Investigating intervention dose frequency for children with speech sound disorders and motor speech involvement.

articulation developmental motor speech disorders dose dose frequency functional outcomes intervention motor speech issues speech intelligibility speech sound disorders treatment intensity

Journal

International journal of language & communication disorders
ISSN: 1460-6984
Titre abrégé: Int J Lang Commun Disord
Pays: United States
ID NLM: 9803709

Informations de publication

Date de publication:
07 2019
Historique:
received: 10 04 2018
revised: 06 03 2019
accepted: 08 03 2019
pubmed: 4 4 2019
medline: 14 2 2020
entrez: 4 4 2019
Statut: ppublish

Résumé

Treatment outcome data for children with severe speech sound disorders with motor speech involvement (SSD-MSI) are derived from Phase I clinical research studies. These studies have demonstrated positive improvements in speech production. Currently there is no research examining the optimal treatment dose frequency for this population. The results of this study, which is the first of its kind, will inform the delivery of effective services for this population. To investigate optimal treatment dose frequency for the Motor Speech Treatment Protocol (MSTP) for children with SSD-MSI. A total of 48 children (aged 43-47 months) with SSD-MSI participated in the study. Participants received 45-min MSTP intervention sessions either once per week (lower dose frequency) or twice per week (higher dose frequency) for a 10-week period. Blinded outcome assessments were carried out at pre- and post-intervention. Treatment-related change was assessed at body structures, functions and activities participation level as per the World Health Organization's International Classification of Functioning framework: Children and Youth Version (ICF-CY) framework WHO (2007). These measures are related to articulation, functional communication and speech intelligibility. One-way analysis of variance (ANOVA) revealed that for all variables the baseline scores were not statistically different (p > 0.05) between the two dose-frequency groups. Overall, there was a significant main effect of Time (pre-post) across all variables (p < 0.01). However, repeated-measures ANOVA did not result in any statistical interactions (Time × Dose frequency) for any of the variables tested (p > 0.05). Only marginal clinical advantages (< 4% change in intelligibility) were noted with the 10 extra sessions. Overall, the MSTP intervention approach in conjunction with home practice led to significant positive changes for all measures in children with SSD-MSI. No statistical differences between high- and low-dose-frequency groups were observed for any of the variables. Clinical effects were examined using effect sizes, as well as changes in articulation, speech intelligibility and functional communication; these differed marginally between the two dose frequencies. This suggests limited benefits of 10 additional sessions per block. Thus, it is recommended that caregivers, speech-language therapists and policy-makers perform a cost-benefit analysis before determining the dose frequency, when considering additional sessions per block.

Sections du résumé

BACKGROUND
Treatment outcome data for children with severe speech sound disorders with motor speech involvement (SSD-MSI) are derived from Phase I clinical research studies. These studies have demonstrated positive improvements in speech production. Currently there is no research examining the optimal treatment dose frequency for this population. The results of this study, which is the first of its kind, will inform the delivery of effective services for this population.
AIMS
To investigate optimal treatment dose frequency for the Motor Speech Treatment Protocol (MSTP) for children with SSD-MSI.
METHODS & PROCEDURES
A total of 48 children (aged 43-47 months) with SSD-MSI participated in the study. Participants received 45-min MSTP intervention sessions either once per week (lower dose frequency) or twice per week (higher dose frequency) for a 10-week period. Blinded outcome assessments were carried out at pre- and post-intervention.
OUTCOMES & RESULTS
Treatment-related change was assessed at body structures, functions and activities participation level as per the World Health Organization's International Classification of Functioning framework: Children and Youth Version (ICF-CY) framework WHO (2007). These measures are related to articulation, functional communication and speech intelligibility. One-way analysis of variance (ANOVA) revealed that for all variables the baseline scores were not statistically different (p > 0.05) between the two dose-frequency groups. Overall, there was a significant main effect of Time (pre-post) across all variables (p < 0.01). However, repeated-measures ANOVA did not result in any statistical interactions (Time × Dose frequency) for any of the variables tested (p > 0.05). Only marginal clinical advantages (< 4% change in intelligibility) were noted with the 10 extra sessions.
CONCLUSIONS & IMPLICATIONS
Overall, the MSTP intervention approach in conjunction with home practice led to significant positive changes for all measures in children with SSD-MSI. No statistical differences between high- and low-dose-frequency groups were observed for any of the variables. Clinical effects were examined using effect sizes, as well as changes in articulation, speech intelligibility and functional communication; these differed marginally between the two dose frequencies. This suggests limited benefits of 10 additional sessions per block. Thus, it is recommended that caregivers, speech-language therapists and policy-makers perform a cost-benefit analysis before determining the dose frequency, when considering additional sessions per block.

Identifiants

pubmed: 30941860
doi: 10.1111/1460-6984.12472
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

673-686

Informations de copyright

© 2019 Royal College of Speech and Language Therapists.

Auteurs

Aravind K Namasivayam (AK)

Oral Dynamics Lab, Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada.
Toronto Rehabilitation Institute, Toronto, ON, Canada.

Margit Pukonen (M)

The Speech and Stuttering Institute, Toronto, ON, Canada.

Debra Goshulak (D)

The Speech and Stuttering Institute, Toronto, ON, Canada.

Francesca Granata (F)

Oral Dynamics Lab, Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada.

D James Le (DJ)

Oral Dynamics Lab, Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada.

Robert Kroll (R)

The Speech and Stuttering Institute, Toronto, ON, Canada.

Pascal van Lieshout (P)

Oral Dynamics Lab, Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada.
Toronto Rehabilitation Institute, Toronto, ON, Canada.
Department of Psychology, University of Toronto Mississauga, Mississauga, ON, Canada.
Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada.
Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.

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