The treatment efficacy of multiple opposition phonological approach via telepractice for two children with severe phonological disorders in rural areas of West Texas in the USA

Abstract

The goals of the present study were to (1) examine the effects of the multiple opposition phonological approach on improving phoneme production accuracy in children with severe phonological disorders and (2) explore whether the multiple opposition approach is feasible for the telepractice service delivery model. A multiple-baseline, single-participant design replicated across two children, was implemented. Two male children who resided in rural areas of West Texas in the USA participated. One child was 4 years and 10 months old and the other child was 6 years old. Both of the children were diagnosed with phonological disorders without any sensory, motoric, or intellectual disabilities. The children's articulation was tested using Goldman-Fristoe Articulation Test-2 and probes were administered across the period of the study. The children received a 30-minute phonological intervention via telepractice twice a week for 12 or 16 weeks. An increasing trend for production accuracy for target sounds was observed during intervention for both children. Maintenance also was observed at 2-week and 2-month follow-ups. Standard scores from a standardized articulation test increased during posttest compared to pretest. The multiple opposition phonological approach can lead to improved speech production accuracy in children with severe phonological disorders. Telepractice may be an effective context for a phonological intervention approach as has been found for other domains of speech and language intervention and a useful service delivery model to underserved children with speech disorders who are unable to access a speech pathologist due to various circumstances.

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

“…Coufal et al (2018) compared connected health therapy with face-to-face therapy in a large-scale retrospective study of children between the ages of 6 and 9 years with speech sound disorders, and found no difference in outcomes between the two groups. Other studies have reported similar findings (Grogan-Johnson et al 2013, Gabel et al 2013, Lee 2018.…”

Implementation factors are neglected in research investigating telehealth delivery of allied health services to rural children: A scoping review

“…The data extracted are presented in Tables 3 and 4. Of the 23 articles selected for data extraction, all were NHMRC evidence level II or below: two level II randomised controlled trials 17,18 ; one level III-1 pseudorandomised controlled trial 19 ; one level III-2 non-randomised experimental trial 20 ; two level III-3 interrupted time series without parallel control groups 21,22 ; 10 level IV case series [23][24][25][26][27][28][29][30][31][32] ; and seven level IV studies of diagnostic yield. [33][34][35][36][37][38][39] Although grey literature was searched, all results were excluded as they lacked child functioning measures.…”

“…Most studies were conducted solely with rural participants, except two that described a combination of rural and urban. 31,32 Eleven studies took place in the USA, [19][20][21][22][23]26,28,29,31,34,35 six in Australia, 17,18,24,25,32,39 three in Canada 27,30,33 and three in India. [36][37][38] Participants included infants under 24 months, 26,34 preschool children from 24 months to six years, 17,23,26,32,37,38 school-aged children over six and under 12 years, 20,21,27,35,39 both preschool and schoolaged children 18,19,22,24,25,28,29,33,36 and both school-aged Table 2.…”

“…Ten studies targeted communication and were conducted by speech-language pathologists. 19,20,22,25,27,29,30,32,33,39 Participants were children with fluency disorders, 30,32 speech-sound disorders, 20,22 speech and language concerns, 27,33 communication concerns, 25 reading and language concerns 39 and the caseload of a school-based therapist. 19 Seven studies targeted behaviour or socio-emotional skills, including: psychologists working with children with behavioural concerns 17,21,28 ; behaviour analysts working with children with autism 23 ; a psychologist and social worker providing cognitive behavioural therapy for children with post-traumatic stress disorder 31 ; and parent support practitioners supervised by mental health clinicians working with children with disruptive behaviour, attention-deficit hyperactivity and learning difficulties 18 or unknown presentations.…”

A shift of treatment approach in speech language pathology services for children with speech sound disorders – a single case study of an intense intervention based on non-linear phonology and motor-learning principles

“…Due to frequently reported shortage of SLPs (Joffe & Pring, 2008;Lee, 2018), there is limited time and resources to assess and treat children. Therefore, indirect approaches are adopted where the SLP provides treatment through proxies such as caregivers or teachers.…”