Faculty Research

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Early intervention in children with cleft palate (NIH R21 proposal submited  October, 2007)

Nancy J. Scherer, PhD ( Email: scherern@etsu.edu )

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 will pilot a early intervention combining an effective language intervention (EMT: Enhanced Milieu Training) augmented with phonological recasts (PR) with 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 (16 children) or control group receiving community early intervention (16 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+PR intervention group compared with the children in a control group, (2) comparing the effects of the EMT +PR 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.