An interventional study of Speech-Language Pathologist-led Speech Motor Chaining and Artificial Intelligence-led Speech Motor Chaining (CHAINING-AI) in Speech Sound Disorder, sponsored by Syracuse University. Recruiting at 1 site in United States. Open to participants aged 9 Years to 17 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-01-08.
Sponsored by Syracuse University · Not applicable, Interventional, and Treatment
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.
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.
46 studies on the registry are indexed under Speech Sound Disorder; 16 are open to participants now.
This study's planned enrollment of 26 is below the median of 40 across 39 interventional studies indexed under Speech Sound Disorder.
Browse Speech Sound Disorder studies →Syracuse University is the lead sponsor of 33 studies on the registry; 7 are open to participants now.
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Exclusion Criteria:
* 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.
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.
Behavioral: Speech-Language Pathologist-led Speech Motor Chaining · Behavioral: Artificial Intelligence-led Speech Motor Chaining (CHAINING-AI)
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.
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.
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.
Time frame: Before the initiation of treatment and again 5 weeks later.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Time frame: After 5 weeks of treatment and again 10 weeks later.
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