Non-speech oral motor treatment for developmental speech sound disorders in children (Review)

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dc.contributor.author Lee, Alice S.
dc.contributor.author Gibbon, Fiona E.
dc.date.accessioned 2016-04-27T09:30:18Z
dc.date.available 2016-04-27T09:30:18Z
dc.date.issued 2015-03-25
dc.identifier.citation Lee, A. S. Y., Gibbon, F. E. (2015) Non-speech oral motor treatment for children with developmental speech sound disorders (Review), Cochrane Database of Systematic Reviews 2015, Issue 3. Art. No.: CD009383. DOI: 10.1002/14651858.CD009383.pub2 en
dc.identifier.volume 3 en
dc.identifier.startpage CD009383 en
dc.identifier.uri http://hdl.handle.net/10468/2485
dc.identifier.doi 10.1002/14651858.CD009383.pub2
dc.description.abstract Background: Children with developmental speech sound disorders have difficulties in producing the speech sounds of their native language. These speech difficulties could be due to structural, sensory or neurophysiological causes (e.g. hearing impairment), butmore often the cause of the problem is unknown. One treatment approach used by speech-language therapists/pathologists is non-speech oral motor treatment (NSOMT). NSOMTs are non-speech activities that aim to stimulate or improve speech production and treat specific speech errors. For example, using exercises such as smiling, pursing, blowing into horns, blowing bubbles, and lip massage to target lip mobility for the production of speech sounds involving the lips, such as /p/, /b/, and /m/. The efficacy of this treatment approach is controversial, and evidence regarding the efficacy of NSOMTs needs to be examined. Objectives: To assess the efficacy of non-speech oral motor treatment (NSOMT) in treating children with developmental speech sound disorders who have speech errors. Search methods: InApril 2014we searched theCochraneCentral Register ofControlledTrials (CENTRAL),OvidMEDLINE (R) andOvidMEDLINE In-Process & Other Non-Indexed Citations, EMBASE, Education Resources Information Center (ERIC), PsycINFO and 11 other databases. We also searched five trial and research registers, checked the reference lists of relevant titles identified by the search and contacted researchers to identify other possible published and unpublished studies. Selection criteria: Randomised and quasi-randomised controlled trials that compared (1) NSOMT versus placebo or control; and (2) NSOMT as adjunctive treatment or speech intervention versus speech intervention alone, for children aged three to 16 years with developmental speech sound disorders, as judged by a speech and language therapist. Individuals with an intellectual disability (e.g. Down syndrome) or a physical disability were not excluded. Data collection and analysis: The Trials Search Co-ordinator of the Cochrane Developmental, Psychosocial and Learning Problems Group and one review author ran the searches. Two review authors independently screened titles and abstracts to eliminate irrelevant studies, extracted data from the included studies and assessed risk of bias in each of these studies. In cases of ambiguity or information missing from the paper, we contacted trial authors. Main results: This review identified three studies (from four reports) involving a total of 22 children that investigated the efficacy of NSOMT as adjunctive treatment to conventional speech intervention versus conventional speech intervention for children with speech sound disorders. One study, a randomised controlled trial (RCT), included four boys aged seven years one month to nine years six months - all had speech sound disorders, and two had additional conditions (one was diagnosed as “communication impaired” and the other as “multiply disabled”). Of the two quasi-randomised controlled trials, one included 10 children (six boys and four girls), aged five years eight months to six years nine months, with speech sound disorders as a result of tongue thrust, and the other study included eight children (four boys and four girls), aged three to six years, with moderate to severe articulation disorder only. Two studies did not find NSOMT as adjunctive treatment to be more effective than conventional speech intervention alone, as both intervention and control groups made similar improvements in articulation after receiving treatments. One study reported a change in postintervention articulation test results but used an inappropriate statistical test and did not report the results clearly. None of the included studies examined the effects of NSOMTs on any other primary outcomes, such as speech intelligibility, speech physiology and adverse effects, or on any of the secondary outcomes such as listener acceptability. The RCT was judged at low risk for selection bias. The two quasi-randomised trials used randomisation but did not report the method for generating the random sequence and were judged as having unclear risk of selection bias. The three included studies were deemed to have high risk of performance bias as, given the nature of the intervention, blinding of participants was not possible. Only one study implemented blinding of outcome assessment and was at low risk for detection bias. One study showed high risk of other bias as the baseline characteristics of participants seemed to be unequal. The sample size of each of the included studies was very small, which means it is highly likely that participants in these studies were not representative of its target population. In the light of these serious limitations in methodology, the overall quality of the evidence provided by the included trials is judged to be low. Therefore, further research is very likely to have an important impact on our confidence in the estimate of treatment effect and is likely to change the estimate. Authors’ conclusions: The three included studies were small in scale and had a number of serious methodological limitations. In addition, they covered limited types of NSOMTs for treating children with speech sound disorders of unknown origin with the sounds /s/ and /z/. Hence, we judged the overall applicability of the evidence as limited and incomplete. Results of this review are consistent with those of previous reviews: Currently no strong evidence suggests thatNSOMTs are an effective treatment or an effective adjunctive treatment for children with developmental speech sound disorders. Lack of strong evidence regarding the treatment efficacy of NSOMTs has implications for clinicians when they make decisions in relation to treatment plans. Well-designed research is needed to carefully investigate NSOMT as a type of treatment for children with speech sound disorders. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher John Wiley & Sons, Ltd en
dc.rights © 2015 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. All rights reserved. This review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews, 2015 Issue 3. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review. en
dc.subject Articulation disorders en
dc.subject Child en
dc.subject Dysphonia en
dc.subject Female en
dc.subject Human en
dc.subject Kinesiotherapy en
dc.subject Language disorders en
dc.subject Male en
dc.subject Preschool child en
dc.subject Procedures en
dc.subject Randomized controlled trial en
dc.subject Speech therapy en
dc.title Non-speech oral motor treatment for developmental speech sound disorders in children (Review) en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Alice Lee, Speech And Hearing Sciences, University College Cork, Cork, Ireland. +353-21-490-3000 Email: a.lee@ucc.ie en
dc.internal.availability Full text available en
dc.date.updated 2015-03-25T12:18:04Z
dc.description.version Published Version en
dc.internal.rssid 287319760
dc.description.status Peer reviewed en
dc.identifier.journaltitle Cochrane Database of Systematic Reviews en
dc.internal.copyrightchecked Yes !!CORA!! PV permitted by publisher after 12 month embargo: "Authors retain the right to post a PDF of the final version, as specified by the Publisher, in an institutional repository or any repository mandated by the author’s funder, such as PubMedCentral, 12 months after publication" http://www.cochranelibrary.com/help/open-access-options-for-the-cochrane-library.html en
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress a.lee@ucc.ie en


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