JMIR Publications

ABSTRACT

Background:

Children born with a cleft palate with or without a cleft lip (CP/L), are at increased risk for delayed language development and speech sound disorders. Research has shown that early intervention is effective in improving speech and language development following palate repair. EMT+PE is a recommended naturalistic intervention for toddlers with cleft palate. The parents’ role in providing naturalistic interventions is critical and they need training based on learning principles to implement these interventions. Existing literature has proved multiple advantages of appropriate training to parents through telepractice for children and families dealing with speech-language disorders.

Objective:

This study includes several objectives: determining the effectiveness of telepractice and parent-based Enhanced Milieu Teaching + Phonological Emphasis (EMT+PE) intervention on language and speech production measures in toddlers with cleft palate, comparing the effectiveness of telepractice and Parent-based EMT+PE intervention with usual interventions on language and speech production measures and also, determining the amount of maintenance of telepractice and parent-based EMT+PE intervention.

Methods:

A randomized controlled trial (RCT) will assess the efficacy of telepractice and parent-implemented EMT+PE intervention in enhancing speech and language skills in children with cleft palate. Eligible participants will be randomly assigned to one of two groups: the conventional intervention group and the EMT+PE intervention group. Participants' speech and language will be evaluated remotely by trained raters before and after the intervention, as well as two months after the completion of the intervention. Participants’ parents in the intervention group will receive three months of training in speech and language strategies based on the telehealth fidelity scales from trained therapists. Participants in the control group will receive conventional speech and language intervention during the three months intervention period. Study outcomes will include some language variables such as mean length of utterance (MLU) and also, speech production variables such as percent correct consonants (PCC).

Results:

The selection process of participants, as well as training therapists and raters, commenced in January 2022 the therapy and follow-up period finished in June 2023, and pre and post-assessments were conducted. The data analysis is ongoing, and we anticipate publishing the results by the summer of 2024.

Conclusions:

We aim to assess the effectiveness of EMT+PE intervention through a telepractice and parent-based approach. The results present either an alternative or supplementary method to deliver speech and language therapy to Persian-speaking toddlers with cleft palate. In line with our hypothesis, speech and language measures are expected to improve. Clinical Trial: Trial registration number: 20220219054063N1.