Visual–acoustic biofeedback: Speech training (Hitchcock et al., 2023)

Purpose: This tutorial summarizes current practices using visual–acoustic biofeedback (VAB) treatment to improve speech outcomes for individuals with speech sound difficulties. Clinical strategies will focus on residual distortions of /ɹ/. Method: Summary evidence related to the characteristics of VAB and the populations that may benefit from this treatment are reviewed. Guidelines are provided for clinicians on how to use VAB with clients to identify and modify their productions to match an acoustic representation. The clinical application of a linear predictive coding spectrum is emphasized. Results: Successful use of VAB requires several key factors including clinician and client comprehension of the acoustic representation, appropriate acoustic target and template selection, as well as appropriate selection of articulatory strategies, practice schedules, and feedback models to scaffold acquisition of new speech sounds. Conclusion: Integrating a VAB component in clinical practice offers additional intervention options for individuals with speech sound difficulties and often facilitates improved speech sound acquisition and generalization outcomes. Supplemental Material S1. Video of a participant changing vowels using VAB. Supplemental Material S2. Video demonstrating template and window selection. Supplemental Material S3. Video of introduction script for /ɹ/. Supplemental Material S4. Video introducing staRt app. Supplemental Material S5. Video of teaching example for /ɹ/ using VAB. Hitchcock, E. R., Ochs, L. C., Swartz, M. T., Leece, M. C., Preston, J. L., & McAllister, T. (2023). Tutorial: Using visual–acoustic biofeedback for speech sound training. American Journal of Speech-Language Pathology, 32(1), 18–36. https://doi.org/10.1044/2022_AJSLP-22-00142