Chaining SPLITS service delivery: A pilot RCT (Herbst et al., 2025)
Purpose: This study evaluates the initial efficacy of Chaining SPeech Lessons in Intensive Ten-minute Sessions (SPLITS), an alternative service delivery model for the Speech Motor Chaining treatment approach. We hypothesized that Chaining SPLITS would result in improvements in /ɹ/ accuracy on syllables and untrained words when compared to a no-treatment condition.
Method: Within a randomized controlled trial, thirteen 7–9-year-old children with difficulty producing /ɹ/ were randomized to receive treatment either immediately or after an 8-week delay. Treatment sessions were conducted 4 times a week over 8 weeks. Syllable and word-level recordings were collected at the baseline, 8-week, and 16-week time points. Recordings were rated along a 5-point scale by three masked, independent listeners. The primary outcome was changed score from the baseline to 8-week time point (Interval 1) and 8-week to 16-week time point (Interval 2).
Results: Linear mixed modeling revealed that Chaining SPLITS led to significantly greater improvement in /ɹ/ accuracy at the syllable level for active treatment compared to a period of no treatment. This improvement was replicated in both groups. There was not sufficient evidence of an effect of Chaining SPLITS on untrained words after 8 weeks of treatment.
Conclusions: The current study provides initial evidence of the effectiveness of 8 weeks of Chaining SPLITS on improvement in /ɹ/ accuracy in syllables. Short, frequent sessions may be a viable approach to promote acquisition of /ɹ/ among school-age children; however, longer courses of treatment may be needed to observe further improvement at the word level.
Supplemental Material S1. Individual participant characteristics.
Supplemental Material S2. Example video of the treatment.
Supplemental Material S3. SAS code.
Supplemental Material S4. De-identified data.
Supplemental Material S5. Individual parent responses.
Herbst, B. M., Beiting, M., Schultheiss, M., Benway, N. R., & Preston, J. L. (2025). Speech in ten-minute sessions: A pilot randomized controlled trial of the chaining SPLITS service delivery model. Language, Speech, and Hearing Services in Schools, 56(1), 102–117. https://doi.org/10.1044/2024_LSHSS-24-00043
Funding
The first author was supported by a fellowship provided by the Syracuse University College of Arts and Sciences. Data analysis for this study was supported by National Institutes of Health (NIH) Grant R01DC020959 (awarded to Principal Investigator: J.L. Preston).
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