“Scientists have recently determined that it takes approximately 400 repetitions to create a new synapse in the brain – unless it is done with play, in which case, it takes between 10 – 20 repetitions”

~ Dr. Kathryn Purvis ~

 You might have seen this quote floating around lately so I’d like to apply it to treating speech sound delay. Children who have delayed speech sound development take up most of my paediatric caseload. I work on delayed phonological processes (this is what children do to simplify speech when they are learning to talk) or articulation errors (how they move their lips, tongue, jar to produce speech sounds) on a daily basis. But how can we determine the best dose, form, frequency, duration and intensity of therapy that results in the best outcomes for our kiddos?

In 2016, a review about the intensity of treatment in speech disorders reported on a range of studies. Here are some of the main points:

  • For individuals with speech and/or language deficits the optimal intensity for treatment is uncertain. This is due to the different rates in which people learn and the different severities of speech and/or language difficulties.

  • Over-learning or under-learning the motor skills can arise when determining the intensity that is ‘just right’.

  • This review reported on studies where intervention 2 – 3 times a week with sessions running 30-60 minutes that includes at least 60 trials resulted in better treatment outcomes.

  • Many variables need to be considered when answering the question “how much therapy is sufficient” and studies such as these can provide valuable information regarding the most effective treatment intensity aiding speech pathologists in making informed clinical decisions for their clients with speech disorders. 

Okay, how can clinicians adapt this to their clinical work? And what have I learnt from working with children with speech sound delay?

  • Practise in PLAY! At SubiSpeech, we love a good theme! Themes can add context, a realistic use of speech sounds and lots of fun whilst doing so.

  • Encourage repetition during play-based activities for quicker learning.

  • Consider shorter but more frequent sessions for some children.

  • Every child is different – trust your clinical judgement in line with a strong evidence base when making decisions about treatment intensity.

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Kaipa. R., & Peterson, A. M. (2016). A systematic review of treatment intensity in speech disorders. International Journal of Speech-Language Pathology, 18, 507 – 520. http://doi.org.10.3109/17549507.2015.1126640