Young children with cleft lip and/or palate are at risk for speech and language delays associated with structural deficits despite early surgical repair. This study proposes to evaluate the effectiveness of an early intervention to facilitate speech and vocabulary development and prevent the habituation of compensatory articulation use. This exploratory investigation consists of a pilot study to operationalize intervention components of an EMT (Enhanced Milieu Teaching) intervention with and without a phonological recasting emphasis (PE) and a randomized group study to compare the optimal combination of EMT/PE (determined in the pilot) to a traditional articulation therapy performed in the community. The pilot study will examine 4 children, 18-24 months of age, in a multiple baseline design. Following refinement of the procedures in the pilot study, a group study will examine the effectiveness of this intervention in 2 groups of children with clefts, 18-24 months of age, randomly assigned to a treatment (14 children) or community-based control group (CBI) (14 children).
Specific aims of the group study includes: (1) examining the effects of a naturalistic vocabulary intervention to promote change in the sound inventories, speech accuracy and use of compensatory articulation for the children in the EMT/PE intervention group compared with the children in a control group, (2) comparing the effects of the EMT/PE intervention on the generalization of speech production changes to home use in the treatment and control groups, and (3) to determine if changes in vocabulary, sound inventory, speech sound accuracy and use of compensatory articulation are maintained 3 months after the conclusion of the treatment. The children will receive a comprehensive speech, language, hearing and cognitive assessment at the beginning of the study, and 3 and 6 months later, corresponding to the beginning, immediately following treatment and a 3 month follow-up.

Public Health Relevance

This project examines treatment efficacy of an early intervention model for children with cleft lip and/or palate that promotes early normalization of speech and language development and prevention of compensatory articulation patterns. The intervention optimizes methods for promoting treatment generalization and maintenance through a collaborative parent-clinician implemented intervention delivered across clinic and home settings. This model will be compared to a traditional articulation treatment provided in the community.

Agency
National Institute of Health (NIH)
Institute
National Institute on Deafness and Other Communication Disorders (NIDCD)
Type
Exploratory/Developmental Grants (R21)
Project #
5R21DC009654-02
Application #
7895673
Study Section
Language and Communication Study Section (LCOM)
Program Officer
Shekim, Lana O
Project Start
2009-07-17
Project End
2012-06-30
Budget Start
2010-07-01
Budget End
2012-06-30
Support Year
2
Fiscal Year
2010
Total Cost
$186,647
Indirect Cost
Name
East Tennessee State University
Department
Psychology
Type
Schools of Allied Health Profes
DUNS #
051125037
City
Johnson City
State
TN
Country
United States
Zip Code
37614
Kaiser, Ann P; Scherer, Nancy J; Frey, Jennifer R et al. (2017) The Effects of Enhanced Milieu Teaching With Phonological Emphasis on the Speech and Language Skills of Young Children With Cleft Palate: A Pilot Study. Am J Speech Lang Pathol 26:806-818
Scherer, Nancy J; Williams, Lynn; Stoel-Gammon, Carol et al. (2012) Assessment of Single-Word Production for Children under Three Years of Age: Comparison of Children with and without Cleft Palate. Int J Otolaryngol 2012:724214