Caregiver-implemented early speech and language intervention for toddlers with cleft palate

PROJECT SUMMARY: The overarching goal of the project is to develop a caregiver-implemented early intervention model available in English and Spanish to improve speech and language outcomes for young children with NSCL/P. We will test if caregiver-implemented Enhanced Milieu Teaching with Phonological Emphasis (EMT+PE) can reduce the severity of speech sound disorders and language delays in toddlers with NSCL/P. Caregivers will receive systematic coaching on utilizing EMT+PE strategies with their toddlers in a telehealth format. EMT+PE implemented by speech language pathologists (SLPs) has been shown to improve child language and speech outcomes in young children with NSCL/P in two randomized trials. 6,8Caregiver-implemented EMT+PE has been shown to be effective in three single-case design studies.39-41 The study will enroll 102 participants, children 24- 26 months old with NSCL/P and their caregivers. The intervention group will be compared to a control condition. Four specific aims guide the study: 1. To prepare for implementation of the multisite clinical trial during the 2-year planning period. 2. To examine the effects of caregiver coaching delivered via telehealth on caregivers’ use of EMT+PE strategies to support children’s speech and language development in a randomized clinical trial. 3. To examine the effects of caregiver-implemented EMT+PE on children’s speech and language outcomes immediately after intervention and at age 3. 4. To assess the feasibility, acceptability, and perceived effectiveness in improving child outcomes of the EMT+PE model with caregivers participating in the study.