Randomized controlled trial comparing Parent Led Therapist Supervised Articulation Therapy (PLAT) with routine intervention for children with speech disorders associated with cleft palate

Sweeney, Triona; Hegarty, Fran; Powell, Katie; Deasy, Liane; Regan, Myra O’; Sell, Debbie

doi:10.1111/1460-6984.12542

Cited by 27 publications

(23 citation statements)

References 38 publications

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“…Nineteen studies contributed with IPD on speech production. As a rough overview of these studies, the therapy was implemented in the form of intensive summer camps in three studies (Pamplona et al, 2014(Pamplona et al, , 2017Van Demark & Hardin, 1986), the SLT was implemented in the form of conventional clinical care in four studies (Derakhshandeh et al, 2016;Pamplona & Ysunza, 2018;Roxburgh et al, 2016;Sweeney et al, 2020), the therapy was implemented through an initial short workshop led by SLTs and then carried out by parents or speech assistants over a long duration in nine studies (Dobbelsteyn et al, 2014;Hanchanlert et al, 2015;Makarabhirom et al, 2015;Prathanee, 2011;Prathanee et al, 2014Prathanee et al, , 2020Pumnum et al, 2015;Scherer et al, 2008;Sritacha et al, 2016), and the therapy was very brief in three studies (Alighieri et al, 2019;Lindeborg et al, 2020;Luyten et al, 2016). See Table 1 for a general overview of these studies, and see Table 2 for risk of bias assessment of these studies.…”

Section: Overview Of the Included Studiesmentioning

confidence: 99%

On the Benefits of Speech-Language Therapy for Individuals Born With Cleft Palate: A Systematic Review and Meta-Analysis of Individual Participant Data

Sand

Hagberg

Lohmander

2022

J Speech Lang Hear Res

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Purpose: Cleft lip and/or palate (CLP) is a common birth defect, and after reconstructive surgery, about 50% of children at 5 years of age have speech deviations and are referred to speech-language therapy (SLT). The peer-reviewed evidence for the benefit of SLT has been uncertain. Our objective was to systematically review and meta-analytically summarize the benefit of SLT for individuals born with CLP. Method: A systematic search was conducted (last search on February 19, 2021) on studies evaluating SLT with pre and post measures on speech production, language ability, intelligibility, and/or patient-reported outcomes. We sought individual participant data (IPD) and evaluated on an individual level if the outcome measure had improved to a clinically relevant degree during SLT and if the outcome measure was on a level with peers or not after SLT. Meta-analyses and meta-regressions were applied to synthesize IPD across studies. Results: Thirty-four eligible studies were found. Nineteen studies provided IPD ( n = 343) for the main analysis on speech production. The synthesized information suggests that, during SLT, speech production improved to a clinically relevant degree for many individuals (95% CI [61%, 87%]) and that speech production was on a level with peers for some individuals after SLT (95% CI [10%, 34%]). Conclusions: The main strength of this meta-analysis is that we evaluated on an individual level pre- and post-intervention data based on considerations of clinical relevance. This approach allowed us to conclude that many individuals benefit from SLT and that further work on evaluating SLT in this patient group is meaningful. Supplemental Material https://doi.org/10.23641/asha.17700992

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Section: Overview Of the Included Studiesmentioning

confidence: 99%

On the Benefits of Speech-Language Therapy for Individuals Born With Cleft Palate: A Systematic Review and Meta-Analysis of Individual Participant Data

Sand

Hagberg

Lohmander

2022

J Speech Lang Hear Res

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“…More specifically, parents found it important to receive information regarding the transfer of learned skills to the home environment which suggests that they are eager to learn techniques to enhance generalization. Sweeney et al (2020) compared the effect of a parent-led therapist-supervised (PLAT) speech intervention with the effect of routine speech intervention in children with a CP±L. Parents allocated to the parent-trained group followed a 2-day training course including lectures, speech samples and quizzes.…”

Section: Discussionmentioning

confidence: 99%

From excitement to self‐doubt and insecurity: Speech–language pathologists’ perceptions and experiences when treating children with a cleft palate

Alighieri

Bettens

Verhaeghe

et al. 2021

Intl J Lang & Comm Disor

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Background: Speech disorders in children with a cleft palate with or without a cleft lip (CP±L) are complex given the magnitude of influencing factors. Providing intervention to eliminate these speech errors is often challenging. Speechlanguage pathologists (SLPs) might have negative perceptions of the treatment of children with a CP±L. Aims:To explore how community SLPs perceive and experience the provision of speech intervention to children with a CP±L.Methods & Procedures: A total of 18 female community SLPs, aged between 23 and 62 years, were included in this study. Semi-structured interviews were conducted. The interviews were analysed using an inductive thematic approach aiming to identify themes driven by the data. Trustworthiness of the data was achieved by including researcher triangulation (involving three researchers with different research backgrounds) and deviant case analysis of two cases.Outcomes & Results: Initial responses demonstrated that the community SLPs were excited and enthusiastic to treat children with a CP±L. Expanding on these initial reports, however, they revealed that their excitement turned into professional self-doubt and insecurity when confronted with the treatment challenges inherent with this population. To cope with this self-doubt, they outlined several responsibilities for the cleft team SLPs. They expressed a strong desire to receive confirmation and approval on their treatment practices from more experienced SLPs (i.e., the cleft team SLPs). Their perceptions were dominated by a polarized thinking pattern. Treatment approaches were divided in categories as 'right' or 'wrong' and 'good' or 'bad'. Conclusions & Implications:The community SLPs are lacking professional confidence when treating children with a CP±L. They put themselves in a subordinate position towards the cleft team SLPs and expect the latter to provide ready-made answers to problems and questions. This expectation can perhaps be explained by their fear of making mistakes during therapy preventing treatment progress. If they handle in accordance with the experts' advice, they cannot blame themselves in cases where no treatment progress is seen. Educational programmes need to pay more attention to gaining professional confidence (in

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“…Speech and language therapy interventions for children with CP±L typically involve direct therapy with a speech and language therapist with follow-up activities for parents to complete at home (Bessell et al, 2013;DeVeney et al, 2017). While the involvement of parents in speech intervention is not new, it has become more of a feature of therapy for children with CP±L, with many using technology to assist in this process (Sweeney et al, 2020). This is sensible given the evidence that parents can be trained to deliver naturalistic intervention techniques for children with non-cleft related speech and language disorders (Kaiser & Hancock, 2003;Kaiser & Hester, 1994) and that parent participation can yield better therapy outcomes for language skills than clinician led interventions (Pamplona & Ysunza, 2000).…”

Section: Facilitator Of Early Interventionmentioning

confidence: 99%

“…For example, Sugden et al (2016) suggested that parent involvement in interventions for children with speech sound disorder is possible and can be effective. Furthermore, a study by Sweeney et al (2020) provided evidence that parents can be trained to carry out speech articulation therapy at home for a child with CP±L and suggested that this can be an alternative method of speech and language therapy service delivery. However, it is important to reflect that the impact of parent-implemented intervention may be dependent on family dynamics and different situations and therefore may not be a reliable or suitable service for all children (Sugden et al, 2016).…”

Section: Facilitator Of Interventionmentioning

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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Randomized controlled trial comparing Parent Led Therapist Supervised Articulation Therapy (PLAT) with routine intervention for children with speech disorders associated with cleft palate

Cited by 27 publications

References 38 publications

On the Benefits of Speech-Language Therapy for Individuals Born With Cleft Palate: A Systematic Review and Meta-Analysis of Individual Participant Data

On the Benefits of Speech-Language Therapy for Individuals Born With Cleft Palate: A Systematic Review and Meta-Analysis of Individual Participant Data

From excitement to self‐doubt and insecurity: Speech–language pathologists’ perceptions and experiences when treating children with a cleft palate

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

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