Multisensory input video-therapy for young children with cleft palate-related speech sound disorder: Examining service delivery and interactional characteristics

BACKGROUND Multisensory input video-therapy (MSIVT) is an early intervention for cleft palate-related speech sound disorder. It is an input-based approach to support the development of accurate internal templates for speech sounds and create opportunities for output practice. Activities are videoed and watched by parents and child at home. Little is known about characteristic features of MSIVT. AIMS 1. Describe the delivery of MSIVT as it is implemented as an episode of care in the NHS 2. Analyse the features of therapist-child interaction during MSIVT sessions 3. Examine interaction over the course of an episode of care METHODS Data were collected on 29 MSIVT sessions featuring five children aged 1;6-2;11 and three speech and language therapists. It included 573 minutes of video data. Descriptive methods examined the delivery of MSIVT. Therapist-child interaction was analysed with conversation analysis to examine features of therapist turns, actions they fulfilled, and the consequences for the child. RESULTS Episodes of care involved up to nine monthly therapy sessions. Characteristic features include multiple speech sound stimuli and modified articulations within skilfully designed activities. Therapist-child interactions fit within four broad kinds of action: a) Demonstration to the camera; b) Invitation to attend to the stimulus; c) Invitation to participate in the stimulus routine; and d) Invitation to produce the stimulus. Therapists use creative methods to demonstrate stimuli and facilitate verbal and nonverbal engagement in activities. DISCUSSION AND IMPLICATIONS This is the first study to analyse characteristic features of MSIVT. The nature of interaction differs from output-based interventions due to the nonverbal responses that the therapist invites from the child. This new evidence extends knowledge of how speech and language therapy works as a real-time interactional process and how very young children are engaged in speech intervention. Results will inform clinical implementation, training of therapists, and the development of future research to evaluate the impact of MSIVT.