The Effectiveness of Ultrasound Visual Biofeedback in Articulation Therapy for Children and Adolescents with Speech Sound Disorders: A Systematic Review and Meta-Analysis
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| Format: | Recurso educativo Open Access |
| Language: | en |
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2026
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| author | Oi Yan Yiu Wilfred Hing Sang Wong Felicia Pokta Agnes Yun Ting Fong Winnie Wan Yee Tso Patrick Ip |
| author_facet | Oi Yan Yiu Wilfred Hing Sang Wong Felicia Pokta Agnes Yun Ting Fong Winnie Wan Yee Tso Patrick Ip Oi Yan Yiu Wilfred Hing Sang Wong Felicia Pokta Agnes Yun Ting Fong Winnie Wan Yee Tso Patrick Ip |
| collection | Education Resources Information Center |
| contents | The Effectiveness of Ultrasound Visual Biofeedback in Articulation Therapy for Children and Adolescents with Speech Sound Disorders: A Systematic Review and Meta-Analysis Oi Yan Yiu Wilfred Hing Sang Wong Felicia Pokta Agnes Yun Ting Fong Winnie Wan Yee Tso Patrick Ip Acoustics Diagnostic Tests Biofeedback Speech Therapy Articulation (Speech) Speech Impairments Children Adolescents Meta Analysis Intelligibility Outcomes of Treatment Accuracy Background: Speech sound disorders (SSD) may compromise speech intelligibility in children and adolescents, impacting communication, social interactions and academic performance. Ultrasound visual biofeedback (U-VBF) has emerged as a promising tool for articulation therapy, providing real-time tongue movement visualization, yet its evidence base requires updating given methodological advancements. Aims: This systematic review and meta-analysis updates the evidence for the effectiveness of the use of U-VBF in improving articulation accuracy for paediatric SSD, synthesizing recent studies with robust designs to quantify outcomes and inform clinical adoption. Methods: Following PRISMA guidelines, a preregistered review (PROSPERO: CRD42024627408) involved searching PubMed, Web of Science, CINAHL Plus, Cochrane Library and Linguistics and Language Behaviour Abstracts (January 2000-July 2025) for studies on U-VBF in children and adolescents (≤18 years) with SSD, using all designs with articulation accuracy outcomes. Three reviewers used Covidence for study selection, data extraction and risk of bias assessment. Busk and Serlin's d2 effect sizes at the study level were calculated where possible for random-effects meta-analysis. Main Contribution: From 545 references, 35 studies (192 unique participants, aged 4-18) were included (16 for meta-analysis). The pooled d2 was 1.32 (95% CI [0.54, 2.10]), indicating substantial improvements in accuracy despite high heterogeneity (Q = 494.36, p < 0.001; I² = 97.0%) and variability (range -0.26 to 4.78). SSD subtype-specific patterns and intensity influences emerged, but small samples limited subgroup analyses. Funnel asymmetry (z = 2.478, p = 0.013) suggested potential publication bias. Implications include enhanced intensity reporting for personalized protocols, though generalizability is restricted by factors including the predominance of English-speaking participants. Conclusions: Evidence indicates that U-VBF is promising for SSD articulation therapy, supported by stronger designs post-2019. Future RCTs, non-English studies and standardized reporting are essential to mitigate bias and refine individualized applications. |
| format | Recurso educativo Open Access |
| id | eric_EJ1500586 |
| institution | ERIC Institute of Education Sciences |
| language | en |
| publishDate | 2026 |
| record_format | eric |
| spellingShingle | The Effectiveness of Ultrasound Visual Biofeedback in Articulation Therapy for Children and Adolescents with Speech Sound Disorders: A Systematic Review and Meta-Analysis Oi Yan Yiu Wilfred Hing Sang Wong Felicia Pokta Agnes Yun Ting Fong Winnie Wan Yee Tso Patrick Ip Acoustics Diagnostic Tests Biofeedback Speech Therapy Articulation (Speech) Speech Impairments Children Adolescents Meta Analysis Intelligibility Outcomes of Treatment Accuracy The Effectiveness of Ultrasound Visual Biofeedback in Articulation Therapy for Children and Adolescents with Speech Sound Disorders: A Systematic Review and Meta-Analysis Oi Yan Yiu Wilfred Hing Sang Wong Felicia Pokta Agnes Yun Ting Fong Winnie Wan Yee Tso Patrick Ip Acoustics Diagnostic Tests Biofeedback Speech Therapy Articulation (Speech) Speech Impairments Children Adolescents Meta Analysis Intelligibility Outcomes of Treatment Accuracy Background: Speech sound disorders (SSD) may compromise speech intelligibility in children and adolescents, impacting communication, social interactions and academic performance. Ultrasound visual biofeedback (U-VBF) has emerged as a promising tool for articulation therapy, providing real-time tongue movement visualization, yet its evidence base requires updating given methodological advancements. Aims: This systematic review and meta-analysis updates the evidence for the effectiveness of the use of U-VBF in improving articulation accuracy for paediatric SSD, synthesizing recent studies with robust designs to quantify outcomes and inform clinical adoption. Methods: Following PRISMA guidelines, a preregistered review (PROSPERO: CRD42024627408) involved searching PubMed, Web of Science, CINAHL Plus, Cochrane Library and Linguistics and Language Behaviour Abstracts (January 2000-July 2025) for studies on U-VBF in children and adolescents (≤18 years) with SSD, using all designs with articulation accuracy outcomes. Three reviewers used Covidence for study selection, data extraction and risk of bias assessment. Busk and Serlin's d2 effect sizes at the study level were calculated where possible for random-effects meta-analysis. Main Contribution: From 545 references, 35 studies (192 unique participants, aged 4-18) were included (16 for meta-analysis). The pooled d2 was 1.32 (95% CI [0.54, 2.10]), indicating substantial improvements in accuracy despite high heterogeneity (Q = 494.36, p < 0.001; I² = 97.0%) and variability (range -0.26 to 4.78). SSD subtype-specific patterns and intensity influences emerged, but small samples limited subgroup analyses. Funnel asymmetry (z = 2.478, p = 0.013) suggested potential publication bias. Implications include enhanced intensity reporting for personalized protocols, though generalizability is restricted by factors including the predominance of English-speaking participants. Conclusions: Evidence indicates that U-VBF is promising for SSD articulation therapy, supported by stronger designs post-2019. Future RCTs, non-English studies and standardized reporting are essential to mitigate bias and refine individualized applications. |
| title | The Effectiveness of Ultrasound Visual Biofeedback in Articulation Therapy for Children and Adolescents with Speech Sound Disorders: A Systematic Review and Meta-Analysis |
| topic | Acoustics Diagnostic Tests Biofeedback Speech Therapy Articulation (Speech) Speech Impairments Children Adolescents Meta Analysis Intelligibility Outcomes of Treatment Accuracy |
| url | https://eric.ed.gov/?id=EJ1500586 |