Combined clinician-parent delivery of rapid syllable transition (ReST) treatment for childhood apraxia of speech

Abstract

Purpose: Although speech-language pathologists use parent-delivered home-practice, little is known about the quality of this practice and its relation to treatment efficacy. This study reports both treatment outcomes and fidelity following combined clinician-parent delivery of Rapid Syllable Transition (ReST) treatment.

Method: Five children aged 5:1–11:7 with childhood apraxia of speech received 12 treatment sessions; six clinic-based and six at home, using multiple baselines across participants design. We investigated the children’s acquisition of treated pseudo words, generalisation to untreated pseudo and real words, and maintenance of gains. We also assessed parent and clinician treatment fidelity and reliability of perceptual judgements.

Result: Two children improved on all treated behaviours; two showed treatment effect on one of their two treated behaviours, and one child had no treatment effect. Only two children generalised to the majority of untreated items. Variable treatment fidelity was found across parents and aspects of treatment. Child outcome was likely influenced by multiple factors, including treatment fidelity, reliability of perceptual judgements and child factors.

Conclusion: Combined clinician-parent delivery of ReST was less efficacious than previously reported clinician-only delivered ReST. Further investigation of the factors affecting outcome is recommended prior to clinical application of the combined model of service delivery.

Keywords:

• therapy
• caregiver
• service-delivery
• dyspraxia
• treatment fidelity

Acknowledgements

We thank the children and parents who participated; Ashleigh Hillyer, Emily Lim and Penny Mason for assistance with data collection; and the various assessors and interns who collected the probe data. We thank Dr Rob Heard for his advice on the statistical analyses.

Declaration of interest

This research was partially funded by an Australian Postgraduate Award and Postgraduate Research Support Scheme funding to Thomas; and the Australian Research Council Future Fellowship FT120100355 to Ballard. The researchers are aware of no conflicts of interest.

Supplementary material

Supplemental data for this article can be accessed at http://dx.doi.org/10.1080/17549507.2017.1316423