Speech Intervention for Speech Sound Disorder

Overseen By Philip Combiths

Age: < 18

Sex: Any

Trial Phase: Phase 1

Sponsor: Philip Combiths

Disqualifiers: Receiving other speech treatment

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 17

Duration: 6 weeks

16 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to identify the most effective speech treatment methods for Spanish-English bilingual children with speech sound disorders. Researchers seek to determine whether focusing on complex speech sounds in either English or Spanish aids in improving speech in one or both languages. Participants will engage in speech therapy sessions conducted in either English or Spanish. The trial suits children regularly exposed to English, whose caregivers are concerned about their child's speech clarity, and who have noticeable gaps in their speech sounds. As a Phase 1 trial, this research focuses on understanding how the treatment works in people, offering participants the opportunity to be among the first to receive this innovative speech therapy.

Will I have to stop taking my current medications?

The trial protocol does not specify whether participants need to stop taking their current medications.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that bilingual speech therapy is generally well-tolerated by children. For instance, one study involved two young boys who participated in bilingual therapy for eight weeks without any reported negative effects, indicating the treatment's safety for children.

Another study examined Spanish-speaking mothers whose children received speech therapy at school. This study focused on the mothers' experiences and did not mention any safety issues, suggesting these interventions are usually safe.

Since this trial is in its early stages, it aims to assess the treatment's safety and how well children handle it. Although direct safety data from these studies is limited, the absence of reported negative effects in similar treatments suggests it is likely safe. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Speech Intervention for Speech Sound Disorder because it uniquely caters to bilingual children, offering treatment in both English and Spanish. Unlike standard therapies that often focus on one language, this approach targets speech sounds specific to each language, helping kids improve their speech in both English and Spanish settings. By using a drill-play format, the intervention is designed to be engaging for young children, which can enhance their learning experience and potentially lead to faster improvements in speech clarity across both languages.

What evidence suggests that this trial's treatments could be effective for speech sound disorder?

Research has shown that focusing on complex language skills in speech therapy can help children with speech sound disorders learn more effectively. In this trial, participants will receive either English Language Intervention or Spanish Language Intervention. For English, studies have found that intensive and focused treatments improve children's speech sound production. In Spanish, working on challenging sound patterns enhances speech in both Spanish and English, as skills transfer between the two languages. Practicing difficult sounds in one language might boost overall speech abilities in bilingual children. Therefore, both English and Spanish treatments in this trial appear promising for addressing speech sound disorders through complex language skills and intensive practice. ^{6 7 8 9 10}

Are You a Good Fit for This Trial?

This trial is for bilingual Spanish-English children with speech sound disorders, who are missing several specific sounds in their speech. They must have regular exposure to English and concerns about their speech development should be reported by caregivers.

Inclusion Criteria

I have a speech disorder with missing sounds in my speech in multiple languages.

My child is regularly exposed to English through family or school.

I am concerned about my child's speech clarity.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

2-4 visits (in-person)

Treatment

Participants attend between 12 and 18 speech intervention sessions in Spanish or English for up to 6 weeks

6 weeks

12-18 visits (in-person)

Follow-up

Participants are monitored for speech generalization and effectiveness after treatment

2 months

3 visits (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• Treatment Targets in Spanish and English Bilingual Speech Intervention

Trial Overview The study tests which speech treatment targets help bilingual children learn the most in both languages. It compares the effects of treatments given in English and Spanish on learning within one language and across both languages.

How Is the Trial Designed?

Group I: Spanish Language Intervention Experimental Treatment 1 Intervention

Treatment will be conducted entirely in Spanish, targeting Spanish speech sounds. Treatment will follow a drill-play format.

Group II: English Language Intervention Experimental Treatment 1 Intervention

Treatment will be conducted entirely in English, targeting English speech sounds. Treatment will follow a drill-play format.

Who Is Running the Clinical Trial?

Philip Combiths

Lead Sponsor

Trials

1

Recruited

20+

National Institute on Deafness and Other Communication Disorders (NIDCD)

Collaborator

Trials

377

Recruited

190,000+

Published Research Related to This Trial

The study found that treating bilingual children with speech sound disorders using shared sounds in their first language (Spanish) led to improved accuracy and generalization of those sounds in their second language (English).

Two bilingual children aged 5 participated in therapy sessions that combined linguistic and motor approaches, showing that focusing on shared sounds can enhance treatment effectiveness and suggests a need for careful selection of treatment targets in bilingual speech therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A cross-linguistic approach to treating speech sound disorders in bilingual children. Irizarry-Pérez, CD., Peña, ED., Bedore, LM., et al.[2023]

The study examined the efficacy of phonological interventions targeting complex consonants in four Spanish-speaking children with speech sound disorder, revealing that while only one child mastered the targeted sounds, all showed some generalization to untargeted phonological structures.

The findings suggest that targeting complex phonological structures may lead to broader improvements in speech, although individual responses varied, indicating that participant characteristics and the complexity of targets play a significant role in intervention outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Phonological complexity in intervention for Spanish-speaking children with speech sound disorder. Combiths, P., Pruitt-Lord, S., Escobedo, A., et al.[2023]

Bilingual intervention for speech sound disorders in two 5-year-old boys resulted in significant improvements in their speech in both English and Spanish after 8 weeks of treatment, suggesting that addressing both languages can enhance overall speech skills.

The study found that not only did the targeted speech sounds improve, but there were also positive changes in some untreated speech errors, indicating a cross-linguistic benefit from the bilingual approach.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cross-linguistic generalization in the treatment of two sequential Spanish-English bilingual children with speech sound disorders. Gildersleeve-Neumann, C., Goldstein, BA.[2022]

There is a lack of normative data on the phonological development of bilingual children, making it challenging to differentiate between typical delays and actual speech disorders in those learning two languages sequentially.

Treatment efficacy studies on two bilingual children revealed that the effectiveness of interventions can vary based on the specific speech processing deficits, indicating that both languages may not always require treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparison of cross-language generalisation following speech therapy. Holm, A., Dodd, B.[2019]

In a study involving 29 bilingual children with primary language impairment, both monolingual and bilingual language interventions showed significant improvements in vocabulary in French, but there was no difference in effectiveness between the two treatment approaches.

The bilingual intervention, which included parent collaboration, did not lead to significant gains in syntax or improvements in the children's home language, suggesting that the intensity of the bilingual context was insufficient for effective treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Monolingual or bilingual intervention for primary language impairment? A randomized control trial. Thordardottir, E., Cloutier, G., Ménard, S., et al.[2022]

A pilot study involving two Spanish-English bilingual children with speech sound disorders showed that targeting complex phonological targets, like consonant clusters in Spanish, can lead to significant improvements in both languages, indicating effective cross-linguistic generalization.

The intervention, conducted via teletherapy over six weeks, resulted in a medium effect size for generalization, with mean effect sizes of 3.6 in Spanish and 4.3 in English, suggesting that treatment in one language can positively impact the other.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Complexity and cross-linguistic transfer in intervention for Spanish-English bilingual children with speech sound disorder. Combiths, P., Escobedo, A., Barlow, JA., et al.[2023]

Citations

1. asha.org asha.org/practice-portal/clinical-topics/articulation-and-phonology/?srsltid=AfmBOorUjSzLpWleW1wA4h3f9ytG1gVLpd7LxHftIHhiU3Dn8zkmuhCj

Speech Sound Disorders: Articulation and Phonology The following data reflect the variability: Overall, 2.1%–23% of 4- to 6-year-old children were estimated to have SSDs (Eadie et al., 2015; Jessup et al., 2008; ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11086453/

Outcome measures for children with speech sound disorder The objective of this umbrella review paper is to provide a rigorous and detailed list of assessments, interventions and outcomes which target SSD in children.

3. clinicaltrials.gov clinicaltrials.gov/study/NCT07061730

NCT07061730 | Evaluating the Effectiveness of Hybrid and ... The purpose of this research study is to evaluate the effectiveness of a hybrid Artificial Intelligence-assisted speech therapy model, ...

4. bmjopenquality.bmj.com bmjopenquality.bmj.com/content/11/2/e001761

Applying evidence to practice by increasing intensity of ... The evidence base shows that intervention for children with SSD is more effective and efficient when provided intensively in relation to the ...

5. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8700312/

The Effectiveness of an Integrated Treatment for Functional ... Developmental speech sound disorders have been reported to account for an estimated 75% of all communication disorders in children [10]. The ...

6. clinicaltrials.gov clinicaltrials.gov/study/NCT06416306

Treatment Targets in Spanish and English Bilingual ... This study is a single-subject experimental design with staggered multiple baselines examining speech intervention for Spanish-English bilingual children with ...

7. pubs.asha.org pubs.asha.org/doi/10.1044/2024_LSHSS-23-00043

Spanish-Speaking Mothers' Experiences of School-Based ... In this qualitative study, we explore the experiences of Spanish-speaking mothers whose children have received school-based speech-language intervention.

8. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6198909/

Tutorial: Speech Assessment for Multilingual Children Who Do ... The aim of this tutorial is to support speech-language pathologists (SLPs) undertaking assessments of multilingual children with suspected speech sound ...

9. shs.unm.edu shs.unm.edu/people/faculty/docs/irizarry-perez-et-al-2024-spanish-speaking-mothers-experiences-of-school-based-speech-therapy.pdf

Spanish-Speaking Mothers' Experiences of School-Based ... In this qualitative study, we explore the experiences of. Spanish-speaking mothers whose children have received school-based speech- language intervention and ...

10. link.springer.com link.springer.com/article/10.1007/s40474-015-0049-3

Bilingualism and Speech Sound Disorders Two 5-year-old sequential Spanish-English boys received bilingual intervention for 8 weeks. Both boys were stronger in Spanish than English.