Background: Non-speech oral motor treatments (NSOMTs) are activities that target non-speech motor movement and oral postures (e.g. sensory stimulation to or actions of the lips, jaw, tongue, soft palate, larynx, and respiratory muscles) with the aim of developing motor skills for correct speech sound production (McCauley, Strand, Lof, Schooling, & Frymark, 2009). NSOMTs are different from standard speech intervention using phonetic and/or phonemic approaches because they do not involve practice of speech sound articulation and auditory discrimination of the error and target sounds. NSOMTs are used extensively by clinicians – between 71.5% and 85% of speech and language therapists in the United Kingdom and speech-language pathologists in the United States and Canada, when treating developmental speech sound disorders (Hodge & Salonka, 2005; Joffe & Pring, 2008; Lof & Watson, 2008). There had not been a systematic review on this issue until the recent work by McCauley and colleagues (2009). However, there are a number of limitations in this systematic review (e.g., only studies published in English were included for review; and the literature search was limited to databases that encompass peer-reviewed journals). A thorough, un-biased systematic review is needed. Since Cochrane Systematic Review has been regarded as the ‘gold standard’ for the evaluation of treatment efficacy in healthcare, a Cochrane Systematic Review will be conducted with the aim to assess the efficacy of non-speech oral motor treatment (NSOMT) for treating developmental speech sound disorders.
Method: A protocol for this systematic review was developed and published in October 2011 (Lee & Gibbon, 2011). The review will include randomised and quasi-randomised controlled trials that compared NSOMT versus treatment with placebo or control, and standard speech intervention with NSOMT as an adjunctive treatment versus speech intervention alone, for individuals aged 3-16 years with development speech sound disorders. The relevant trials will be identified by searching 14 databases (e.g., MEDLINE) and Google using a list of search terms developed for this review; checking reference lists of relevant journal papers and book chapters; and approaching researchers by email to identify possible grey literature (e.g. technical reports). The first and third author will conduct the literature search. All references generated from the searches will be managed using a reference management programme (Endnote). The authors will independently screen the titles and abstracts to eliminate any irrelevant references. They will then independently evaluate each paper against the inclusion criteria. In case of disagreement, the second author will be consulted. Information of the trials, such as number, age and gender of participants, speech assessment(s) and outcome measure(s) used, type and frequency of interventions, will be extracted from each paper based on the details stated in the full paper. The authors will independently assess the risk of bias in each included study in six domains – sequence generation, allocation concealment, blinding, incomplete outcome data, selective reporting bias, and other sources of bias (e.g. baseline-imbalance). Meta-analysis will be conducted using Review Manager if sufficient homogenous trials are identified. The searches of relevant trials and subsequent data analysis will be completed by April 2012.
Hodge, M. M., Salonka, R., & Kollias, S. (2005, November). Use of nonspeech oral-motor exercises in children’s speech therapy. Paper presented at the Annual meeting of the American Speech-Language-Hearing Association, San Diego, CA.
Joffe, V., & Pring, T. (2008). Children with phonological problems: A survey of clinical practice. International Journal of Language & Communication Disorders, 43, 154-164.
Lee, A. S.-Y. & Gibbon, F. E. (2011). Non-speech oral motor treatment for developmental speech sound disorders in children. Cochrane Database of Systematic Reviews 2011, Issue 10. Art. No.: CD009383. DOI: 10.1002/14651858.CD009383.
Lof, G. L., & Watson, M. M. (2008). A nationwide survey of nonspeech oral motor exercise use: Implications for evidence-based practice. Language, Speech & Hearing Services in the Schools, 39, 392-407.
McCauley, R. J., Strand, E., Lof, G. L., Schooling, T., & Frymark, T. (2009). Evidence-based systematic review: Effects of nonspeech oral motor exercises on speech. American Journal of Speech-Language Pathology, 18(4), 343-360.