The Effectiveness of Ultrasound Visual Biofeedback in Articulation Therapy for Children and Adolescents With Speech Sound Disorders: A Systematic Review and Meta‐Analysis

What is already known on this subject A 2019 systematic review qualitatively synthesized early evidence for ultrasound visual biofeedback (U-VBF) in speech sound disorders (SSDs), highlighting its promise as an adjunct for persistent errors but limited by small samples, few RCTs and no effect size pooling. Subsequent studies have introduced more robust designs and quantitative data, necessitating an update to quantify U-VBF's impact amid growing clinical interest. What this paper adds to existing knowledge This review updates the evidence with 35 studies (192 unique participants) and a novel meta-analysis of 16 studies, yielding a large pooled effect on articulation accuracy despite high heterogeneity. It identifies SSD subtype-specific variability and intensity influences, revealing reporting gaps that limit subgroup analyses. These findings provide the first quantitative benchmark, enabling future power calculations and stratified research. What are the potential or actual clinical implications of this work? U-VBF offers a viable tool for personalized SSD therapy, with enhanced intensity reporting guiding tailored protocols. Clinicians should integrate U-VBF judiciously, mindful of English-centric evidence and potential bias inflating effects. Future research should prioritize RCTs and non-English trials to refine applicability across diverse populations.