Parent-implemented focused stimulation in toddlers with cleft palate

    Publikation: Ph.d. afhandling/ kandidat/ diplomPh.d. afhandlingForskningpeer review


    This dissertation presents three studies concerned with early intervention in toddlers with cleft palate ± cleft lip (CP) and delayed speech and/or language acquisition.
    The central aim of the PhD project was to assess both short- and long-term effects of a parent-implemented focused stimulation (FS) program in which productive vocabulary and consonant inventory were targeted directly.
    The intervention group were compared to a control group of toddlers with CP
    who were matched in pairs on language development but did not receive direct intervention.
    The second aim was to investigate if reliable and valid early identification of intervention need was possible in toddlers with CP. Fifty-five toddlers with CP in total were included in this project. Speech-language performance was evaluated at pre-test, immediately after intervention (four months after pre-test), and six
    months after intervention (ten months after pre-test). Fourteen toddlers received intervention (INT group), and fourteen toddlers with CP constituted the control group (CONT group). Twenty-two toddlers participated in the validation of a screening procedure to identify intervention need based on speech-language performance. The screening procedure was a valid and reliable tool for identifying toddlers in need of intervention. Immediately after intervention, the INT group had significantly higher gain scores with large effect sizes for two outcome measures compared to the CONT group: lexical age, a measure of observed productive vocabulary, and true consonant types in words. Odds of
    need for intervention were eight times lower in the INT group than in the CONT group. Six months after intervention, measures of speech accuracy, reported productive vocabulary, and receptive language were not significantly different between the INT group and the CONT group. Toddlers with CP had significantly poorer speech accuracy than toddlers without CP, and only a few toddlers with CP performed within two standard deviations of the mean of toddlers without CP.
    In conclusion, early identification of toddlers with CP who need intervention was possible, but the predictive value of the screening tool is still unknown. Parent-implemented FS had shortterm effect on the speech-language performance of toddlers with CP, but no long-term effects were found. Possible explanations for the lack of long-term effects are discussed, but the results of this project suggest that early intervention should not be ventured without careful
    consideration of intervention method, dose frequency and total intervention duration, and intervention targets.
    Sponsorer for afhandling
    StatusUdgivet - 2018