March 7, 2017

Cluster randomized controlled trial evaluating the effectiveness of computer-assisted intervention delivered by educators for children with speech sound disorders

The following manuscript has been accepted for publication. It is the main outcomes paper from the Sound Start Study.
McLeod, S., Baker, E., McCormack, J., Wren, Y., Roulstone, S. Crowe, K., Masso, S., White, P., & Howland, C. (2017, in press). Cluster randomized controlled trial evaluating the effectiveness of computer-assisted intervention delivered by educators for children with speech sound disorders. Journal of Speech, Language, and Hearing Research.

We received extremely positive feedback from the editors and reviewers. For example, the associate editor wrote “The reviewers and I enthusiastically await the publication of this important article on delivering services to children with speech sound disorders.”

Here is the abstract:
Purpose: To evaluate the effectiveness of computer-assisted input-based intervention for children with speech sound disorders (SSD).
Method: The Sound Start Study was a cluster randomized controlled trial. Seventy-nine early childhood centers were invited to participate, 45 were recruited, and 1,205 4- to 5-year-old children’s parents/educators returned questionnaires. Children whose parents/educators had concerns about speech were assessed (n=275); 132 children who were identified with phonological impairment of unknown origin underwent additional assessment. Children with SSD and no receptive language or hearing difficulties, typical non-verbal intelligence, and English as their primary language were eligible; 123 were randomized (Intervention n=65; Control n=58); 3 withdrew. Intervention involved Phoneme Factory Sound Sorter software administered by educators over 9 weeks; Control involved typical classroom practices. Participants were re-assessed twice by a speech-language pathologist (SLP) blinded to the initial assessment and intervention conditions.
Results: For the primary outcome variable (percentage of consonants correct), the significant mean change from pre- to post-intervention for the Intervention group (mean change+6.15, p<.001) was comparable in magnitude to the significant change for the Control group (mean change+5.43, p<.001) with a small between groups effect size for change (Cohen’s d=0.08). Similar results occurred for measures of emergent literacy, phonological processing, participation, and wellbeing.
Conclusion: Computer-assisted input-based intervention administered by educators did not result in greater improvement than typical classroom practices.