randomized clinical trial of phonological interventions

Conditions: Speech Articulation Disorder; Developmental Articulation Disorder; Phonological Impairment; Dyslexia

Summary: recent research reveals genetic and symptomatic overlap among children with speech sound disorders (i.e., those who (misarticulate more sounds than would be expected for their age) and children with dyslexia (i.e., those who struggle to learn to read). children who have speech sound disorders as preschoolers are at risk for the later emergence of dyslexia, a risk that often reveals itself in the form of poor phonological awareness skills during the preschool period. traditional speech therapy methods focus on articulation accuracy and do not focus on the child's more abstract knowledge of the sound system of the language. the ultimate objective of this research program is to prevent reading disability in children who present with speech sounds disorders. the relative effectiveness of different interventions to help these children achieve age-appropriate phonological processing skills prior to school entry will be investigated. it is expected that a combination of treatment approaches that focus on speech perception skills and vocabulary knowledge will have a superior impact on phonological awareness in comparison with a treatment approach that focuses solely on articulation accuracy.

the 72 children participating in the study will be randomly assigned (with concealment of the randomization sequence from study staff) to one of two child speech interventions: speech perception or speech production. these interventions will be provided in individualized one-hour treatment sessions once per week for six consecutive weeks during the first treatment block. during the second 6 week treatment block all children will receive a group phonological awareness intervention. concurrently their parents will be randomly assigned to receive instruction in the provision of a home program, either articulation therapy or dialogic reading. this will result in 4 groups of 18 children with each group receiving one of four combinations of intervention: speech production intervention + articulation parent group; speech production intervention + dialogic reading parent group; speech perception intervention + articulation parent group; and speech perception intervention + dialogic reading parent group. assessments will occur pretreatment, after the first treatment block, after the second treatment block, and 9 months after the end of the second treatment block.

Eligibility criteria:
inclusion criteria: * primary diagnosis of speech articulation disorder/phonological impairment * age 4 to 5 years of age at onset of treatment * maternal language canadian french (at least 75% exposure) * must misarticulate at least two phonemes that would typically be mastered by their normally developing age peers exclusion criteria: * speech disorder is secondary to a primary condition (e.g., hearing impairment, cleft palate, autism, down syndrome etc.)

Keywords: phonological awareness speech articulation disorder development articulation disorder phonological impairment dyslexia speech therapy school transition