Speech Intervention for Children With Cleft Palate Using Principles of Motor Learning

Abstract

Purpose: This is a pilot study to apply an articulatory kinematic speech intervention that uses the principles of motor learning (PML) to improve speech and resonance outcomes for children with cleft palate. It is hypothesized that (a) treatment that applies select PML during practice will improve production of treated phonemes, representing both active and inconsistent passive errors, at word level in children with cleft palate; (b) effects of practice on phonemes with active or inconsistent passive errors will generalize to untreated exemplars of treated phonemes; and (c) learning will be retained for at least 1-month posttreatment. Method: A multiple-baseline design across participants combined with a crossover single-case experimental model was used. Participants attended two 8-week blocks of twice-weekly face-to-face speech therapy (40–50 min/treatment) to treat active and inconsistent passive cleft speech errors using articulatory kinematic speech intervention that applied PML. The participants were four children with cleft-type speech errors. The primary dependent variable measured was percentage of words correct across treatment items, generalization items, and control items. Perceptual accuracy of target words was scored. Effect sizes were calculated to quantify the magnitude of treatment effect. Results: For three children with active and inconsistent passive cleft speech errors and one child with active cleft speech errors and developmental phonological speech errors, this approach resulted in improvements to their treated items and generalization to their untreated items. Inconsistent passive cleft speech errors were particularly responsive to the treatment in the three children who presented with these errors. Conclusion: This Phase I study has shown that articulatory kinematic speech intervention that applies the PML is effective in improving the speech outcomes for children with cleft palate and that there is validity in pursuing further research into this approach. Supplemental Material: https://doi.org/10.23641/asha.21644831

A Mixed-Methods Pilot Randomised Control Trial of Ultrasound Visual Biofeedback versus Standard Intervention for Children with Cleft Palate +/- Cleft Lip: Parents’ and Children’s Perspectives.

“…Nevertheless, several recent studies suggest that articulatory approaches can be effective, especially when they employ the principles of motor learning (Hanley et al, 2023). Moreover, the distinction between articulatory and phonological approaches is likely a false dichotomy since children must both learn a new motor programme for a sound in error and then generalise this to other linguistic units.…”