{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T22:39:01Z","timestamp":1782513541029,"version":"3.54.5"},"reference-count":48,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,7,29]],"date-time":"2020-07-29T00:00:00Z","timestamp":1595980800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Temple Street Foundation"},{"name":"Cleft-Bridging the Gap charity"},{"name":"Cleft Lip and Palate Association of Ireland"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Lang &amp;amp; Comm Disor"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A total of 68% of pre\u2010school children with cleft palate have speech problems requiring speech therapy. There is a lack of access to regular targeted therapy. Parent training leads to positive outcomes in early communication skills in cleft palate and non\u2010cleft speech disorders. Connected health has been used to address inadequate access to therapy, providing intervention to those who would not otherwise receive therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To evaluate the speech, activity and participation outcomes of Parent Led, Therapist Supervised, Articulation Therapy (PLAT) compared with routine speech therapy intervention in parent\u2013child dyads.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods &amp; Procedures<\/jats:title><jats:p>A total of 44 children, aged 2.9\u20137.5 years, were included in a two\u2010centre, two\u2010phase randomized controlled trial. Informed consent and assent were obtained. Participants and speech and language therapists (SLTs) were unblinded to the groups. Parents, in the parent\u2010trained group (<jats:italic>n<\/jats:italic>= 23), attended 2 days\u2019 training, received a detailed speech therapy programme, and undertook intervention over 12 weeks supported by the cleft specialist SLT using FaceTime and one face\u2010to\u2010face session. In the control arm (<jats:italic>n<\/jats:italic>= 21), parent\u2013child dyads received six therapy sessions over 12 weeks with a research SLT, comparable with usual care. Speech recordings were undertaken pre\u2010 and post\u2010intervention. Percent consonant correct (PCC) was analysed by external SLTs blinded to the time and group. Activity and participation were measured using the Intelligibility in Context Scale (ICS) and Focus on Outcomes for Children Under Six (FOCUS) questionnaire.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcomes &amp; Results<\/jats:title><jats:p>There was no evidence of an interaction between Time and Group or an overall statistical difference between groups for PCC scores. There was a statistically significant difference over time for both groups (words:<jats:italic>p<\/jats:italic>&lt; 0.002; confidence interval (CI) = 9.38\u201316.27;<jats:italic>d<\/jats:italic>= 0.57; sentences:<jats:italic>p<\/jats:italic>&lt; 0.002; CI = 16.04\u201325.97;<jats:italic>d<\/jats:italic>= 0.23). Effect sizes were medium for words and small for sentences. For intelligibility and participation, there was no evidence of an interaction between Time and Group or an overall statistical difference between groups. A statistically significant difference over time was found for intelligibility (<jats:italic>F<\/jats:italic>= 29.97, d.f. = 1, 42,<jats:italic>p<\/jats:italic>&lt; 0.001, 95 % CI = 1.45\u20133.15<jats:italic>d<\/jats:italic>= 0.46) and for participation (<jats:italic>F<\/jats:italic>= 14.19, d.f. = 1, 41,<jats:italic>p<\/jats:italic>&lt; 0.001 95% CI = 7.63\u201325.03;<jats:italic>d<\/jats:italic>= 0.36) with FOCUS results indicating clinically meaningful (parent\u2010led group) and significant (control group) change in participation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Implications<\/jats:title><jats:p>PLAT can be as effective as routine care in changing speech, activity and participation outcomes for children with cleft palate, when supported by a specialist cleft SLT using connected health.<\/jats:p><\/jats:sec><jats:sec><jats:label\/><jats:p><jats:boxed-text content-type=\"box\" position=\"anchor\"><jats:sec><jats:title>What this paper adds<\/jats:title><jats:sec><jats:title>What is already known on this subject<\/jats:title><jats:p><jats:list list-type=\"bullet\"><jats:list-item><jats:p>Over 50% of children with cleft palate require speech therapy. However, there is a lack of timely, accessible speech therapy services in the UK and Ireland. Previous studies have shown that parents can deliver therapy effectively, and that connected health can support the delivery of speech therapy. This study aims to provide evidence that parent\u2010led therapy with the supervision of a specialist cleft therapist using FaceTime is effective.<\/jats:p><\/jats:list-item><\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>What this paper adds to existing knowledge<\/jats:title><jats:p><jats:list list-type=\"bullet\"><jats:list-item><jats:p>This randomized controlled trial indicates that parents can be trained to deliver therapy for children with cleft palate speech disorders, under the supervision of an SLT. This approach results in improved speech, activity and participation outcomes similar to routine care.<\/jats:p><\/jats:list-item><\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>What are the potential or actual clinical implications of this work?<\/jats:title><jats:p><jats:list list-type=\"bullet\"><jats:list-item><jats:p>This study indicates that both parent\u2010led articulation therapy and routine care showed meaningful gains in speech, activity and participation, and that parent\u2010led articulation therapy when supported by a cleft SLT using connected health could be an additional service delivery model for children with cleft palate speech disorders.<\/jats:p><\/jats:list-item><\/jats:list><\/jats:p><\/jats:sec><\/jats:sec><\/jats:boxed-text><\/jats:p><\/jats:sec>","DOI":"10.1111\/1460-6984.12542","type":"journal-article","created":{"date-parts":[[2020,7,29]],"date-time":"2020-07-29T14:29:15Z","timestamp":1596032955000},"page":"639-660","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Randomized controlled trial comparing Parent Led Therapist Supervised Articulation Therapy (PLAT) with routine intervention for children with speech disorders associated with cleft palate"],"prefix":"10.1111","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1673-4856","authenticated-orcid":false,"given":"Triona","family":"Sweeney","sequence":"first","affiliation":[{"name":"Speech at Home Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran","family":"Hegarty","sequence":"additional","affiliation":[{"name":"Children's Health Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie","family":"Powell","sequence":"additional","affiliation":[{"name":"South Thames Cleft Service London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liane","family":"Deasy","sequence":"additional","affiliation":[{"name":"formerly Loughlinstown Health Centre Dublin Ireland (RIP)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myra O\u2019","family":"Regan","sequence":"additional","affiliation":[{"name":"Trinity College Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2488-5881","authenticated-orcid":false,"given":"Debbie","family":"Sell","sequence":"additional","affiliation":[{"name":"Centre for Outcomes and Experience Research in Health, Impairment and Disability (ORCHID) Great Ormond Street Hospital for Children NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,7,29]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1044\/1092-4388(2012\/11-0076)"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.3109\/13682828409007182"},{"key":"e_1_2_8_4_1","unstructured":"Bercow Report10 years on. 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