TY - JOUR
T1 - Toward a paradigm shift from deficit-based to proactive speech and language treatment
T2 - Randomized pilot trial of the Babble Boot Camp in infants with classic galactosemia
AU - Peter, Beate
AU - Potter, Nancy
AU - Davis, Jennifer
AU - Donenfeld-Peled, Inbal
AU - Finestack, Lizbeth
AU - Stoel-Gammon, Carol
AU - Lien, Kari
AU - Bruce, Laurel
AU - Vose, Caitlin
AU - Eng, Linda
AU - Yokoyama, Hanako
AU - Olds, Daniel
AU - VanDam, Mark
N1 - Funding Information:
Grant information: This work was supported by a seed grand from the Arizona State University Institute for Social Science Research and an Arizona State University New Faculty Startup Fund award to B. Peter and by NSF SBE RIDIR 1539129 and the Washington Research Foundation to M. VanDam.
Publisher Copyright:
© 2020 Peter B et al.
PY - 2020
Y1 - 2020
N2 - Background: Speech and language therapy is typically initiated reactively after a child shows delays. Infants with classic galactosemia (CG), a metabolic disease with a known high risk for both speech and language disorders, hold the keys towards evaluating whether preventive treatment is effective when the risks are known at birth. We present pilot data from a randomized parallel trial of an innovative proactive speech and language intervention program, the Babble Boot Camp (BBC). Method: Five children with CG, otherwise healthy, participated in the study from approximately 2 to 24 months of age. One of these was randomly selected as control receiving conventional management, which typically starts at age 2-3 years. A pediatric speech-language pathologist met weekly via telepractice with the parents in the treatment cohort. Parents implemented the prespeech, speech, and language stimulation and expansion activities according to the intervention protocol. The control child was still too young for conventional treatment. Primary outcome measures were speech sound production complexity in babble and speech and expressive vocabulary size. Secondary outcome measures were vocalization rates and developmental milestones in communication, motor, and cognition. The trial is ongoing. Results: All four treated children had higher speech sound skills in babble, three had higher speech sound skills in meaningful speech, two had higher expressive vocabularies, three had higher global developmental scores, and two had higher vocalization rates, compared to the control child with CG. Discussion: Given the high risk for speech and language delays in children with CG, finding on-schedule abilities in two or more of the treated children but not the untreated child is unexpected under random conditions. The trends toward beneficial effects of the BBC on speech sound production, expressive language, and communication milestones warrant appropriately powered larger clinical trials with full randomization. Trial registration: ClinicalTrials.gov NCT03838016 (12 th February 2019).
AB - Background: Speech and language therapy is typically initiated reactively after a child shows delays. Infants with classic galactosemia (CG), a metabolic disease with a known high risk for both speech and language disorders, hold the keys towards evaluating whether preventive treatment is effective when the risks are known at birth. We present pilot data from a randomized parallel trial of an innovative proactive speech and language intervention program, the Babble Boot Camp (BBC). Method: Five children with CG, otherwise healthy, participated in the study from approximately 2 to 24 months of age. One of these was randomly selected as control receiving conventional management, which typically starts at age 2-3 years. A pediatric speech-language pathologist met weekly via telepractice with the parents in the treatment cohort. Parents implemented the prespeech, speech, and language stimulation and expansion activities according to the intervention protocol. The control child was still too young for conventional treatment. Primary outcome measures were speech sound production complexity in babble and speech and expressive vocabulary size. Secondary outcome measures were vocalization rates and developmental milestones in communication, motor, and cognition. The trial is ongoing. Results: All four treated children had higher speech sound skills in babble, three had higher speech sound skills in meaningful speech, two had higher expressive vocabularies, three had higher global developmental scores, and two had higher vocalization rates, compared to the control child with CG. Discussion: Given the high risk for speech and language delays in children with CG, finding on-schedule abilities in two or more of the treated children but not the untreated child is unexpected under random conditions. The trends toward beneficial effects of the BBC on speech sound production, expressive language, and communication milestones warrant appropriately powered larger clinical trials with full randomization. Trial registration: ClinicalTrials.gov NCT03838016 (12 th February 2019).
KW - Genetic risk
KW - Infant
KW - Language impairment
KW - Prevention
KW - Speech disorder
KW - Very early intervention
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U2 - 10.12688/f1000research.18062.4
DO - 10.12688/f1000research.18062.4
M3 - Article
AN - SCOPUS:85087518539
SN - 2046-1402
VL - 8
JO - F1000Research
JF - F1000Research
M1 - 271
ER -