Conversations with SLPs (2)

Some of you know that SAILS, my speech perception intervention software, is available for free to any speech therapist working with children who speak a North American dialect of English. The license is available from McGill University and I receive many requests every week along with some feedback and questions from users.  Gissella wrote to me with the following interesting question and I would like to share it and the answer with my readers:

“I am currently using the SAILS program with some children and have found it very helpful. I was wondering if the program could be used by parents with the help (training and treatment) of the treating S-LP. If that is possible, how would the parent go around getting the software.”

I answered that I am not comfortable with releasing the licence directly to parents because I would prefer that the parent be working under the guidance of an SLP so the best thing is for the SLP to apply for the license on behalf of the parent via flintbox .  (By the way I have worked out a way to make this old software run on 64-bit computers – you can download instructions in the revised BACKGROUNDER from the flintbox site. The tablet app is still under construction but I am hopeful that it will be available in 2014).

Further to the topic of parent application of SAILS, I also sent Gissella a copy of my paper – Rvachew, Nowak, & Cloutier (2004) – describing a randomized control trial in which we taught parents to administer SAILS to their children in the clinic, after their child’s regularly scheduled speech therapy session. Children in the control group played with Living Books after their speech therapy session and their parent asked them questions about the story according to sImagecripts that we provided. Both groups showed similar gains in phonological awareness but the SAILS (Sp Percn) group made dramatically better improvements in articulation accuracy as measured by number of errors on the Goldman-Fristoe Test of Articulation (see Figure inserted into this post) and by Percent Consonants Correct as reported in the paper. In that study we didn’t send SAILS home with the parents – as Gissella commented in a subsequent e-mail: “I now realize that the frequency of once per week seems to be sufficient, and therefore it can be done within the clinic most of the time, no need for the parent to do this at home.” This is absolutely correct, in all of my studies we have found that the intensity of the speech perception intervention does not have to be that great – a 20 minute session once per week during the first three sessions on a new phoneme works just fine.

In a follow-up e-mail, Gissella had another really interesting question however; “often times parents ask if they can have this program at home as they see it is easy to use and enjoyable for the child. There has been one case where we had treated the phonological delay, but there was residual articulation (frontal lisp) that will be treated at a later time. The parent had seen how SAILS worked for the phonology part and was interested in continuing exposing the child to the samples for /s/.”  I think that this would be a really interesting application for SAILS but unfortunately there is no empirical evidence to prove that this would be effective. I have always wanted to do a randomized control trial in which children with residual errors in kindergarten were treated with SAILS and then measures of speech accuracy, functional communication and psychosocial outcomes were collected at 6-month intervals for the next two years. Would we see more cases of “spontaneous” resolution of the residual errors in the SAILS group than in the control group? Unfortunately I can’t get decent funding for randomized control trials that involve even children with severe speech sound disorders so I doubt that I could get enough funding for something like this (to have enough statistical power it would have to be a big multisite study with a lot of funding even though 18 percent of 8 year olds can be expected to have speech errors; see Roulstone et al., 2009). You cannot believe how often other researchers, even those working in the field of speech sound disorders, tell me that this most common of neurodevelopmental disorders is just “not important” (see Bishop, 2010)!

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