Randomized Clinical Trial of Phonological Interventions

Phase 2

• Conditions: Speech Articulation Disorder; Developmental Articulation Disorder; Phonological Impairment; Dyslexia
• Interventions: Behavioral: Speech Production Intervention; Behavioral: Speech Perception Intervention; Behavioral: Articulation Parent Group; Behavioral: Dialogic Reading Parent Group

• Registration Number: NCT00818428
• Lead Sponsor: McGill University

Brief Summary

Recent research reveals genetic and symptomatic overlap among children with speech sound disorders (i.e., those who (misarticulate more sounds than would be expected for their age) and children with dyslexia (i.e., those who struggle to learn to read). Children who have speech sound disorders as preschoolers are at risk for the later emergence of dyslexia, a risk that often reveals itself in the form of poor phonological awareness skills during the preschool period. Traditional speech therapy methods focus on articulation accuracy and do not focus on the child's more abstract knowledge of the sound system of the language. The ultimate objective of this research program is to prevent reading disability in children who present with speech sounds disorders. The relative effectiveness of different interventions to help these children achieve age-appropriate phonological processing skills prior to school entry will be investigated. It is expected that a combination of treatment approaches that focus on speech perception skills and vocabulary knowledge will have a superior impact on phonological awareness in comparison with a treatment approach that focuses solely on articulation accuracy.

Detailed Description

The 72 children participating in the study will be randomly assigned (with concealment of the randomization sequence from study staff) to one of two Child Speech Interventions: Speech Perception or Speech Production. These interventions will be provided in individualized one-hour treatment sessions once per week for six consecutive weeks during the first treatment block. During the second 6 week treatment block all children will receive a group phonological awareness intervention. Concurrently their parents will be randomly assigned to receive instruction in the provision of a home program, either Articulation Therapy or Dialogic Reading. This will result in 4 groups of 18 children with each group receiving one of four combinations of intervention: Speech Production Intervention + Articulation Parent Group; Speech Production Intervention + Dialogic Reading Parent Group; Speech Perception Intervention + Articulation Parent Group; and Speech Perception Intervention + Dialogic Reading Parent Group. Assessments will occur pretreatment, after the first treatment block, after the second treatment block, and 9 months after the end of the second treatment block.

Study Timeline

• Study Start: 2008-11
• Study First Submitted: 2009-01-05
• Study First Submitted QC: 2009-01-05
• Study First Posted: 2009-01-07
• Status Verified: 2009-09
• Last Update Submitted: 2009-09-22
• Last Update Posted: 2009-09-23
• Primary Completion: 2010-07
• Study Completion: 2010-07

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 96

Inclusion Criteria

• primary diagnosis of speech articulation disorder/phonological impairment
• age 4 to 5 years of age at onset of treatment
• maternal language Canadian French (at least 75% exposure)
• must misarticulate at least two phonemes that would typically be mastered by their normally developing age peers

Exclusion Criteria

• speech disorder is secondary to a primary condition (e.g., hearing impairment, cleft palate, autism, Down syndrome etc.)

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: FACTORIAL

Arm && Interventions

Group	Intervention	Description
1	Speech Production Intervention	Speech Production Intervention + Articulation Parent Group
1	Articulation Parent Group	Speech Production Intervention + Articulation Parent Group
2	Speech Production Intervention	Speech Production Intervention + Dialogic Reading Parent Group
2	Dialogic Reading Parent Group	Speech Production Intervention + Dialogic Reading Parent Group
3	Speech Perception Intervention	Speech Perception Intervention + Articulation Parent Group
3	Articulation Parent Group	Speech Perception Intervention + Articulation Parent Group
4	Speech Perception Intervention	Speech Perception Intervention + Dialogical Reading Parent Group
4	Dialogic Reading Parent Group	Speech Perception Intervention + Dialogical Reading Parent Group

Primary Outcome Measures

Name	Time	Method
Phonological Awareness (Test d'Analyse Auditive en Français [Auditory Analysis Test in French])	12 months post treatment onset

Secondary Outcome Measures

Name	Time	Method
Articulation Accuracy (Test Francophone de Phonologie, Paul et Rvachew [Test of French Phonology)	6 weeks post treatment onset; 12 weeks post-treatment onset; 12 months post-treatment onset
Vocabulary Knowledge (Échelle de Vocabulaire en Image Peabody [Peabody Picture Vocabulary Test - French Edition)	12 months post-treatment onset
Phonological Awareness (Test de Conscience Phonologique, Brosseau-Lapre et Rvachew [Phonological Awareness Test - French Version])	6 weeks post-treatment onset; 12 weeks post-treatment onset

Trial Locations

Locations (2)

McGill University; 🇨🇦 Montreal, Quebec, Canada

Montreal Children's Hospital; 🇨🇦 Montreal, Quebec, Canada