Treatment of Phonological Disorder: A Feasibility Study With Focus on Outcome Measures Purpose In a feasibility study for a randomized controlled trial of treatments for phonological disorders conducted over a period of 8 months, we examined 6 clinically relevant outcome measures. We took steps to reduce error variance and to maximize systematic variance. Method Six children received traditional treatment (Van ... Clinical Focus
Clinical Focus  |   May 03, 2018
Treatment of Phonological Disorder: A Feasibility Study With Focus on Outcome Measures
 
Author Affiliations & Notes
  • Ann Bosma Smit
    School of Family Studies and Human Services, Kansas State University, Manhattan
  • Klaire Mann Brumbaugh
    Heart of Texas Region Mental Health Mental Retardation Center, Waco
  • Barbara Weltsch
    School of Family Studies and Human Services, Kansas State University, Manhattan
  • Melanie Hilgers
    School of Family Studies and Human Services, Kansas State University, Manhattan
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. ×
  • Correspondence to Ann Bosma Smit: asmit@ksu.edu
  • Editor: Krista Wilkinson
    Editor: Krista Wilkinson×
  • Associate Editor: Lynn Williams
    Associate Editor: Lynn Williams×
Article Information
Research Issues, Methods & Evidence-Based Practice / Normal Language Processing / Speech, Voice & Prosody / Clinical Focus
Clinical Focus   |   May 03, 2018
Treatment of Phonological Disorder: A Feasibility Study With Focus on Outcome Measures
American Journal of Speech-Language Pathology, May 2018, Vol. 27, 536-552. doi:10.1044/2017_AJSLP-16-0225
History: Received November 14, 2016 , Revised June 27, 2017 , Accepted September 11, 2017
 
American Journal of Speech-Language Pathology, May 2018, Vol. 27, 536-552. doi:10.1044/2017_AJSLP-16-0225
History: Received November 14, 2016; Revised June 27, 2017; Accepted September 11, 2017

Purpose In a feasibility study for a randomized controlled trial of treatments for phonological disorders conducted over a period of 8 months, we examined 6 clinically relevant outcome measures. We took steps to reduce error variance and to maximize systematic variance.

Method Six children received traditional treatment (Van Riper, 1939), and 7 received expansion points (Smit, 2000), a treatment program with both phonological and traditional elements. Outcome measures, which were applied to both word list and conversational samples, included percentage of consonants correct (PCC; Shriberg & Kwiatkowski, 1982), PCC for late and/or difficult (L/D) consonants and number of L/D consonants acquired.

Results In repeated-measures analyses of variance, all measures showed significant differences from pretreatment to posttreatment, and the word list measures were associated with very high power values. In analyses of covariance for between-groups contrasts, the adjusted expansion points mean exceeded the adjusted traditional treatment mean for every measure; however, no differences reached significance. For the L/D PCC (conversation) measure, the contrast between groups was associated with a large effect size.

Conclusion We recommend that practitioners use outcome measures related to a word list. We recommend that researchers consider using L/D PCC on the basis of conversational samples to detect differences among treatment groups.

Supplemental Materials https://doi.org/10.23641/asha.5872677

Acknowledgments
The authors are grateful to Kansas State University for a Faculty Development Award for 2009–2010, to the College of Human Ecology for two SRO grants (one for 2008–2009 and one for 2010–2011), and to the Program in Communication Sciences and Disorders for several small grants that made this research possible. The authors thank United School District 383 for the support provided by the Speech Groups contract. The authors also thank Chelsie, Sarah, Julie, Erica, and Carly for devoting many hours to serving as transcibers of these study videos. Finally, the authors are grateful to all the children, their parents, and the student clinicians for all that they contributed to this study.
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