How acceptable is high-intensity speech intervention for children with a cleft palate? A qualitative study

Area of Science:

• Pediatric Speech-Language Pathology
• Child Psychology
• Health Services Research

Background:

• Cleft palate speech therapy requires effective intervention strategies.
• Understanding children's perspectives on intervention intensity is crucial for adherence.
• The Theoretical Framework of Acceptability (TFA) provides a structure for evaluating patient experiences.

Purpose of the Study:

• To investigate the retrospective acceptability of high-intensive versus low-intensive speech intervention in children with cleft palate.
• To explore children's subjective experiences with different speech intervention dosages using the TFA.
• To identify factors influencing children's acceptance of speech intervention intensity.

Main Methods:

• Eleven children (6-12 years) with cleft palate participated.
• Participants received either high-intensive (10 sessions/2 weeks) or low-intensive (10 sessions/10 weeks) speech intervention.
• Child-friendly, semi-structured interviews were conducted and analyzed deductively using the TFA.

Main Results:

• Children reported varied affective attitudes, with some feeling happy about faster progress and others feeling tired.
• A link was observed between more frequent sessions and perceived quicker progress.
• Despite potential burdens, shorter total intervention times in high-intensive groups were associated with a lower likelihood of quitting.

Conclusions:

• Speech intervention planning must integrate clinical effectiveness with child-centered acceptability.
• Aligning intervention intensity with children's emotional responses and daily routines is vital.
• A flexible approach balancing intensity and individual preferences can enhance adherence and long-term outcomes.