Groundbreaking Speech Therapy Research Helps Child Master The ‘R' Sound In Weeks: Montclair State University

Press release from Montclair State University:

Eight-year-old Colette Fougere is finally learning to pronounce her ‘r’ sounds after just a few weeks of a new speech-language therapy intervention at Montclair State University’s Speech-Language Pathology Clinic. Working closely with a graduate student researcher and using visual-acoustic biofeedback technology created by Communication Sciences and Disorders Chairperson Elaine Hitchcock, Colette is rediscovering what professionals in the field call “the lost ‘r,’ ”a common speech sound error in school-age children.

“Colette has made tremendous progress,” says SLP graduate student researcher Alexis Gallagher, who has been working with her throughout the study. “It can be disheartening in the beginning because they’re trying something new, and it’s not changing. Then, I think it was session four or five, suddenly, there was the ‘r’ sound. It’s thrilling.”

The software program they are using was designed by Hitchcock, a leading expert in speech-sound disorders, who, along with more than 20 colleagues across 3 universities, published “gold-standard evidence that biofeedback accelerates early progress with children” in the Journal of Speech, Language, and Hearing Research.

A Rapid Breakthrough for a Young Learner

After nearly three years of school-based therapy in Florida, improvement on the ‘r’ sound remained painfully slow for Colette, a general indicator of a Residual Speech Sound Disorder (RSSD). “While she’d made gains with other sounds, we just never saw progress with the ‘r’ sound,” says Colette’s mother, Meghan Fougere, a speech language pathologist herself. A 2014 Montclair SLP alumna, she also tried helping her daughter.

“I kept thinking, ‘I can fix it,’ and I wasn’t fixing it. I had done my best at home with her until she realized that she didn’t want her mommy working on her speech sounds with her. She wanted me to just be mommy.”

After moving back to New Jersey and before investing in private therapy, Fougere reached out to her former professor, Hitchcock—who invited Colette to participate in a new research project using biofeedback technology. “In just a few weeks, we started hearing a difference,” Fougere says.

Hitchcock says: “We managed to create this pilot study for Colette to work on a sound that has long been difficult for her, but to also work on a developing aspect of our treatment program.” Hitchcock’s research is funded by a National Institutes of Health (NIH) grant focused on improving children’s speech therapy. The goal is to better understand how kids hear and produce speech sounds, and to see whether new visual biofeedback tools and listening-based training work just as well online as they do in person. So far, more than 100 children ages 8 to 18 have taken part in the study. Gallagher then applied for—and received—a Montclair Graduate Student Research Award to move the pilot program forward.

How the Game-Changing Technology Works

The visual-acoustic biofeedback software program provides a real-time display of Colette’s ‘r’ compared to a target representing the desired output, enabling her to both hear and see when she pronounces her ‘r’ correctly. Biofeedback has shown promising results in people with RSSD who have not responded to previous treatments.

More traditional motor-based treatment for speech disorders often relies on imitation, sound modeling or props such as a mouth-and-tongue puppet. But the ‘r’ sound is uniquely challenging: there is no single right tongue placement, as partly evidenced by 22 different ultrasound images of ‘r’ production pinned to the wall where Colette practices.

“We’ve had a lot of success in situations that have not been successful before with the use of visual biofeedback,” Hitchcock explains. “They’re using the biofeedback as a way to ‘see’ if they’re saying the sound correctly; we’re working around a flawed auditory feedback system to utilize the visual system.”

Why Early Speech Intervention Matters

Many children struggle with but self-correct the R sound. When the issue persists, however, it can become problematic when teasing or frustration begins and lead to obstacles in both social and academic environments.

The biofeedback technology “is more effective, and a faster means to an end,” says Hitchcock.
The stakes are surprisingly high. Left unaddressed, speech sound disorders and articulation challenges can affect people well into adulthood—impacting confidence, relationships and even income, says Hitchcock. “So, across the lifespan, it’s a surprisingly large impact, given that it can be as simple as one sound error.”

Montclair’s SLP Nationally Recognized Program Offers Research Opportunities

The long-term goal is to train clinicians in the effective use of biofeedback technology including in telehealth practices, making speech therapy more accessible to people, including in rural areas, who may need treatment for speech sound disorders.

Montclair State University’s Speech-Language Pathology program is nationally recognized for integrating clinical training with faculty-led research, giving graduate students hands-on experience with innovative treatments like visual biofeedback. Currently, Montclair is vetting an app developed by an NYU researcher, which could be more accessible to clinicians.

Making a Lasting Impact as an SLP Graduate Student

For Gallagher, the project is more than just a research opportunity—it’s personal. A former theater, TV and film actor who changed careers post-COVID, she came to Montclair specifically to work with Hitchcock. She also witnessed firsthand the life- changing impact that speech therapy had on her own daughter, who overcame similar speech difficulties as Colette’s.

Gallagher explains that Montclair offers her “a biofeedback clinic where you can learn” from one of the best researchers in the field. “She literally wrote the program we were doing. Why would I not take the opportunity to learn how to teach a child how to do their Rs using this equipment when the author of it is standing over my shoulder, training me, helping me, guiding me?”

While Colette can now produce her ‘r’s in syllables, words and phrases, she occasionally slips back into losing the ‘r’ in casual conversation and will continue working with the research therapist in the spring, until Gallagher graduates with a master’s in SLP.

Meanwhile, Gallagher is determined to make a difference for Colette. “I know what that feels like as a parent, it’s devastating,” she says, “I want to help this child.”

Story by Sylvia A. Martinez

Ready to shape the future of speech-language pathology? Apply to Montclair’s SLP graduate program. Explore other nationally ranked programs, visit campus, connect with an advisor, or apply today.

This press release was produced by Montclair State University. The views expressed here are the author’s own.