Purpose: This study evaluated whether outcomes from treatment, which includes ultrasound visual feedback (UVF), would be more or less effective when combined with auditory perception training for children with residual /[voiced alveolar approximant]/ errors. Method: Children ages 8-16 years with /[voiced alveolar approximant]/ distortions participated in speech therapy that included real-time UVF of the tongue. Thirty-eight participants were randomized to speech therapy conditions that included a primary focus on articulation using UVF or a condition that included auditory perceptual training plus UVF (incorporating category goodness judgments and self-monitoring). Generalization of /[voiced alveolar approximant]/ production accuracy to untrained words was assessed before and after 14 hr of therapy. Additionally, the role of auditory perceptual acuity was explored using a synthetic /[voiced alveolar approximant]/--/w/ continuum. Results: There was no difference between the treatment groups in rate of improvement of /[voiced alveolar approximant]/ accuracy (increase of 34% for each group; p = 0.95, n[subscript p][superscript 2] = 0.00). However, pretreatment auditory acuity was associated with treatment progress in both groups, with finer perceptual acuity corresponding to greater progress (p = 0.015, n[subscript p][superscript 2] = 0.182). Conclusion: Similar gains in speech sound accuracy can be made with treatment that includes UVF with or without auditory perceptual training. Fine-grained perceptual acuity may be a prognostic indicator with treatment.