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Effects of Maternal Attitudes Upon Improvement in Articulation When Mothers Are Trained to Assist in Speech Correction

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... Several studies have shown that parents are effective as adjuncts to or replacements for therapy provided by the speech-language pathologist (speech therapist). However, in these studies the parents received structured and closely monitored training in the application of the home program and the time requirement for parent administered intervention was not less than that required for the program provided by the speech-language pathologist alone (Eiserman, et al. 1992;Eiserman, et al. 1995;Sommers 1962;Sommers, et al. 1964). The benefits of mothers as intervention agents were not found to be in efficiency relative to therapy provided by the speech-language pathologist but rather in the opportunity to increase intensity and parent satisfaction. ...
Chapter
Introduction Children with a developmental phonological disorder (DPD) misarticulate many more speech sounds than is expected for their age (Shriberg et al. 1997c) and suffer activity limitations and participation restrictions due to reduced intelligibility or social acceptability of their speech (Mc Cormack et al. 2009). Given that the disorder is identified in relation to the speech abilities of age peers, a brief discussion of normal speech development is provided for context in this chapter. A review of the literature regarding the prevalence of DPD and long-term outcomes for children with this disorder follows. Current research on the aetiology and cognitive-linguistic underpinnings of DPD is considered and theoretical perspectives on subtypes of DPD are evaluated in view of this literature. Finally, approaches to intervention are discussed.Normal phonological development.Phonological development begins in infancy and progresses throughout childhood via processes that involve aggregation and linkage of developing knowledge in the perceptual, articulatory and linguistic domains (Pierrehumbert 2003; Munson et al. 2005a). There is considerable evidence for an early word-based phonology with gradual emergence of phonological units as the lexicon expands (Ferguson and Farwell 1975; Metsala and Walley 1998; Beckman and Edwards 2000). Although most accounts of normal phonological development focus on the acquisition of individual phonemes (Sander 1972; Smit et al. 1990), knowledge of the prosodic structure of the language at supra- and intrasyllabic levels is also crucial (Bernhardt and Stemberger 1998). Initial milestones in phonological development are the shift from language-general to language-specific speech perception and the emergence of canonical babble (Mc Cune and Vihman 2001; Kuhl et al. 2008). The pronunciation of first words may be highly variable and idiosyncratic while adapted to the form of the child’s preferred word templates nonetheless (Vihman and Croft 2007). Subsequently, the child’s speech is characterized by more predictable error patterns that gradually give way to improved accuracy as the repertoire of phones and syllable shapes expands and consistency in segment production increases (Preisser et al. 1988; Porter and Hodson 2001; Dodd et al. 2003). Most children achieve fully intelligible speech by age 4 years and adult-like levels of speech accuracy between 6 and 9 years (Smit et al. 1990). Ongoing improvements in precision are seen throughout childhood while the child adjusts to changing articulatory structure and increasing linguistic complexity (Smith and Zelaznik 2004; Goffman et al. 2007; Sadagopan and Smith 2008).
... Furthermore, it was assumed that the screening techniques used to diagnose FASD and SLD have not changed over time in terms of their sensitivity and specifi city. However, since there have been increases in the population (Statistics Canada, 2013), improvements in the use of screening techniques for FASD (Chudley et al., 2005), and stable rates of consuming alcohol while pregnant (Statistics Canada, 2011), the use, Furlong, Rhodes, Fichter, Bowser, Copetas, et al. (1964) 200 minutes a week for 4 weeks 13.3 Sommers, Schaeffer, Leiss, Gerber, Bray, Fundrella, et al. (1966) 40 minutes of therapy a week for 8.5 months 22.7 Tufts & Holliday (1959), 1997; Cole & Dale, 1986 of the previously-noted assumptions allowed for a conservative estimate of the cost associated with 1:1 speech-language interventions among children with FASD and SLD for Canada in 2011 to be made. All cost fi gures are presented in 2011 Canadian dollars. ...
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This study, which is part of a large economic project on the overall burden and cost associated with Foetal Alcohol Spectrum Disorder (FASD) in Canada, estimated the cost of 1:1 speech-language interventions among children and youth with FASD for Canada in 2011. The number of children and youth with FASD and speech-language disorder(s) (SLD), the distribution of the level of severity, and the number of hours needed to treat were estimated using data from the available literature. 1:1 speech-language interventions were computed using the average cost per hour for speech-language pathologists. It was estimated that ˜ 37,928 children and youth with FASD had SLD in Canada in 2011. Using the most conservative approach, the annual cost of 1:1 speech-language interventions among children and youth with FASD is substantial, ranging from $72.5 million to $144.1 million Canadian dollars. Speech-language pathologists should be aware of the disproportionate number of children and youth with FASD who have SLD and the need for early identification to improve access to early intervention. Early identification and access to high quality services may have a role in decreasing the risk of developing the secondary disabilities and in reducing the economic burden of FASD on society.
... However, half as much treatment may be sufficient if the child receives a structured home program in addition to speech therapy. Several studies have demonstrated that parents can be effective treatment agents when provided with structured and appropriately intensive training in the implementation of the home program (Sommers, 1962;Sommers et al., 1964;Eiserman, Weber, & McCoun, 1992;Eiserman, Weber, & McCoun, 1995). For complex cases, as many as 100 hours of treatment may be required (Campbell, 1999). ...
Article
The aim of this Campbell systematic review is to examine the effectiveness of speech and language interventions for children with primary speech and language delay/disorder. Thirty‐six studies were found, based on a total of 1,500 children involved in thirty‐three randomised controlled trials. This Review concludes, on the basis of the available international studies in this field, that speech and language therapy generally has a positive effect on children with expressive phonological difficulties. The therapy also helps children who have a problem with their active vocabulary, i.e. children who have difficulty in using words they understand. Children, who have difficulty with active vocabulary alone, but no problem understanding and acquiring language, also benefit from speech and language therapy. Speech and language therapy for children who have difficulty in applying grammar and constructing sentences is, however, only thought to have a positive effect if the child does not have other significant receptive speech and language difficulties. Synopsis Primary speech and language delay/disorder is a common developmental difficulty which, if unresolved, can cause difficulties of both learning and socialisation lasting into adolescence and beyond. This review examines the effectiveness of speech and language therapy interventions for children with primary speech and language delay/disorder. The review concludes that whilst there may be some support for the effectiveness of speech and language therapy for children with expressive phonological and expressive vocabulary difficulties, the evidence concerning the effectiveness of interventions for expressive syntax is mixed, and no evidence is available concerning interventions for children with receptive language difficulties. Abstract Background It is thought that approximately 6% of children have speech and language difficulties of which the majority will not have any other significant developmental difficulties. Whilst most children's difficulties resolve, children whose difficulties persist into primary school may have long‐term problems concerning literacy, socialisation, behaviour and school attainment. Objectives To examine the effectiveness of speech and language interventions for children with primary speech and language delay/disorder. Search strategy The following databases were searched: The Cochrane Controlled Trials Register (Cochrane Library, CENTRAL: 2002/3), CINAHL (1982 – July 2002), EMBASE (1980 – Sept Week 4 2002), ERIC (1965 – 2002), MEDLINE (1966 – Sept Week 3 2002), PsycINFO (1872 – 2002/10 Week 2), The National Research Register (2002/3). In addition to this references were taken from reviews of the literature and reference lists from articles. Selection criteria The review considered randomised controlled trials of speech and language therapy interventions for children or adolescents with primary speech and language delay/disorder. Data collection & analysis Titles and abstracts were identified and assessed for relevance, before the full text version was obtained of all potentially relevant articles. The data were categorised depending on the nature of the control group and considered in terms of the effects of intervention on expressive and receptive phonology, syntax and vocabulary. The outcomes used in the analysis were dependent on the focus of the study with only the primary effects of therapy being considered in this review. Main results The results of twenty‐five studies were used in the meta‐analysis. The results suggest that speech and language therapy is effective for children with phonological (SMD=0.44, 95%CI: 0.01,0.86) or vocabulary difficulties (SMD=0.89, 95%CI: 0.21,1.56), but that there is less evidence that interventions are effective for children with receptive difficulties (SMD=−0.04, 95%CI: −0.64,0.56). Mixed findings were found concerning the effectiveness of expressive syntax interventions (n=233; SMD=1.02, 95%CI: 0.04–2.01). No significant differences were shown between clinician administered intervention and intervention implemented by trained parents, and studies did not show a difference between the effects of group and individual interventions (SMD=0.01, 95%CI: −0.26,1.17). The use of normal language peers in therapy was shown to have a positive effect on therapy outcome (SMD=2.29, 95%CI: 1.11,3.48). Reviewers' conclusions The review shows that overall there is a positive effect of speech and language therapy interventions for children with expressive phonological and expressive vocabulary difficulties. The evidence for expressive syntax difficulties is more mixed, and there is a need for further research to investigate intervention for receptive language difficulties. There is a large degree of heterogeneity in the results, and the sources of this need to be investigated.
Article
Detailed information on the speech, language, prosody, and voice characteristics of children with developmental phonological disorders is central to diverse research questions. The present study provides a clinical profile of 178 children with developmental phonological disorders. It includes information from prior reports (Shriberg & Kwiatkowski, 1982a; Shriberg, Kwiatkowski, Best, Hengst, & Terselic-Weber, 1986) and from several new measures on a sample of 64 children. The speech, prosody-voice, and causal-correlates profiles for the most recent sample are consistent with prior findings, providing a descriptive profile for forthcoming subgroup research and companion studies addressing short-term (Shriberg, Kwiatkowski, & Gruber, 1994) and long-term (Shriberg, Gruber, & Kwiatkowski, 1994) speech-sound normalization.
Article
Partiendo de una perspectiva interaccional de análisis según la cual los cambios en las conductas desadaptadas de los sujetos se logran y se mantienen a través de cambios en el ambiente natural, el artículo revisa algunos trabajos en los que se ha utilizado a los padres como terapeutas en áreas de la patología del lenguaje tales como los trastornos articulatorios en sujetos normales y los déficit lingüísticos en sujetos deficientes. En el ámbito de los trastornos articulatorios los trabajos revisados se clasifican de acuerdo con el mayor o menor grado de involucración de los padres en las tareas terapéuticas y se describen secuencias específicas de intervención que pueden alcanzar ya sea al planteamiento terapéutico considerado globalmente, ya sea únicamente a las últimas fases de la terapia, con énfasis en los aspectos de generalización. A nivel de la intervención en el lenguaje de los deficientes, se sigue una clasificación similar a la anterior, para concluir con una reflexión acerca de algunas de las variables que pueden determinar el nivel de éxito en todos aquellos programas pensados para ser utilizados por los padres.
Article
This study contributes to the discussion of appropriate parent and therapist roles in early intervention by comparing the costs and effects of two programs for speech-disordered preschoolers: a home parent training program and a clinic-based program with low parent involvement. The posttest results indicated that the children in the home parent training group performed at least as well as those in the clinic-based group on measures of speech and language functioning as well as on a measure of general development. On several of these variables, the home parent training group performed significantly better than the other group. Results of the cost analysis indicated that, excluding the value of parent time, there was no meaningful difference in program costs. The implications of this study are that parents can be given significant responsibilities in early intervention and that program administrators have a viable option of using parents as a substantive support to a program. In addition, findings support the need for therapists to be trained to work with parents as well as with the child.
Article
This study examined the extent to which generalization of correct phoneme production occurred in various speaking environments and across word positions without direct training. Three preschool children with articulation disorders received treatment in a clinic setting. Treatment targets consisted of specific phonemes restricted to particular word positions. Data were collected on the children's productions of the target phonemes in treated and untreated word positions. In addition, the children's productions were monitored with different adults in the clinic and at home. The results indicated that generalization occurred in the two speaking environments without direct training. The extent to which generalization occurred across word position varied and seemed to be related to specific phonemes. The practical implications of the results and methodology are discussed.
Article
The study was aimed at evaluating the effectiveness of a systematic population-based screening programme for specific language impairment (SLI) in preschool children in Germany. The study question was divided into a review of (1) evidence from studies evaluating screening programmes, (2) diagnostic instruments in the German language, and (3) studies evaluating speech and language interventions. A systematic database search was conducted between June and October 2007 and was updated in January and again in May 2008. Relevant studies were identified by 2 independent reviewers based on screened titles/abstracts and full texts. 4,806 studies were screened. The only existing controlled screening study did not provide data for SLI. No diagnostic study met the inclusion criteria. Sixteen randomized intervention studies were included, 3 studies contributed to the appraisal of earlier against later initiation of treatment. Most studies were of limited quality. We found indications of short-term positive effects from language therapies in children with SLI. Long-term outcomes were not investigated. No evidence supporting the advantage of earlier treatment initiation was identified. The benefit of population-based language screening of preschool children with SLI is not proven. Controlled screening studies are therefore necessary. For Germany, the accuracy of existing diagnostic instruments has not yet been sufficiently examined.
Article
The present investigation had two purposes: (a) to assess significant changes in the attitudes and perceptions of mothers of young children who were enrolled in 15 wk. of individual speech-language therapy and (b) to compare changes in mothers' attitudes and perceptions with university supervisors' ratings of children's over-all communication skills and speech intelligibility. 17 children, ages 2;10 to 5;8, and their mothers were participants. Mothers received speech-language services and counseling from graduate-student clinicians and university clinical supervisors but no special counseling was provided to alter their attitudes and perceptions concerning the intervention process. The typical child in the intervention program received 24 individual speech and language therapy sessions. Mothers and supervisors completed questionnaires before and after the 15-wk. intervention. Neither group was made aware of the purpose of the investigation. Analysis showed a pattern of significant changes in mothers' pre- and postrankings of questionnaire items and significant changes in the total communication and speech intelligibility rankings made by supervisors. Significant relationships were found for changes in attitudes and perceptions of mothers and changes in the children's communication skills. The results bolster the need for use of family-based therapy approaches in intervention programs for young children's communication disorders.
Article
Background: It is thought that approximately 6% of children have speech and language difficulties of which the majority will not have any other significant developmental difficulties. Whilst most children's difficulties resolve, children whose difficulties persist into primary school may have long-term problems concerning literacy, socialisation, behaviour and school attainment. Objectives: To examine the effectiveness of speech and language interventions for children with primary speech and language delay/disorder. Search strategy: The following databases were searched: The Cochrane Controlled Trials Register (Cochrane Library, CENTRAL: 2002/3), CINAHL (1982 - July 2002), EMBASE (1980 - Sept Week 4 2002), ERIC (1965 - 2002), MEDLINE (1966 - Sept Week 3 2002), PsycINFO (1872 - 2002/10 Week 2), The National Research Register (2002/3). In addition to this references were taken from reviews of the literature and reference lists from articles. Selection criteria: The review considered randomised controlled trials of speech and language therapy interventions for children or adolescents with primary speech and language delay/disorder. Data collection and analysis: Titles and abstracts were identified and assessed for relevance, before the full text version was obtained of all potentially relevant articles. The data were categorised depending on the nature of the control group and considered in terms of the effects of intervention on expressive and receptive phonology, syntax and vocabulary. The outcomes used in the analysis were dependent on the focus of the study with only the primary effects of therapy being considered in this review. Main results: The results of twenty-five studies were used in the meta-analysis. The results suggest that speech and language therapy is effective for children with phonological (SMD=0.44, 95%CI: 0.01,0.86) or vocabulary difficulties (SMD=0.89, 95%CI: 0.21,1.56), but that there is less evidence that interventions are effective for children with receptive difficulties (SMD=-0.04, 95%CI: -0.64,0.56). Mixed findings were found concerning the effectiveness of expressive syntax interventions (n=233; SMD=1.02, 95%CI: 0.04-2.01). No significant differences were shown between clinician administered intervention and intervention implemented by trained parents, and studies did not show a difference between the effects of group and individual interventions (SMD=0.01, 95%CI: -0.26,1.17). The use of normal language peers in therapy was shown to have a positive effect on therapy outcome (SMD=2.29, 95%CI: 1.11,3.48). Reviewer's conclusions: The review shows that overall there is a positive effect of speech and language therapy interventions for children with expressive phonological and expressive vocabulary difficulties. The evidence for expressive syntax difficulties is more mixed, and there is a need for further research to investigate intervention for receptive language difficulties. There is a large degree of heterogeneity in the results, and the sources of this need to be investigated.
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