shortages. A successful Artificial intelligencesystem that can predict the clinical gold standard of trained listeners' perceptions could not only improve access to clinical care but also mitigate known confounds to accurate clinical feedback, including clinical experience and drift due to increasing familiarity between the speaker and listener. The Artificial intelligence tool used in this study includes a speech classifier trained to predict clinician judgment of American English "r" that is integrated into an existing evidence-based treatment software called Speech Motor Chaining.
- Conditions
- Speech Sound Disorder
- Being tested
- Speech-Language Pathologist-led Speech Motor Chaining, Artificial Intelligence-led Speech Motor Chaining (CHAINING-AI)
- Medical subject headings
- Speech Sound Disorder
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Speech-Language Pathologist-led Speech Motor ChainingBehavioural
Sessions begin with Pre-practice to elicit the /r/ sound. During Structured Practice, the same utterance is practiced several times in a row (with systematic increases in difficulty based on performance). Our web-based software manipulates the principles of motor learning, including feedback prompts for the clinician, the complexity of the utterance, and the variability in the practice trial; the software will analyze the clinician's rating to increase the difficulty of practice when the child is more accurate. Randomized Practice will also be guided by the software and includes all linguistic levels that were produced correctly during Structured Practice, with items presented in random order. A trained speech-language pathologist is involved in all practice trials to provide feedback throughout the session.
Artificial Intelligence-led Speech Motor Chaining (CHAINING-AI)Behavioural
Sessions include Structured Practice and Randomized Practice using our web-based software with an Artificial Intelligence clinician to address the /r/ sound. Within a practice session, participants speak into a microphone, and the audio file is sent to a server to be analyzed by a classifier, which returns a binary accurate/inaccurate rating of productions in a fashion similar to SLP judgment. Our web-based software manipulates the principles of motor learning, including feedback prompts, the complexity of the utterance, and the variability in the practice trial. The software will analyze the child's accuracy as determined by the classifier to increase the difficulty of practice when the child is more accurate.
| Study group | Role | What they receive |
|---|---|---|
| CONCURRENT treatment order | Experimental | * 5 speech lessons with a human speech-language clinician: 1 time per week for 5 weeks.
* 15 speech lessons with an AI clinician (supervised by the caregiver), 3 times per week DURING the same 5 weeks as the human clinician sessions. Receives: Behavioral: Speech-Language Pathologist-led Speech Motor Chaining; Behavioral: Artificial Intelligence-led Speech Motor Chaining (CHAINING-AI) |
| SEQUENTIAL treatment order | Experimental | * 5 speech lessons with a human speech-language clinician: 1 time per week for 5 weeks.
* 15 speech lessons with an AI clinician (supervised by the caregiver), 3 times per week for the 5 weeks AFTER the human clinician sessions end. Receives: Behavioral: Speech-Language Pathologist-led Speech Motor Chaining; Behavioral: Artificial Intelligence-led Speech Motor Chaining (CHAINING-AI) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in percent correct for the /ɹ/ sound in untreated words, rated by blinded listeners.
To assess generalization of treatment gains to untreated words, participants will read a word list eliciting /ɹ/. Stimuli in each list will be presented individually in randomized order. Individual words will be isolated from the audio record of each word probe and presented in randomized order for perceptual rating by trained listeners who are blind to treatment condition and time point (but will see the written representation of each target word). We will use the change in percent correct as our primary measure of perceptually rated accuracy.
Measured: Before the initiation of treatment and again 5 weeks later.
Secondary outcomes (6)
Retention of percent correct for the /ɹ/ sound in untreated words, rated by blinded listeners.
To assess generalization of treatment gains to untreated words, participants will read a word list eliciting /ɹ/. Stimuli in each list will be presented individually in randomized order. Individual words will be isolated from the audio record of each word probe and presented in randomized order for perceptual rating by trained listeners who are blind to treatment condition and time point (but will see the written representation of each target word). We will use the change in percent correct as our primary measure of perceptually rated accuracy. The timeframe of 10 weeks differs from the primary outcome of 5 weeks, and assesses longer-term retention and captures the effects after both groups have received both interventions.
Measured: Before the initiation of treatment and again 10 weeks later.
Change in percent correct for the /ɹ/ sound in untreated words, rated by blinded listeners.
To assess generalization of treatment gains to untreated words, participants will read a word list eliciting /ɹ/. Stimuli in each list will be presented individually in randomized order. Individual words will be isolated from the audio record of each word probe and presented in randomized order for perceptual rating by trained listeners who are blind to treatment condition and time point (but will see the written representation of each target word). We will use the change in percent correct as our primary measure of perceptually rated accuracy. This timeframe compares the rate of improvement with Chaining-AI for the SEQUENTIAL group and the retention after a 5 week break for the CONCURRENT group.
Measured: After 5 weeks of treatment and again 10 weeks later.
Survey evaluating impacts of speech disorder on participants' social, emotional, and academic well-being.
This survey asks parents and participants to report the impact of speech disorder on their child's/their social, emotional, and academic well-being along a 5-point scale. A higher score indicates a greater degree of negative impact of speech disorder on social, emotional, or academic well-being.
Measured: Before the initiation of treatment and again 5 weeks later.
Change in percent correct for the /ɹ/ sound in practiced words, rated by blinded listeners.
Participants will read word list eliciting /ɹ/ in practiced words to assess acquisition. Stimuli in each list will be presented individually in randomized order. Individual words will be isolated from the audio record of each word probe and presented in randomized order for perceptual rating by trained listeners who are blind to treatment condition and time point (but will see the written representation of each target word). We will use the change in percent correct as our primary measure of perceptually rated accuracy.
Measured: Before the initiation of treatment and again 5 weeks later.
Change in percent correct for the /ɹ/ sound in practiced words, rated by blinded listeners.
Participants will read word list eliciting /ɹ/ in practiced words to assess acquisition. Stimuli in each list will be presented individually in randomized order. Individual words will be isolated from the audio record of each word probe and presented in randomized order for perceptual rating by trained listeners who are blind to treatment condition and time point (but will see the written representation of each target word). We will use the change in percent correct as our primary measure of perceptually rated accuracy. The timeframe of 10 weeks captures longer-term retention of practiced words and captures the effects after both groups have received both interventions.
Measured: Before the initiation of treatment and again 10 weeks later.
Change in percent correct for the /ɹ/ sound in practiced words, rated by blinded listeners.
Participants will read word list eliciting /ɹ/ in practiced words to assess acquisition. Stimuli in each list will be presented individually in randomized order. Individual words will be isolated from the audio record of each word probe and presented in randomized order for perceptual rating by trained listeners who are blind to treatment condition and time point (but will see the written representation of each target word). We will use the change in percent correct as our primary measure of perceptually rated accuracy. This timeframe compares the rate of improvement with Chaining-AI for the SEQUENTIAL group and the retention after a 5 week break for the CONCURRENT group.
Measured: After 5 weeks of treatment and again 10 weeks later.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted14 Aug 2023
- Study start5 Sep 2024
- Primary completion31 Dec 2027 (estimated)
- Study completion31 Dec 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Speech Sound DisorderStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Participants will be randomized across two conditions, CONCURRENT and SEQUENTIAL Participants randomized to receive CONCURRENT treatment will receive speech lessons with a human clinician once per week for five weeks, along with 3 sessions per week of parent-supervised Chaining-AI (15 Chaining-AI sessions). Therefore, clinician-led and Chaining-AI are completed concurrently. Participants randomized to receive SEQUENTIAL treatment will receive speech lessons with a human clinician once per week for five weeks, followed by three sessions per week of parent-supervised Chaining-AI for the NEXT five weeks. Therefore, clinician-led and Chaining-AI are completed sequentially.
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 26 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Syracuse University
- Sponsor type
- University, hospital or other
- Collaborators
- National Institutes of Health (NIH), State University of New York - Upstate Medical University, National Institute on Deafness and Other Communication Disorders (NIDCD)
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05988515
- Sponsor's protocol ID
- 22-426b
- Other IDs
- 1R01DC020959-01
- Status last verified
- Jan 2026
- First submitted
- 4 Aug 2023
- Last updated
- 8 Jan 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 8 Jan 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- AI-Assisted Treatment for Residual Speech Sound Disorders
- ClinicalTrials.gov ID
- NCT05988515
- Acronym / sponsor ID
- 22-426b
- Conditions
- Speech Sound Disorder
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 26 participants (estimated)
- Lead sponsor
- Syracuse UniversityUniversity, hospital or other
- Collaborators
- National Institutes of Health (NIH), State University of New York - Upstate Medical University, National Institute on Deafness and Other Communication Disorders (NIDCD)
- Study start
- 5 Sep 2024 (actual)
- Primary completion
- 31 Dec 2027 (estimated)
- Study completion
- 31 Dec 2027 (estimated)
- First posted
- 14 Aug 2023 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this randomized-controlled trial is to determine how artificial intelligence-assisted home practice may enhance speech learning of the "r" sound in school-age children with residual speech sound disorders. All child participants will receive 1 speech lesson per week, via telepractice, for 5 weeks with a human speech-language clinician. Some participants will receive 3 speech sessions per week with an Artificial Intelligence (AI)-clinician during the same 5 weeks as the human clinician sessions (CONCURRENT treatment order group), whereas others will receive 3 speech sessions per week with an AI-clinician after the human clinician sessions end (SEQUENTIAL treatment order group.
Detailed description
Artificial Intelligence-assisted treatment that detects mispronunciations within an evidence-based motor learning framework could increase access to sufficiently intense, efficacious treatment despite provider shortages. A successful Artificial intelligencesystem that can predict the clinical gold standard of trained listeners' perceptions could not only improve access to clinical care but also mitigate known confounds to accurate clinical feedback, including clinical experience and drift due to increasing familiarity between the speaker and listener. The Artificial intelligence tool used in this study includes a speech classifier trained to predict clinician judgment of American English "r" that is integrated into an existing evidence-based treatment software called Speech Motor Chaining.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
- Model description
- Participants will be randomized across two conditions, CONCURRENT and SEQUENTIAL Participants randomized to receive CONCURRENT treatment will receive speech lessons with a human clinician once per week for five weeks, along with 3 sessions per week of parent-supervised Chaining-AI (15 Chaining-AI sessions). Therefore, clinician-led and Chaining-AI are completed concurrently. Participants randomized to receive SEQUENTIAL treatment will receive speech lessons with a human clinician once per week for five weeks, followed by three sessions per week of parent-supervised Chaining-AI for the NEXT five weeks. Therefore, clinician-led and Chaining-AI are completed sequentially.
| Arm | Type | Receives |
|---|---|---|
| CONCURRENT treatment order | Experimental | Behavioral: Speech-Language Pathologist-led Speech Motor Chaining, Behavioral: Artificial Intelligence-led Speech Motor Chaining (CHAINING-AI)* 5 speech lessons with a human speech-language clinician: 1 time per week for 5 weeks. * 15 speech lessons with an AI clinician (supervised by the caregiver), 3 times per week DURING the same 5 weeks as the human clinician sessions. |
| SEQUENTIAL treatment order | Experimental | Behavioral: Speech-Language Pathologist-led Speech Motor Chaining, Behavioral: Artificial Intelligence-led Speech Motor Chaining (CHAINING-AI)* 5 speech lessons with a human speech-language clinician: 1 time per week for 5 weeks. * 15 speech lessons with an AI clinician (supervised by the caregiver), 3 times per week for the 5 weeks AFTER the human clinician sessions end. |
Who may qualify
- Ages
- 9 to 17 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child
Key inclusion criteria (13 listed)
- Must speak a rhotic dialect of American English as a dominant language.
- Must have begun learning English by at least the age of 3 years.
- Must be between 9;0 to 17;11 years of age.
- Must have reported difficulty with /ɹ/ production.
- Must have reported hearing within normal limits.
Key exclusion criteria (5 listed)
- Must have no known history of autism spectrum disorder, Down Syndrome, cerebral palsy, intellectual disability, permanent hearing loss, epilepsy/antiepileptic medication, or brain injury/neurosurgery/stroke.
- Must not have diagnosis of attention deficit disorder, attention deficit hyperactivity disorder, Tourette's, or Obsessive-compulsive disorder.
- Must have no orthodontic appliances that block the roof of the mouth (e.g., palate expanders).
- Must not have current cleft palate, fluency disorder, or voice disorder.
- Must not demonstrate childhood apraxia of speech (CAS-only) features in BOTH articulatory and rate/prosody domains of the ProCAD.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Speech-Language Pathologist-led Speech Motor ChainingSessions begin with Pre-practice to elicit the /r/ sound. During Structured Practice, the same utterance is practiced several times in a row (with systematic increases in difficulty based on performance). Our web-based software manipulates the principles of motor learning, including feedback prompts for the clinician, the complexity of the utterance, and the variability in the practice trial; the software will analyze the clinician's rating to increase the difficulty of practice when the child is more accurate. Randomized Practice will also be guided by the software and includes all linguistic levels that were produced correctly during Structured Practice, with items presented in random order. A trained speech-language pathologist is involved in all practice trials to provide feedback throughout the session. | Behavioural | CONCURRENT treatment order, SEQUENTIAL treatment order |
| Artificial Intelligence-led Speech Motor Chaining (CHAINING-AI)Sessions include Structured Practice and Randomized Practice using our web-based software with an Artificial Intelligence clinician to address the /r/ sound. Within a practice session, participants speak into a microphone, and the audio file is sent to a server to be analyzed by a classifier, which returns a binary accurate/inaccurate rating of productions in a fashion similar to SLP judgment. Our web-based software manipulates the principles of motor learning, including feedback prompts, the complexity of the utterance, and the variability in the practice trial. The software will analyze the child's accuracy as determined by the classifier to increase the difficulty of practice when the child is more accurate. | Behavioural | CONCURRENT treatment order, SEQUENTIAL treatment order |
Primary outcome
Change in percent correct for the /ɹ/ sound in untreated words, rated by blinded listeners.
Time frame: Before the initiation of treatment and again 5 weeks later.
To assess generalization of treatment gains to untreated words, participants will read a word list eliciting /ɹ/. Stimuli in each list will be presented individually in randomized order. Individual words will be isolated from the audio record of each word probe and presented in randomized order for perceptual rating by trained listeners who are blind to treatment condition and time point (but will see the written representation of each target word). We will use the change in percent correct as our primary measure of perceptually rated accuracy.
6 secondary outcomes
Retention of percent correct for the /ɹ/ sound in untreated words, rated by blinded listeners.
Time frame: Before the initiation of treatment and again 10 weeks later.
Change in percent correct for the /ɹ/ sound in untreated words, rated by blinded listeners.
Time frame: After 5 weeks of treatment and again 10 weeks later.
Survey evaluating impacts of speech disorder on participants' social, emotional, and academic well-being.
Time frame: Before the initiation of treatment and again 5 weeks later.
Change in percent correct for the /ɹ/ sound in practiced words, rated by blinded listeners.
Time frame: Before the initiation of treatment and again 5 weeks later.
Change in percent correct for the /ɹ/ sound in practiced words, rated by blinded listeners.
Time frame: Before the initiation of treatment and again 10 weeks later.
Change in percent correct for the /ɹ/ sound in practiced words, rated by blinded listeners.
Time frame: After 5 weeks of treatment and again 10 weeks later.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 8 Jan 2026.
- Lab website with recruitment informationLink provided by the sponsor.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Nina Benway, PhD contact
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Speech-Language Pathologist-led Speech Motor Chaining and Artificial Intelligence-led Speech Motor Chaining (CHAINING-AI) in people with Speech Sound Disorder, run by Syracuse University at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 13 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 8 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Jonathan Preston, PhD (315-443-1351, jopresto@syr.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in percent correct for the /ɹ/ sound in untreated words, rated by blinded listeners. (time frame: Before the initiation of treatment and again 5 weeks later.). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Jan 2026.