Treating children with phonological problems: does an eclectic approach to therapy work?

Abstract

A survey of clinicians made by Joffe and Pring in 2008 revealed that different approaches exist between researchers and clinicians in the treatment of children with phonological problems. Researchers have examined specific approaches to treatment often giving substantial amounts of therapy and have obtained encouraging results; clinicians, with less time available, often use an eclectic approach mixing different treatment methods. The reasons for this difference are discussed. We examined the effectiveness of an eclectic approach giving amounts of therapy more consistent with clinical practice and involving parents in treating their children. We report two small experiments conducted within Speech and Language Therapy clinics. In the first, a group of treated children are compared with a group of children whose treatment is delayed. Parents attended therapy sessions and were given homework tasks to do with their children. The second compared children treated as in the first experiment with children treated at home by their parents who had attended training sessions and with untreated children. In the first experiment, a general trend towards improvement was seen in all children. Change during treatment periods was statistically significant. In the second experiment, children treated by therapists showed strongly significant gains. Lesser but significant gains were made by children treated by their parents; no change was found in untreated children. The findings offer encouragement to clinicians who use an eclectic approach and who are only able to offer limited amounts of therapy. They also suggest that parental involvement is helpful. However, we find the current incompatibility of research and clinical work worrying and a hindrance to our efforts to understand and treat these children.