Is More Therapy Better for Children with Speech Sound Disorders?
Identifying optimal treatment dosage (e.g. amount of therapy: once vs. twice a week) for children with severe speech sound disorders has a direct impact on service delivery and, as a consequence, has serious logistical and economic ramifications for caregivers, insurance companies and policy-makers.
In a large scale study led by Dr. Namasivayam and colleagues (2010-2013), funded by the Ministry of Children and Youth Services, the effects of variations in treatment intensity on outcome measures were assessed using two paradigms: a lower intensity paradigm (therapy provided 1x week for 10 weeks) and a higher intensity paradigm (therapy provided 2x week for 10 weeks).
The results of the study revealed that for children with childhood apraxia of speech (CAS; a speech disorder subtype), only higher intensity treatment (2×/week) led to significantly better speech outcomes compared with lower intensity (1×/week) intervention (Namasivayam et al., 2015).
However, for children with speech sound disorders who were not the CAS subtype, both low- and high-intensity treatments yielded similar results (Namasivayam et al., 2019). The results from this large-scale study have been published in several peer-reviewed journals (see references below). Overall, these findings suggest that the general idea that more therapy is better, cannot be universally applied across different pediatric speech sound disorders.
References:
Namasivayam, A.K., Pukonen, M., Goshulak, D., Francesca, G., Le, D. L., Kroll, R., & Van Lieshout, P. H. H. M. (2019). Investigating intervention dose frequency for children with speech sound disorders and motor speech involvement. International Journal of Language & Communication Disorders. 54(4), 673–686. https://doi.org/10.1111/1460-6984.12472.
Namasivayam, A. K., Granata, F., Pukonen, M., Goshulak, D., Kroll, R., & Van Lieshout, P.H.H.M. (2018). Investigating Treatment Dose Frequency for Children With Speech Sound Disorders & Motor Speech Involvement (SSD-MSI). Presentation at the American Speech-Language-Hearing Association Convention, Boston, USA (November 15–17).
Namasivayam, A. K., Pukonen, M., Goshulak, D., Hard, J., Rudzicz, F., Rietveld, T., Maassen, B., Kroll, R., & Van Lieshout, P.H.H.M. (2015). Treatment Intensity and Childhood Apraxia of Speech. International Journal of Language & Communication Disorders. 50(4), 529-46. https://doi.org/10.1111/1460-6984.12154.
Namasivayam A.K., Pukonen, M., Hard, J., Jahnke, R., Kearney, E., Kroll, R., & Van Lieshout, P.H.H.M. (2015). Motor Speech Treatment Protocol for Developmental Motor Speech Disorders. Developmental Neurorehabilitation. 18(5), 296–303. https://doi.org/10.3109/17518423.2013.832431.
For the full articles, please visit:
https://onlinelibrary.wiley.com/doi/abs/10.1111/1460-6984.12472.
https://www.ncbi.nlm.nih.gov/pubmed/25581372.