Clinical trial NCT00818428: Randomized Clinical Trial of Phonological Interventions
Official title: The Contribution of a Speech Perception Intervention to the Prevention of Phonological Awareness Deficits in Children With Speech Sound Disorders
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: PHASE2
PHASE3
Conditions: Speech Articulation Disorder
Developmental Articulation Disorder
Phonological Impairment
Dyslexia
Keywords: Phonological Awareness
Speech Articulation Disorder
Development Articulation Disorder
Phonological Impairment
Dyslexia
Speech Therapy
School Transition
Lead sponsor: McGill University
Sponsor class: OTHER
First posted: 2009-01-07
Enrollment: 96
Sex: ALL
Minimum age (years): 48
Maximum age (years): 71
Standard ages: CHILD
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: FACTORIAL
Primary purpose: PREVENTION

Brief 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.

Detailed description: 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.)

Primary outcomes:
measure: Phonological Awareness (Test d'Analyse Auditive en Français [Auditory Analysis Test in French])
timeFrame: 12 months post treatment onset
Secondary outcomes:
measure: Articulation Accuracy (Test Francophone de Phonologie, Paul et Rvachew [Test of French Phonology)
timeFrame: 6 weeks post treatment onset; 12 weeks post-treatment onset; 12 months post-treatment onset
measure: Vocabulary Knowledge (Échelle de Vocabulaire en Image Peabody [Peabody Picture Vocabulary Test - French Edition)
timeFrame: 12 months post-treatment onset
measure: Phonological Awareness (Test de Conscience Phonologique, Brosseau-Lapre et Rvachew [Phonological Awareness Test - French Version])
timeFrame: 6 weeks post-treatment onset; 12 weeks post-treatment onset
Other outcomes:
Locations:
city: Montreal
country: Canada
facility: McGill University
state: Quebec
city: Montreal
country: Canada
facility: Montreal Children's Hospital
state: Quebec
Study officials:
affiliation: McGill University
name: Susan Rvachew, Ph.D.
role: PRINCIPAL_INVESTIGATOR
References: