Chaining SPLITS service delivery: A pilot RCT (Herbst et al., 2025)

<p dir="ltr"><b>Purpose:</b> 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.</p><p dir="ltr"><b>Method: </b>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).</p><p dir="ltr"><b>Results: </b>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.</p><p dir="ltr"><b>Conclusions:</b> 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.</p><p dir="ltr"><b>Supplemental Material S1. </b>Individual participant characteristics.</p><p dir="ltr"><b>Supplemental Material S2.</b> Example video of the treatment.</p><p dir="ltr"><b>Supplemental Material S3.</b> SAS code.</p><p dir="ltr"><b>Supplemental Material S4. </b>De-identified data.</p><p dir="ltr"><b>Supplemental Material S5. </b>Individual parent responses.</p><p dir="ltr">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. <i>Language, Speech, and Hearing Services in Schools, 56</i>(1), 102–117. <a href="https://doi.org/10.1044/2024_LSHSS-24-00043" rel="noreferrer" target="_blank">https://doi.org/10.1044/2024_LSHSS-24-00043</a></p>