Treatment Efficacy for Developmental Motor Speech Disorders

The Prompt Institute45 enrolled

Overview

The purpose of this study is to carry out a high-level treatment efficacy study on children with speech sound disorders with motor speech involvement (SSD-MSI) using a well-controlled Randomized Controlled Trial design. The intervention of choice is the Prompts for Restructuring Oral Muscular Phonetic Targets (PROMPT) approach, which has been effective in treating motor speech disorders in adults and in children with autism and cerebral palsy.

The results of this study will allow us to determine if there is a causal relationship between PROMPT treatment and outcome measures and predict how much improvement can be expected from this therapy. This study is being conducted as a part of a multicenter clinical trial in the province of Ontario, Canada with three sites: The John McGivney Children's Centre in Windsor, The ErinoakKids Centre for Treatment and Development in Mississauga, and The Speech and Stuttering Institute in Toronto. The study integrity will be monitored by an arms-length, external agency, The Applied Health Research Centre (AHRC) at St. Michael's Hospital in Toronto. The study is coordinated by the Department of Speech-Language Pathology at the University of Toronto and funded by the PROMPT Institute in Santa Fe, New Mexico.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Randomized Controlled Trial for Speech Disorders in Children

Interventions

PROMPTBEHAVIORAL

The PROMPT approach utilizes a motor-speech hierarchy (MSH) to guide speech language pathologists (SLP) in selecting speech movement goals for treatment. PROMPT treatment generally proceeds systematically in a bottom-up fashion starting with the lowest subsystem in the hierarchy where a child has control issues. Furthermore, in the PROMPT approach specific techniques are used to stimulate sensory input that are assumed to facilitate the formation of sensory-motor pathways required for the acquisition and accurate production of speech movement patterns. As the speech motor behaviors are established, the clinician reduces the number of cues and the frequency and immediacy of feedback and practices transfer and generalization activities.

Eligibility

Sex: ALLMin age: 3 YearsMax age: 10 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * The child is between 3 and 10 Years. * English is the primary language spoken by the primary caregiver at home. * Hearing/Vision (corrected is acceptable- e.g., spectacles) is within normal limits. * Readiness for direct speech therapy. * Age appropriate social interaction and play skills. * Age appropriate or mildly delayed receptive language skills. * Normal to any amount of delay in expressive language development. * Moderate to severe speech sound disorder. * Age appropriate or slight delay non-verbal intelligence. * 4 red flags for motor speech involvement. Exclusion Criteria: * Signs and symptoms suggesting global motor involvement (Cerebral Palsy). * Signs and symptoms suggesting Autism Spectrum Disorders. * Oral structural deficits. * Feeding impairments. * Signs of Dysarthric speech or significant drooling. * Prosodic and / or resonance disorders. * Diagnosis of Childhood Apraxia of Speech features

Locations (3)

ErinoakKids Centre for Treatment and Development

Mississauga, Ontario, Canada

The Speech and Stuttering Institute

Toronto, Ontario, Canada

The John McGivney Children's Centre of Essex County

Windsor, Ontario, Canada

Outcomes

Primary Outcomes

Change in speech motor control

Formal assessment of the neuromotor integrity of the motor speech system will be carried out using the verbal motor production assessment for children (VMPAC).