# Efficacy of the adapted Cycles approach in telepractice speech-language pathology with a parental focus for children with speech sound disorders

## TL;DR

This study shows that a modified speech therapy approach using telepractice and involving parents can effectively help children with speech sound disorders.

## Contribution

The study introduces an adapted Cycles approach in telepractice with a focus on parental involvement for treating speech sound disorders.

## Key findings

- Participants showed improved speech accuracy and reduced phonological errors after the intervention.
- Family involvement (Group 2) showed a trend toward greater effectiveness compared to therapist-only sessions.
- Caregivers reported high engagement and positive experiences using digital tools for daily speech training.

## Abstract

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.

Avaliar a eficácia da abordagem dos Ciclos adaptada à telefonoaudiologia e o engajamento familiar no tratamento de crianças com transtorno dos sons da fala (TSF).

Participaram 10 crianças, de 5:0 a 7:8 anos, com diagnóstico de TSF. Avaliou-se utilizando linha de base múltipla e duas avaliações pós-tratamento. A eficácia foi medida comparando pré e pós-intervenção para a porcentagem de consoante correta (PCC), porcentagem de consoante correta revisada (PCC-R), Process Density Index (PDI) e número de processos fonológicos com ocorrência >25%, nas provas de fonologia do teste ABFW, calculando-se o tamanho do efeito (TE) da intervenção. A percepção das famílias sobre os treinos foi obtida por entrevista e escala Likert. Os sujeitos foram distribuídos aleatoriamente em G1: realizou duas sessões online semanais com a fonoaudióloga, e G2: realizou metade das sessões conduzidas pelo cuidador treinado pela fonoaudióloga. Ambos receberam 12 sessões e realizaram treinos diários de fala.

Todos os participantes apresentaram aumento em PCC, PCC-R e redução em PDI e no número de processos fonológicos com ocorrência >25%, com TE variando de pequeno a grande. Houve tendência à significância estatística (TE G2>G1). Todos os pais relataram grande interesse das crianças pelas atividades, com boa experiência familiar (Likert=4) ao treinar a fala da criança usando recursos digitais.

A eficácia da abordagem proposta variou de médio a alta. O desempenho dos grupos foi semelhante, com tendência à maior eficácia para o G2, focado na família. O treinamento dos pais resultou em bom engajamento nas sessões e treinos diários.