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

Trial Summary

What is the purpose of this trial?

The goal of this clinical trial is to learn which speech treatment targets result in the greatest amount of speech learning in Spanish-English bilingual children with speech sound disorders. The main questions it aims to answer are: * Does linguistic complexity of the treatment target increase the amount of generalized learning within the treated language? * Does linguistic complexity of the treatment target increase the amount of generalized speech across languages? Researchers will compare intervention effects across treatment provided in English and Spanish to see if the effect differs according to the language of intervention. Participants will: * Attend between 12 and 18 45-minute speech intervention sessions in Spanish or English for up to 6 weeks * Attend assessment visits before and after intervention * Attend follow-up assessment visits 1 month and 2 months after intervention

Will I have to stop taking my current medications?

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

What data supports the effectiveness of the treatment for Speech Sound Disorder in bilingual children?

Research shows that treating speech sound disorders in bilingual children by targeting sounds in both languages can lead to improvements in both languages. Studies found that focusing on complex sounds in one language can help children improve their speech in both languages, suggesting that bilingual intervention can be effective. ^{1 2 3 4 5}

How does the Bilingual Speech Therapy for Speech Sound Disorder differ from other treatments?

This treatment is unique because it targets both Spanish and English languages simultaneously, promoting cross-linguistic generalization, which means improvements in one language can lead to improvements in the other. It uses complex phonological targets, like consonant clusters, to induce system-wide changes, making it more efficient for bilingual children compared to traditional single-language interventions. ^{1 2 4 5 6}

Eligibility Criteria

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

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)

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

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]

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]

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]

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]

References

1. England pubmed.ncbi.nlm.nih.gov

A cross-linguistic approach to treating speech sound disorders in bilingual children. [2023]

2. England pubmed.ncbi.nlm.nih.gov

Phonological complexity in intervention for Spanish-speaking children with speech sound disorder. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

Monolingual or bilingual intervention for primary language impairment? A randomized control trial. [2022]

4. England pubmed.ncbi.nlm.nih.gov

Cross-linguistic generalization in the treatment of two sequential Spanish-English bilingual children with speech sound disorders. [2022]

5. England pubmed.ncbi.nlm.nih.gov

Complexity and cross-linguistic transfer in intervention for Spanish-English bilingual children with speech sound disorder. [2023]

6. Switzerland pubmed.ncbi.nlm.nih.gov

Comparison of cross-language generalisation following speech therapy. [2019]