Cluster-Randomized Controlled Trial Evaluating the Effectiveness of Computer-Assisted Intervention Delivered by Educators for Children With Speech Sound Disorders.

Sharynne Mcleod,Sue Roulstone,Paul White,Sarah Masso,Elise Baker,Yvonne Wren,Kathryn Crowe,Jane Mccormack,Charlotte Howland

doi:10.1044/2017_jslhr-s-16-0385

Abstract

The aim was to evaluate the effectiveness of computer-assisted input-based intervention for children with speech sound disorders (SSD). The Sound Start Study was a cluster-randomized controlled trial. Seventy-nine early childhood centers were invited to participate, 45 were recruited, and 1,205 parents and educators of 4- and 5-year-old children returned questionnaires. Children whose parents and educators had concerns about speech were assessed (n = 275); 132 children who were identified with phonological pattern-based errors underwent additional assessment. Children with SSD and no difficulties with receptive language or hearing, typical nonverbal intelligence, and English as their primary language were eligible; 123 were randomized into two groups (intervention n = 65; control n = 58), and 3 withdrew. The intervention group involved Phoneme Factory Sound Sorter software (Wren & Roulstone, 2013) administered by educators over 9 weeks; the control group involved typical classroom practices. Participants were reassessed twice by a speech-language pathologist who was unaware of the initial assessment and intervention conditions. For the primary outcome variable (percentage of consonants correct), the significant mean change from pre- to postintervention for the intervention group (mean change = +6.15, p < .001) was comparable in magnitude to the significant change for the control group (mean change = +5.43, p < .001) with a small between-groups effect size for change (Cohen's d = 0.08). Similar results occurred for measures of emergent literacy, phonological processing, participation, and well-being. Computer-assisted input-based intervention administered by educators did not result in greater improvement than typical classroom practices.

Highlights

To evaluate the effectiveness of computer-assisted input-based intervention for children with speech sound disorders (SSD)
An intention-to-treat analysis was carried out on the primary outcome measure (PCC) and the secondary outcome measures followed by an analysis per protocol to account for the variation, and receipt of additional speech-language pathologist (SLP) intervention received by each group
Effectiveness of Phoneme Factory Sound Sorter® (PFSS): Intention to Treat The 123 participants who were eligible for intervention in stage 4 of the Sound Start Study were randomized into two groups

Summary

Introduction

To evaluate the effectiveness of computer-assisted input-based intervention for children with speech sound disorders (SSD). In an effort to close the gap between empirically-based recommendations regarding intensity of intervention, and real-world speech-language pathology service delivery constraints, some interventions for children with SSD have been trialled using alternative models of delivery in which parents or educators deliver intervention given training and guidance from an SLP (Broen & Westman, 1990; Dodd & Barker, 1990; Eiserman, McCoun, & Escobar, 1990; Lancaster, Keusch, Levin, Pring, & Martin, 2010; Ruscello, Cartwright, Haines, & Shuster, 1993). This idea has appeal, because children with SSD are at risk of literacy difficulties (Anthony et al, 2011)

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