Effects of a naturalistic intervention on the speech outcomes of young children with cleft palate.
Nancy J Scherer, Ann P Kaiser, Jennifer R Frey and 3 others
PMID 32164442WHAT IT FOUND
The early speech intervention did not improve overall speech accuracy or number of different consonants more than usual care.
Children who already spoke at a higher word rate showed larger gains, but that subgroup finding does not prove the intervention works for all.
Key findings
01After controlling for age and pre-intervention performance, assignment to EMT+PE was not a significant predictor of post-intervention speech accuracy or consonant inventory.
02In post hoc high-rate analyses, the EMT+PE group exceeded the comparison group in overall consonants, stop, fricative, liquid, and alveolar consonants.
03Children with pre-intervention word rates below 10 WPM showed limited benefit, and low-rate EMT+PE gains were not clinically meaningful except liquids and glides.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Only 30 children were enrolled, 15 in each group, so the study is small and the primary outcome was null. The EMT+PE group had lower pre-intervention speech accuracy than the BAU group, which may have influenced the results. The positive speech gains were from post hoc subgroup analyses by word rate, not the planned primary comparison. The SLP knew group assignment, although PEEPS scoring was checked by a blind second coder. PEEPS was used as the primary speech measure and has a small normative sample and limited validity and reliability data. Children in BAU could receive community services, and six did, so comparison was not no-treatment. No definitive velopharyngeal function information was available for children with audible nasal emission. Parents were not trained to implement the intervention, and parent behaviour was not measured. EMT+PE was delivered as a package, so the study cannot determine which component was responsible for any observed gains.
Declared interests
No conflicts-of-interest or funding declaration appears in the article text; the metadata lists N.I.H. extramural research support.
The easy way to misread this
Do not conclude that EMT+PE improves speech for all toddlers with cleft palate. The primary comparison did not show a significant treatment effect on speech accuracy or consonant inventory, and the larger consonant gains were only in a post hoc high-word-rate subgroup.