Parent- and SLP-delivered multiple oppositions (Sugden et al., 2019)

Purpose: Evidence for the multiple oppositions intervention approach indicates it should be delivered 3 times weekly; however, this high dose frequency is not provided by many speech-language pathologists worldwide. This study investigated whether parents could be involved in delivering phonological intervention to fulfill this intensity shortfall.
Method: Five children with moderate-to-severe phonological impairment aged 3;3–5;11 (years;months) and 1 of their parents participated in this study using a multiple-baseline across participants design. Participants attended one 60-min clinic-based session per week for 8 weeks, and parents completed home practice 2 times per week over this period after receiving training. Parents also attended a 60-min training session prior to commencing intervention.
Results: All children showed a treatment effect to treated words. Three of the 5 children demonstrated a large effect size for generalization to nontreatment words, with 1 child demonstrating a moderate effect and 1 child demonstrating no effect. However, all children showed qualitative changes to their speech system. Three of the 5 children experienced significant changes to communicative participation. Measures of treatment fidelity indicated that parents were able to competently deliver the intervention both within the clinic and at home.
Conclusions: Combined parent- and speech-language pathologist–delivered multiple oppositions intervention is effective for some children with moderate-to-severe phonological impairment. The findings indicate that parents can be trained to competently and confidently deliver phonological intervention. Further evidence is needed to identify optimal child and parent characteristics most suited to this modified service delivery approach.

Supplemental Material S1. Speech analysis results.

Supplemental Material S2. Details of multiple oppositions intervention provided in this study.

Supplemental Material S3. Integration of principles of parent training outlined by Rush & Shelden (2011) into clinic-based sessions.

Supplemental Material S4. Summary of intervention tailoring provided to participants.

Sugden, E., Baker, E., Williams, A. L., Munro, N., & Trivette, C. M. (2019). Evaluation of parent- and speech-language pathologist–delivered multiple oppositions intervention for children with phonological impairment: A multiple-baseline design study. American Journal of Speech-Language Pathology. Advance online publication. https://doi.org/10.1044/2019_AJSLP-18-0248