Department of Rehabilitation Sciences, Center for Speech and Language Sciences (CESLAS), Ghent University, Ghent, Belgium.
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium.
Int J Lang Commun Disord. 2023 Nov-Dec;58(6):2212-2221. doi: 10.1111/1460-6984.12920. Epub 2023 Jun 28.
Children born with a cleft palate with or without cleft lip (CP ± L) are known to be at risk for speech-language disorders that impact educational and social-emotional growth. It is hypothesized that speech-language intervention delivered before the age of 3 years could decrease the impact of CP ± L on speech-language development. Infant sign training in combination with verbal input expands the natural communication of young children including multimodal speech-language input (i.e., verbal and manual input) via caregivers who act as co-therapists.
To determine the effectiveness of infant sign training in 1-year-old children with CP ± L by comparing different interventions.
METHODS & PROCEDURES: This is a two-centre, randomized, parallel-group, longitudinal, controlled trial. Children are randomized to either an infant sign training group (IST group), a verbal training group (VT group) or no intervention control group (C group). Caregivers of children who are assigned to the IST group or VT group will participate in three caregiver training meetings to practise knowledge and skills to stimulate speech-language development. Outcome measures include a combination of questionnaires, language tests and observational analyses of communicative acts.
OUTCOMES & RESULTS: It is hypothesized that speech-language development of children with CP ± L will benefit more from IST compared with VT and no intervention. Additionally, the number and quality of communicative acts of both children and caregivers are expected to be higher after IST.
CONCLUSIONS & IMPLICATIONS: This project will contribute to the development of evidence-based clinical practice guidelines regarding early speech-language intervention in children with CP ± L under the age of 3 years.
What is already known on the subject Children with CP ± L are known to be at risk for speech-language delays that impact educational and social emotional growth. Given the limited scientific prove of the impact of early speech-language intervention, no standardized clinical practice guidelines are available yet for children with CP ± L under the age of 3 years. Early intervention in this population mostly focuses on improving verbal input via caregivers or professionals without including a multimodal language input. A growing scientific interest has been seen in the use of infant signs to support speech-language development and caregiver-child interaction in typically developing children and children with developmental delays. What this study adds to existing knowledge No evidence is yet available for the effectiveness and feasibility of early intervention based on infant sign training in combination with verbal input to improve speech-language skills in young children with CP ± L. The current project will investigate the effect of infant sign training on the speech-language development in this population. Outcome measures are compared with those of two control groups: verbal training only and no intervention. It is hypothesized that infant signs may support the intelligibility of verbal utterances produced by children with CP ± L. Improving children's intelligibility may increase the opportunities for these children to engage in early, frequent and high-quality interactions with their caregivers resulting in a richer social and linguistic environment. As a result, infant sign training may result in better speech-language skills compared with the control interventions. What are the potential or actual clinical implications of this work? If providing early intervention based on infant sign training is effective, there is the potential for improved speech-language outcomes in early childhood, resulting in increased speech intelligibility, increased well-being of the child and family and less need for speech-language therapy on the long-term. This project will contribute to the development of evidence-based clinical practice guidelines regarding early speech-language intervention in children with CP ± L under the age of 3 years.
患有唇腭裂（CP ± L）或不伴有唇腭裂的儿童已知存在言语语言障碍的风险，这会影响其教育和社会情感成长。人们假设，在 3 岁之前进行言语语言干预可以降低 CP ± L 对言语语言发展的影响。婴儿手语训练与言语输入相结合，可以通过作为共同治疗师的照顾者扩展幼儿的自然沟通，包括多模态言语语言输入（即言语和手动输入）。
通过比较不同干预措施，确定婴儿手语训练对 CP ± L 一岁儿童的有效性。
这是一项两中心、随机、平行组、纵向、对照临床试验。儿童被随机分配到婴儿手语训练组（IST 组）、言语训练组（VT 组）或无干预对照组（C 组）。被分配到 IST 组或 VT 组的儿童的照顾者将参加三次照顾者培训会议，以练习知识和技能，以刺激言语语言发展。结果测量包括问卷、语言测试和交际行为的观察分析的组合。
假设与 VT 组和无干预组相比，CP ± L 儿童的言语语言发展将从 IST 中受益更多。此外，预计 IST 后儿童和照顾者的交际行为数量和质量都更高。
本项目将有助于制定针对 3 岁以下 CP ± L 儿童的早期言语语言干预的循证临床实践指南。
