School of Speech and Language Pathology, Zuyd University, Heerlen, the Netherlands.
Int J Lang Commun Disord. 2010 May-Jun;45(3):345-53. doi: 10.1080/13682820903026762.
Along with the severity of the disorder, the motivation of the children and their parents is an important element in explaining the extensive variance in therapeutic success. There is consensus that parental cooperation and homework are important for successful therapy. Systematic investigation into the effects of including homework in therapy is lacking, as are methodological approaches to increasing parental involvement.
The aim was to determine whether the efficiency of traditional articulation therapy for children with speech-sound disorders can be improved by adding a behavioural treatment approach (contingency management) to treatment in order to increase the time that patients spend doing homework.
METHODS & PROCEDURES: A total of 91 children between the ages of four and six with articulation impairments participated in the study. They were divided into three groups: 32 children were treated with traditional articulation therapy (eight sessions of 45 minutes each), 33 children received a combination of contingency management and traditional therapy, and 26 children received no therapy at all. A picture-labelling test measuring the treated target sound at different levels was used before and after therapy to quantify therapy-induced improvement.
OUTCOMES & RESULTS: The results confirm the fact that the traditional articulation therapy approach is effective for children with articulation impairments. However, adding contingency management significantly increased the frequency of homework sessions and improved the efficiency of treatment by decreasing the variance in therapeutic success.
CONCLUSIONS & IMPLICATIONS: Contingency management has a positive impact on therapeutic success and leads to an increase in the number of homework sessions.
随着障碍的严重程度的增加，孩子和他们的父母的动机是解释治疗成功的广泛差异的一个重要因素。人们普遍认为，父母的合作和家庭作业对于成功的治疗是很重要的。系统地调查包括家庭作业在内的治疗效果，以及增加父母参与的方法学方法，都缺乏共识。
目的是确定通过在治疗中添加行为治疗方法（随因管理）是否可以提高传统发音治疗对言语障碍儿童的效率，以增加患者做家庭作业的时间。
共有 91 名年龄在四到六岁之间的有发音障碍的儿童参加了这项研究。他们被分为三组：32 名儿童接受传统发音治疗（每次 45 分钟，共 8 次），33 名儿童接受随因管理和传统治疗的组合治疗，26 名儿童根本不接受治疗。在治疗前后，使用一个图片标签测试来测量治疗的目标音在不同水平上的发音，以量化治疗引起的改善。
结果证实了传统发音治疗方法对发音障碍儿童有效的事实。然而，添加随因管理显著增加了家庭作业的次数，并通过减少治疗成功的差异提高了治疗的效率。
随因管理对治疗成功有积极影响，并导致家庭作业次数的增加。
