Retroflex versus bunched in treatment for rhotic misarticulation: evidence from ultrasound biofeedback intervention

J Speech Lang Hear Res. 2014 Dec;57(6):2116-30. doi: 10.1044/2014_JSLHR-S-14-0034.


Purpose: To document the efficacy of ultrasound biofeedback treatment for misarticulation of the North American English rhotic in children. Because of limited progress in the first cohort, a series of two closely related studies was conducted in place of a single study. The studies differed primarily in the nature of tongue-shape targets (e.g., retroflex, bunched) cued during treatment.

Method: Eight participants received 8 weeks of individual ultrasound biofeedback treatment targeting rhotics. In Study 1, all 4 participants were cued to match a bunched tongue-shape target. In Study 2, participants received individualized cues aimed at eliciting the tongue shape most facilitative of perceptually correct rhotics.

Results: Participants in Study 1 showed only minimal treatment effects. In Study 2, all participants demonstrated improved production of rhotics in untreated words produced without biofeedback, with large to very large effect sizes.

Conclusions: The results of Study 2 indicate that with proper parameters of treatment, ultrasound biofeedback can be a highly effective intervention for children with persistent rhotic errors. In addition, qualitative comparison of Studies 1 and 2 suggests that treatment for the North American English rhotic should include opportunities to explore different tongue shapes, to find the most facilitative variant for each individual speaker.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Articulation Disorders / physiopathology
  • Articulation Disorders / therapy*
  • Biofeedback, Psychology / methods*
  • Child
  • Cues
  • Female
  • Humans
  • Language
  • Male
  • North America
  • Speech Sound Disorder / physiopathology
  • Speech Sound Disorder / therapy*
  • Speech Therapy / methods*
  • Tongue
  • Ultrasonography / methods