TY  - JOUR
AU  - Tahmasebi, Neda
AU  - Zarifian, Talieh
AU  - Ashtari, Atieh
AU  - Biglarian, Akbar
PY  - 2024
DA  - 2024/4/19
TI  - Telepractice Parent Training of Enhanced Milieu Teaching With Phonological Emphasis (EMT+PE) For Persian-Speaking Toddlers With Nonsyndromic Cleft Palate: Protocol for a Randomized Controlled Trial
JO  - JMIR Res Protoc
SP  - e54426
VL  - 13
KW  - telepractice
KW  - cleft palate
KW  - language intervention
KW  - parent training
KW  - Phonological Emphasis
KW  - Enhanced Milieu Teaching
KW  - Persian-speaking toddlers
KW  - toddler
KW  - toddlers
KW  - children
KW  - child
KW  - cleft lip
KW  - language development
KW  - speech sound disorders
KW  - speech sound disorder
KW  - effectiveness
KW  - parent-based
KW  - intervention
KW  - speech
KW  - therapy
AB  - Background: Children born with a cleft palate with or without a cleft lip (CP/L) are at increased risk for delayed language development and speech sound disorders. Enhanced Milieu Teaching with Phonological Emphasis (EMT+PE) is a recommended naturalistic intervention for toddlers with CP/L. The parents’ role in providing naturalistic interventions is critical and they need training based on learning principles to implement these interventions. Telepractice is an appropriate method for training parents and children with various speech-related disorders. Objective: This study aims to determine and compare the effectiveness of telepractice and the parent-implemented EMT+PE intervention on language and speech measures in toddlers with CP/L with usual interventions and determine the effectiveness maintenance of the intervention. Methods: A randomized controlled trial (RCT) will assess the efficacy of telepractice and the parent-implemented EMT+PE intervention in enhancing speech and language measures in toddlers with CP/L. Eligible participants will be randomly assigned to one of 2 groups: the conventional intervention group and the EMT+PE intervention group. Participants’ speech and language measures will be evaluated remotely by trained raters before and after the intervention and 2 months after the intervention. Parents of participants in the intervention group will receive 3 months of training in speech and language supportive strategies from trained therapists using telehealth fidelity scales. Parents of participants in the control group will receive the conventional speech and language intervention by cleft team therapists. Study outcomes will include language variables (mean length of utterance) and speech production variables (percent correct consonants). Results: The protocol was approved by the Research Ethics Committee of the University of Social Welfare and Rehabilitation Sciences in February 2022. The selection process of participants, as well as training therapists and raters, commenced in January 2022, the therapy and follow-up period ended in June 2023, and pre- and postintervention assessments have been conducted. Data analysis is ongoing, and we expect to publish our results by the summer of 2024. Funding is yet to be received. Conclusions: The results of this study may help us develop a speech and language intervention with a different delivery model for toddlers with CP/L, and the cleft team care can use these results in service delivery. Consistent with our hypothesis, speech and language measures are expected to improve. International Registered Report Identifier (IRRID): DERR1-10.2196/54426 
SN  - 1929-0748
UR  - https://www.researchprotocols.org/2024/1/e54426
UR  - https://doi.org/10.2196/54426
UR  - http://www.ncbi.nlm.nih.gov/pubmed/38640014
DO  - 10.2196/54426
ID  - info:doi/10.2196/54426
ER  -