Addition of contingency management to increase home practice in young children with a speech sound disorder.
BACKGROUND
Along with the severity of the disorder, the motivation of the children and their parents is an important element in explaining the extensive variance in therapeutic success. There is consensus that parental cooperation and homework are important for successful therapy. Systematic investigation into the effects of including homework in therapy is lacking, as are methodological approaches to increasing parental involvement.


OBJECTIVE
The aim was to determine whether the efficiency of traditional articulation therapy for children with speech-sound disorders can be improved by adding a behavioural treatment approach (contingency management) to treatment in order to increase the time that patients spend doing homework.


METHODS
A total of 91 children between the ages of four and six with articulation impairments participated in the study. They were divided into three groups: 32 children were treated with traditional articulation therapy (eight sessions of 45 minutes each), 33 children received a combination of contingency management and traditional therapy, and 26 children received no therapy at all. A picture-labelling test measuring the treated target sound at different levels was used before and after therapy to quantify therapy-induced improvement.


RESULTS
The results confirm the fact that the traditional articulation therapy approach is effective for children with articulation impairments. However, adding contingency management significantly increased the frequency of homework sessions and improved the efficiency of treatment by decreasing the variance in therapeutic success.


CONCLUSIONS
Contingency management has a positive impact on therapeutic success and leads to an increase in the number of homework sessions.
School of Speech and Language Pathology, Zuyd University, Heerlen, the Netherlands. gunther@hszuyd.nl
Thoms
T
Günther
Sarah
S
Hautvast
D001184:Articulation Disorders / Q000628:therapy*; D001521:Behavior Therapy / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents; D010349:Patient Compliance; D010700:Phonetics; D011214:Practice, Psychological; D013070:Speech Therapy / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome