Parent-led articulation therapy using recasts for deaf and hard-of-hearing children

Project PAIR: Parent-implemented Articulation Intervention With Recast

This project tests whether teaching parents to use Broad Treatment Speech Recast at home, alongside clinician-led articulation drills, helps elementary-aged deaf and hard-of-hearing children produce clearer speech sounds.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 10 (estimated)
• Ages: 4 Years to 10 Years
• Sex: All
• Sponsor: Vanderbilt University (Academic / other)
• Locations: 1 site (Nashville, Tennessee)
• Trial ID: NCT06936696 on ClinicalTrials.gov

What this trial studies

This single-case multiple-baseline across participants interventional design trains parents to deliver Broad Treatment Speech Recast (BTSR) at home while children receive traditional clinician-led drill-based articulation therapy. Speech sound production is measured repeatedly across baseline, intervention, and follow-up phases to identify changes and timing of effects. The study also examines whether improved speech accuracy generalizes to conversation-level speech. Eligible participants are 4;0–9;11-year-old children with permanent prelingual sensorineural hearing loss who use spoken English and meet cognitive and language screening cutoffs, and sessions are conducted at Vanderbilt University Medical Center.

Who should consider this trial

Good fit: Ideal candidates are children aged 4;0–9;11 with permanent, prelingual sensorineural hearing loss who primarily use spoken English, have standard scores ≥70 on the Leiter and OWLS-II listening comprehension, and show at least two stimulable speech sound errors without motor speech, structural oral, ASD, ADHD, or uncorrected vision problems.

Not a fit: Children with motor speech disorders, oral structural deficits (e.g., cleft palate), a diagnosis of autism spectrum disorder or ADHD, uncorrected vision impairment, or who do not use spoken English primarily are unlikely to benefit from this protocol.

Why it matters

Potential benefit: If successful, this combined parent-and-clinician approach could improve everyday speech clarity and conversational communication for deaf and hard-of-hearing children by increasing effective practice at home.

How similar studies have performed: Parent-implemented recast and parent-training approaches have shown promise for improving speech and language in some pediatric groups, but combining BTSR with concurrent clinician-led drill for elementary-aged DHH children is relatively novel with limited prior evidence.

Eligibility criteria

Inclusion Criteria:

* Age 4;0-9;11
* Permanent, prelingual sensorineural hearing loss
* Uses spoken English as their primary home language (≥ 51% of the time)
* Standard score ≥70 on the Leiter
* Standard score ≥70 on the OWLS-II Listening Comprehension
* At least two speech sound errors appropriate to target based on speech norms and general stimulability

Exclusion Criteria:

* Motor speech disorder (e.g., childhood apraxia of speech)
* Oral structural functional disorder (e.g., cleft palate)
* Diagnosis of autism spectrum disorder
* Diagnosis of ADHD
* Uncorrected vision impairment (i.e., identified vision loss without the use of corrective lenses)

Where this trial is running

Nashville, Tennessee

• Vanderbilt University Medical Center — Nashville, Tennessee, United States (Recruiting)

Study contacts

• Study coordinator: Meganne Muir

Conditions Hearing Impaired Children; deaf and hard of hearing; articulation; speech sound production; parent training; children