Examining the Role of Parents in Intervention for Speech Sound Disorders

Speech sound disorders (SSD) are among the most common childhood communication disorders. Timely and effective intervention, ideally delivered 2-3 times per week by a speech pathologist (SLP) for at least 30 sessions, is crucial. Unfortunately, many children cannot access treatment at this intensity. This thesis presents findings from five studies to examine the role of parents in overcoming this intensity shortfall. The first study (a review of the evidence base and survey of current clinical practice) confirmed that children with SSD receive insufficient intensities of treatment. The second study reviewed the evidence for parent involvement in intervention for SSD and concluded that SLPs do not have a clear nor comprehensive evidence base to guide clinical decisions when involving parents. The third study (a survey) confirmed that SLPs engage parents to overcome intensity shortfalls and highlighted the need for more research investigating how to best involve parents in treatment for SSD. In the fourth study, six parents of children with SSD were interviewed about their experiences of being involved in intervention. These parents valued the experience, but needed support from their SLP to overcome challenges. The findings from these four studies informed an intervention study—the fifth study presented in this thesis—investigating the outcomes following SLP and parent-delivered intervention for SSD. In a single-case experimental study, five children received treatment using an established treatment approach that was delivered by both an SLP and a parent. All participants responded to treatment but with different levels of generalisation. Collectively, the research presented in this thesis highlights the important role that parents play in intervention for SSD. This thesis argues for further consideration of intervention intensity, motor learning, and treatment fidelity in intervention for SSD.