Barbosa Daniela Aparecida, Wertzner Haydée Fiszbein
Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina, Universidade de São Paulo - USP - São Paulo (SP), Brasil.
Codas. 2025 Aug 11;37(4):e20240216. doi: 10.1590/2317-1782/e20240216pt. eCollection 2025.
To evaluate the effectiveness of the adapted Cycles approach to telepractice and family engagement in the treatment of children with speech sound disorder (SSD).
Ten children aged 5:0 to 7:8 years with a diagnosis of SSD participated. Two multiple baseline assessments and two post-treatment assessments were conducted. Effectiveness was measured by comparing pre- and post-intervention percentage of consonants correct (PCC), percentage of consonants correct revised (PCC-R), Process Density Index (PDI), and the number of phonological processes with occurrence >25% and the intervention effect size (ES). Family perceptions of daily training were obtained via digital interview and Likert scale. Subjects were randomly distributed to G1: two weekly online sessions with the speech therapist, and G2: half the sessions conducted by the caregiver trained by the speech therapist. Both groups received 12 sessions and performed daily speech training.
All participants showed increased PCC, PCC-R, and decreased PDI and number of phonological processes with occurrence >25%, with ES ranging from small to large. There was a trend towards statistical significance (ES G2 > G1). All caregivers reported high child interest in activities and ease of execution, with a positive family experience (Likert=4) training the child's speech using digital resources.
The effectiveness of the proposed approach ranged from medium to high. The performance of the groups was similar, with a trend towards greater effectiveness for G2, which focused on family involvement. Parental training resulted in good engagement in sessions and daily training.
评估适应性循环方法在远程治疗及家庭参与治疗儿童语音障碍(SSD)中的有效性。
10名年龄在5:0至7:8岁、被诊断为语音障碍的儿童参与研究。进行了两次多重基线评估和两次治疗后评估。通过比较干预前后的辅音正确百分比(PCC)、修正后的辅音正确百分比(PCC-R)、过程密度指数(PDI)以及出现频率>25%的语音过程数量和干预效应大小(ES)来衡量有效性。通过数字访谈和李克特量表获取家庭对日常训练的看法。受试者被随机分配到G1组:每周与言语治疗师进行两次在线课程;G2组:一半课程由言语治疗师培训的照顾者进行。两组均接受12次课程并进行日常语音训练。
所有参与者的PCC、PCC-R均有所增加,PDI以及出现频率>25%的语音过程数量均有所减少,效应大小从小到中等。存在统计学显著性趋势(G2组的ES>G1组)。所有照顾者均报告孩子对活动兴趣高且易于执行,使用数字资源训练孩子语音的家庭体验良好(李克特量表评分为4)。
所提出方法的有效性从中等到较高。两组的表现相似,G2组(侧重于家庭参与)有效果更佳的趋势。家长培训使他们积极参与课程和日常训练。