Treating speech sound deficits at home. Can it work? Effect of a no-training needed home programme for children with speech sound disorder

Background: Children with phonological delays and disorders are a large proportion of a speech-therapist’s caseload (Dodd, 2008). Unfortunately, in Ireland Speech-therapists’ waiting-lists can be as long as two years. Previous home-programmes required parent-training, which still demands speech-therapist resources (Brady, 2011). A novel home-programme which does not require parent-training would facilitate prompt treatment with reduced resources, and potentially be an effective alternative service delivery for this population. Aim: Determine if a no-training input-based home-programme delivered by parents’ results in measurable gains in the speech profile of children with consistent-phonological disorder and phonological delay. Method: A volunteer sample of 13 children diagnosed with (i)phonological delay or (ii)consistent-phonological disorder participated in the study. The home-programme was administered by parents fifteen minutes a day over five weeks. The home-programme utilised an input-based phonological-contrast therapy approach, in combination with phonological-awareness activities and a whole-language approach to facilitate reorganisation of the participant’s phonological system. Results: As a group, the children demonstrated statistically significant improvements in the reduction of their overall speech errors. Results further revealed that structural processes benefited more that substitution process. An increase in phonemic-inventory was also observed, however the improvement in both speech errors and phonemic inventories were small and not clinically significant. Conclusion: The results provide preliminary evidence that a parent-led home- programme is effective in improving the speech errors of children, in particular structural processes. However, as the improvements made in the speech errors and phonemic inventory of children were limited and not clinically significant, the home-programme used in this study is not an alternative service delivery to clinician directed therapy. Further research and a larger sample size are required to strengthen the evidence-base of an input-based home-programme.