Age-related Correlates of Treatment for Late-acquired Sounds

Study Overview
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Brief Summary
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Late-acquired sounds, such as /r/ are difficult to learn and many children experience persistent errors on these sounds. The purpose of the present study is to determine whether treating these sounds earlier in the child's life may result in better outcomes.

Detailed Description
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Late-acquired sounds, such as /r/ are difficult to learn and many children experience persistent errors on these sounds. However, these sounds are often treated later in a child's life because they are not expected to be fully acquired until quite late--age 7-8 for some sounds. This practice places treatment in a time of the child's development in which they struggle to learn new sounds.The purpose of the present study is to determine whether treating these sounds earlier in the child's life may result in better outcomes, and to examine treatment efficacy and efficiency for two methods of treatment.

Official Title
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Age-related Correlates of Treatment Efficacy and Efficiency for Late-acquired Sounds

Conditions
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Speech Delay, Speech Sound Disorder, Phonology Disorder, Phonology Impairment, Phonological Disorder, Articulation Disorders in Children, Developmental Phonological Disorder, Speech Disorders, Articulation Disorders, Developmental

Intervention / Treatment
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* Behavioral: articulation therapy
* Behavioral: phonologic treatment


Participation Criteria
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Eligibility Criteria
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Inclusionary Criteria: Normal Hearing Typical Receptive Language Speech Sound Disorder No motor speech impairment Typical non-verbal intelligence Produces at least one late-acquired sound with <7% accuracy Monolingual English-speaking Typical in terms of motoric and neurological development Exclusionary Criteria: Neurological disorder Hearing loss Nonverbal IQ < 16th percentile

Ages Eligible for Study
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Minimum Age: 4 Years
Maximum Age: 8 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Young children (age 4-5) and Old children (age 7-8) will be enrolled in either a Motoric behavioral treatment arm or phonological treatment arm.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Motoric Arm<br>Children will participate in an intervention based on traditional articulation approaches to speech therapy. | Behavioral: articulation therapy<br>* children receive instruction in producing new sounds at the isolation, syllable and word level.<br>|
| Active Comparator: Phonologic Arm<br>Children will receive intervention that targets the conceptual representation of sounds. | Behavioral: phonologic treatment<br>* children receive instruction in producing new sounds at the word level<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Treatment Efficacy: Number of correct productions of treated speech sounds in treatment words | Accurate Production of treatment sound at baseline and at posttest | baseline until accuracy criterion is met; up to 18 weeks after final baseline session | 
| Treatment Efficiency: Number of sessions required to meet accuracy criteria | Number of treatment sessions required to meet accuracy criteria (90% accuracy across three consecutive sessions or a maximum of 35 treatment sessions) | baseline until accuracy criterion is met; up to 18 weeks after final baseline session | 
| Session Length: Mean duration of sessions in minutes | Start and end time of session is recorded on scoresheet, then number of minutes for each session for each participant is found and the mean across all sessions is calculated. | First treatment session until final treatment session. Final treatment session occurs when accuracy of treatment sound is met (90% accuracy across three consecutive sessions or a maximum of 35 treatment sessions) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Accuracy of production of untreated sounds measured on pretest and posttest probes | Some children may generalize their skills learned through treatment to sounds that were not treated in the trial. | baseline and at posttest up to 18 weeks after final baseline session | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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treatment, efficacy, efficiency, late-acquired sounds