Early speech and language intervention in Brazilian-Portuguese toddlers with cleft lip and/or palate

Scherer, Nancy J.; Yamashita, Renata Paciello; Oliveira, Débora Natália de; DiLallo, Jennifer; Trindade, Inge Elly Kiemle; Fukushiro, Ana Paula; Richards, Kacey

doi:10.1080/02699206.2021.1912187

Cited by 15 publications

(5 citation statements)

References 42 publications

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“…A randomized study of 30 parent-child dyads (n = 15 treatment, n = 15 control) showed that this approach improved speech articulation for children in the treatment group [ 10 ]. Similar results, as well as improvements in expressive and receptive language, were observed in a Brazilian cohort (N = 24) [ 11 ] and a recent pilot study examining remote delivery of the intervention (N = 4) [ 12 ]. Although promising, the small sample sizes in these studies raise questions about generalizability and the potential to deliver these programs at scale.…”

Section: Introductionsupporting

confidence: 78%

Book-Sharing for Toddlers with Clefts (BOOST): Protocol for a randomized controlled trial of a remote intervention to promote language development in children with cleft palate

Collett,

Gallagher,

Johns

et al. 2024

PLoS ONE

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Background Children with cleft palate, with or without cleft lip (CP±L), exhibit language delays on average compared to children without clefts. Interventions to address these disparities are scarce. In this multi-center study, Book Sharing for Toddlers with Clefts (BOOST), we will test a remote, parent-focused intervention to promote language development in children with CP±L. Objectives The study will test two primary hypotheses. First, toddlers randomized to BOOST will exhibit better language outcomes than children receiving standard-of-care (SOC). Second, we hypothesize that the BOOST program’s effect on language outcomes is mediated by the frequency and quality of parent-child reading interactions. Methods The study is a randomized-controlled trial comparing the BOOST group to a SOC comparison group. We will enroll N = 320 English and/or Spanish-speaking children ages 24–32 months with isolated CP±L (n = 160 per group). Both groups will receive children’s books, and parents will record and upload videos of themselves reading the books with their children using a smartphone app developed for the study. Parents will also complete surveys asking whether they read to their children on five randomly selected days each week. In addition, the BOOST group will participate in 3 remote dialogic book-sharing intervention sessions via Zoom. We will code book-sharing videos to assess parents’ target skill usage and children’s expressive language. End-of-study assessments will include measures of child language outcomes (e.g., clinician-administered measures, parent reports, and naturalistic child language samples). Results Enrollment began in April 2024 and will continue through approximately April 2028. Conclusion The BOOST study will address a critical gap in the literature on interventions to improve language in children with CP±L. The results will inform the care for toddlers with oral clefts and have potential applications for other populations.

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Section: Introductionsupporting

confidence: 78%

Book-Sharing for Toddlers with Clefts (BOOST): Protocol for a randomized controlled trial of a remote intervention to promote language development in children with cleft palate

Collett,

Gallagher,

Johns

et al. 2024

PLoS ONE

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“…Next, the weaknesses and strengths of the video will be described on the basis of a fidelity checklist through a video call. Trainees will learn 7 supportive speech and language strategies that are arranged hierarchically from easy to difficult, including environment arrangement, match turns, modeling, prompting, time delay, expansion, and recasting [12,22]. The environment arrangement strategy aims to enhance the child's engagement with the physical setup by selecting, arranging, and managing materials.…”

Section: Parent Trainingmentioning

confidence: 99%

“…PE or speech recasts are a subset of recasts that target correct phonological production in response to the child's incorrect productions [5,11,12,21]. Studies have reported positive effects of EMT+PE on language and speech outcomes including the percentage of correct consonants (PCC), consonant inventory, word production speed, compensatory errors, expressive vocabulary, and receptive language [5,21,22]. EMT+PE delivery methods are flexible for children with CP/L.…”

Section: Introductionmentioning

confidence: 99%

Telepractice Parent Training of Enhanced Milieu Teaching With Phonological Emphasis (EMT+PE) For Persian-Speaking Toddlers With Nonsyndromic Cleft Palate: Protocol for a Randomized Controlled Trial

Tahmasebi,

Zarifian,

Ashtari

et al. 2024

JMIR Res Protoc

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Background Children born with a cleft palate with or without a cleft lip (CP/L) are at increased risk for delayed language development and speech sound disorders. Enhanced Milieu Teaching with Phonological Emphasis (EMT+PE) is a recommended naturalistic intervention for toddlers with CP/L. The parents’ role in providing naturalistic interventions is critical and they need training based on learning principles to implement these interventions. Telepractice is an appropriate method for training parents and children with various speech-related disorders. Objective This study aims to determine and compare the effectiveness of telepractice and the parent-implemented EMT+PE intervention on language and speech measures in toddlers with CP/L with usual interventions and determine the effectiveness maintenance of the intervention. Methods A randomized controlled trial (RCT) will assess the efficacy of telepractice and the parent-implemented EMT+PE intervention in enhancing speech and language measures in toddlers with CP/L. Eligible participants will be randomly assigned to one of 2 groups: the conventional intervention group and the EMT+PE intervention group. Participants’ speech and language measures will be evaluated remotely by trained raters before and after the intervention and 2 months after the intervention. Parents of participants in the intervention group will receive 3 months of training in speech and language supportive strategies from trained therapists using telehealth fidelity scales. Parents of participants in the control group will receive the conventional speech and language intervention by cleft team therapists. Study outcomes will include language variables (mean length of utterance) and speech production variables (percent correct consonants). Results The protocol was approved by the Research Ethics Committee of the University of Social Welfare and Rehabilitation Sciences in February 2022. The selection process of participants, as well as training therapists and raters, commenced in January 2022, the therapy and follow-up period ended in June 2023, and pre- and postintervention assessments have been conducted. Data analysis is ongoing, and we expect to publish our results by the summer of 2024. Funding is yet to be received. Conclusions The results of this study may help us develop a speech and language intervention with a different delivery model for toddlers with CP/L, and the cleft team care can use these results in service delivery. Consistent with our hypothesis, speech and language measures are expected to improve. International Registered Report Identifier (IRRID) DERR1-10.2196/54426

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“…Given the early presentation of disordered speech development in children born with CP±L, it would be reasonable to assume that intervention should also start early. Certainly, early intervention is often recommended by cleft palate teams (Scherer et al, 2021). However, there are few studies which report efficacy of speech interventions delivered in the first 3 years of life for this population (Bessell et al, 2013).…”

Section: Speech Intervention Approaches For Young Children Born With Cp±lmentioning

confidence: 99%

A systematic review of early speech interventions for children with cleft palate

Lane

Harding

Wren

2021

Intl J Lang & Comm Disor

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Background: Children with cleft palate with or without cleft lip (CP±L) are at high risk of problems with early speech sound production, and these difficulties can persist into later childhood. Early intervention could help to reduce the number of children whose problems become persistent. However, much research in the field to date has focused on older children. There is a need to determine if providing intervention during the phase of early typical speech development leads to better outcomes. Aims: To review the evidence for the effectiveness of interventions targeting speech, delivered in the first 3 years of life for children with CP±L, and discuss factors such as intervention type, facilitator, dosage, outcome measures and the age of the child. Methods & Procedures: The systematic review was registered with PROS-PERO (CRD42019121964). Eight bibliographic databases including CINAHL and MEDLINE were searched in August 2018. Studies were included if participants received speech and language interventions before 37 months and if they reported outcomes for speech. Two reviewers independently completed inclusion reviews, quality analysis and data extraction. Outcome & Results:The review included seven papers: one pilot randomized controlled trial, one controlled trial, four cohort studies and one case series report. Interventions largely took a naturalistic approach, namely focused stimulation and milieu teaching. The findings provide preliminary support for naturalistic interventions and suggest that these interventions can be delivered by parents with suitable training. Studies included in the review provided low-strength evidence with variation in both the type of intervention, the manner of delivery and in the risk of bias in the designs used. Conclusions & Implications:The papers included in this review suggest that early naturalistic interventions can have positive impacts on the speech development of children with CP±L. However, the reported methodological quality of the publications overall was weak, and the current evidence lacks clarity and specificity in terms of therapy technique, delivery and optimum age of delivery.Future research should use more robust methodological designs to determine whether early speech interventions are beneficial for children born with CP±L.

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Early speech and language intervention in Brazilian-Portuguese toddlers with cleft lip and/or palate

Cited by 15 publications

References 42 publications

Book-Sharing for Toddlers with Clefts (BOOST): Protocol for a randomized controlled trial of a remote intervention to promote language development in children with cleft palate

Book-Sharing for Toddlers with Clefts (BOOST): Protocol for a randomized controlled trial of a remote intervention to promote language development in children with cleft palate

Telepractice Parent Training of Enhanced Milieu Teaching With Phonological Emphasis (EMT+PE) For Persian-Speaking Toddlers With Nonsyndromic Cleft Palate: Protocol for a Randomized Controlled Trial

A systematic review of early speech interventions for children with cleft palate

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