Intervention dose frequency: Phonological generalization is similar regardless of schedule

Abstract

This study examined how intervention dose frequency affects phonological acquisition and generalization in preschool children with speech sound disorders (SSD). Using a multiple-baseline, single-participants experimental design, eight English-speaking children with SSD (4;0 to 5;6) were split into two dose frequency conditions (4 children/condition) targeting word-initial complex singleton phonemes: /ɹ l ʧ/. All children received twenty 50-minute sessions that were either provided twice a week (2×/week) for ten weeks or four times a week (4×/week) for five weeks. Tau- U effect sizes for two generalization measures, treated phoneme and percent consonants correct (PCC), were calculated for each participant. Group d-scores were calculated to measure generalization of the treated phoneme in untreated words for each condition. All eight children demonstrated gains in their phonological measures. Two children in 2×/week condition demonstrated significant changes in generalization of treated phonemes in untreated words. One child in each condition demonstrated significant changes in PCC scores. Group d-scores were similar suggesting children in both conditions generalized their treated phoneme in untreated words to a similar level. Regardless of whether speech intervention occurred 2×/week or 4×/week, children demonstrated similar phonological gains. This suggests that both dose frequencies are viable intervention schedules for preschoolers with SSD. Children in the 4×/week condition made their phonological gains in approximately half the time of children in the 2×/week condition. Thus, more frequent weekly speech intervention sessions could be more efficient in teaching phonological information than less frequent sessions.

The retrospective acceptability of high intensity versus low intensity speech intervention in children with a cleft palate: A qualitative study from the parents’ point of view using the Theoretical Framework of Acceptability

“…Children are more likely to remember the skills practiced in a session that recently occurred and regular therapy sessions may help families establish a consistent home practice routine, leading to more rapid speech gains. Indeed, even when children receive daily therapy sessions, home practice remains important for improving long‐term intervention outcomes following high‐intensity speech intervention (Cummings et al., 2020). These parental concerns highlight limitations of the handbook with the daily schedule that was used in the previous RCT that compared high‐intensity with low‐intensity speech intervention (Alighieri, Van Lierde, et al., 2021).…”

“…If speech intervention is provided daily, parents may have assumed that daily practice was less necessary. In contrast, Cummings et al (2020) described that providing more intensive speech intervention could be a more efficient way of delivering interventions. Children are more likely to remember the skills practiced in a session that recently occurred and regular therapy sessions may help families establish a consistent home practice routine, leading to more rapid speech gains.…”

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

“…Internationally, there have been few studies that have addressed how dosage and frequency impacts speech intervention outcomes (Baker & McLeod, 2011;Cummings et al, 2020) and even fewer focusing on the dosage of intervention for children with CP±L (Alighieri et al, 2020). Alighieri et al (2020) compared the effects of a traditional motor-phonetic approach and a linguistic-phonological approach on the speech outcomes of children with CP±L aged 4-12 years old.…”

“…Post-intervention, the linguistic-phonological group had greater gains in PCC, compared with the motor-phonetic group and Alighieri et al hypothesized that the increased dosage of home practice may have contributed to these gains. However, there have been several intervention studies for children with speech sound disorder that have reported that variations in dosage and frequency of intervention does not affect speech outcomes (Cummings et al, 2020;Page et al, 1994). For example, Cummings et al (2020) found that children with speech sound disorder made similar gains regardless of the intensity and frequency of intervention.…”

“…However, there have been several intervention studies for children with speech sound disorder that have reported that variations in dosage and frequency of intervention does not affect speech outcomes (Cummings et al, 2020;Page et al, 1994). For example, Cummings et al (2020) found that children with speech sound disorder made similar gains regardless of the intensity and frequency of intervention. However, the authors reflected that providing a higher dose frequency may be a more efficient way of delivering speech interventions because children are more likely to remember the skills practiced in a session that recently occurred and that regular therapy sessions may help families establish a consistent routine, leading to more rapid speech gains.…”