Speech sound disorders, such as apraxia, can negatively impact a child’s wellbeing - both their social wellbeing and their academic achievement. Traditionally speech and language therapy has attempted to remediate these difficulties using auditory feedback. More recently, advances in technology have allowed the use of visual feedback as an addition. This may include charts, illustrating the soundwave the child uses against the target soundwave, or use of an avatar representing the child’s tongue movements against the target tongue movements. Treatment intensity may be a key component in guaranteeing the success of such an intervention, but as yet there is little guidance in this area. This study sought to explore the relationship between treatment intensity and treatment outcomes. Systematic searches of electronic databases identified 29 studies that met the inclusion criteria. These were coded for treatment intensity measures (treatment dose x frequency x duration) and treatment effect measures (raw difference between mean % of items correct at different intervals). Results demonstrate that changes in speech using biofeedback were better when a higher dose of therapy was given over a shorter period (clustered sessions). The optimal practice schedule may depend on the specific motor speech disorder. This study provides preliminary evidence that can enable speech and language therapists to justify why they may need to deliver an intense cluster of therapy sessions in order to achieve the optimal outcomes. Spreading therapy sessions out enables more children to be seen concurrently but may prove less effective. Thus, this article can justify the use of appropriate waiting lists and consequent intensive intervention periods resulting in better outcomes.
Spread the therapy thick and quick to make sure it works
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