Enhancing generalisation in biofeedback intervention using the challenge point framework: A case study

Elaine R. Hitchcock, Tara Mcallister Byun

Research output: Contribution to journalArticle

21 Scopus citations


Biofeedback intervention can help children achieve correct production of a treatment-resistant error sound, but generalisation is often limited. This case study suggests that generalisation can be enhanced when biofeedback intervention is structured in accordance with a "challenge point" framework for speech-motor learning. The participant was an 11-year-old with residual /r/ misarticulation who had previously attained correct /r/ production through a structured course of ultrasound biofeedback treatment but did not generalise these gains beyond the word level. Treatment difficulty was adjusted in an adaptive manner following predetermined criteria for advancing, maintaining, or moving back a level in a multidimensional hierarchy of functional task complexity. The participant achieved and maintained virtually 100% accuracy in producing /r/ at both word and sentence levels. These preliminary results support the efficacy of a semi-structured implementation of the challenge point framework as a means of achieving generalisation and maintenance of treatment gains.

Original languageEnglish
Pages (from-to)59-75
Number of pages17
JournalClinical Linguistics and Phonetics
Issue number1
Publication statusPublished - 1 Jan 2015



  • Biofeedback
  • Challenge-point framework
  • Generalisation
  • Principles of motor learning
  • Speech sound disorder

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