Toward Preventing Speech and Language Disorders of Known Genetic Origin: First Post-Intervention Results of Babble Boot Camp in Children With Classic Galactosemia

Beate Peter, Jennifer Davis, Sarah Cotter, Alicia Belter, Emma Williams, Melissa Stumpf, Laurel Bruce, Linda Eng, Yookyung Kim, Lizbeth Finestack, Carol Stoel-Gammon, Delaney Williams, Nancy Scherer, Mark VanDam, Nancy Potter, Beate Peter, Jennifer Davis, Sarah Cotter, Alicia Belter, Emma Williams, Melissa Stumpf, Laurel Bruce, Linda Eng, Yookyung Kim, Lizbeth Finestack, Carol Stoel-Gammon, Delaney Williams, Nancy Scherer, Mark VanDam, Nancy Potter

Abstract

Purpose Babble Boot Camp (BBC) is a package of proactive activities and routines designed to prevent speech and language disorders in infants at predictable risk. It is implemented via parent training and currently undergoing clinical trial in children with a newborn diagnosis of classic galactosemia (CG), a metabolic disease with high risk of speech and language disorders. The purpose of this study is to provide updates to a previous pilot study and to present the first set of post-intervention results. Method The intervention and data collection occurred during child ages < 6-24 months, with follow-up assessments of speech and language at ages 2.5 and 3.5 years. Treatment targets included earliest vocalization rates, babble complexity, speech production accuracy, and vocabulary and syntactic growth. The oldest 15 children with CG (including three untreated controls) completed the first set of follow-up assessments. Aggregate data up to 10 months were available for 17 treated children with CG, six untreated children with CG, and six typical controls. Results At ages 7-9 months, babbling complexity, as measured with mean babbling level, was higher in the treated children with CG than in the untreated children with CG and the typical controls. Prior to 24 months of age, the treated children with CG had greater expressive but not receptive vocabulary sizes than an untreated control. Follow-up testing showed typical language scores for all 12 treated children with CG and typical articulation scores for 11 of these, whereas one of three untreated children with CG had low articulation and expressive language scores. Conclusions The BBC appears to be a viable intervention to support the speech and expressive language development of children with GC. Future studies will evaluate the relative contributions of the earliest and later BBC components to outcomes.

Figures

Figure 1.
Figure 1.
Babble Boot Camp conceptualization of parents receiving and implementing the training. SLP = speech-language pathologist.
Figure 2.
Figure 2.
Summary of available data for the participating children by subgroup and health status. Diagonal pattern fill: treatment and data collection. Solid fill: data collection only. Rightward arrow: continues in the study. Rightward vertical line: withdrew from the study. Dashed line: start of follow-up testing. CDI = MacArthur–Bates Communicative Development Inventories–Second Edition; CG = classic galactosemia; Expr. = expressive; GFTA-3 = Goldman-Fristoe Test of Articulation–Third Edition; MBL = mean babbling level; PLS-5 = Preschool Language Scales–Fifth Edition; RQ = research question; SSL = syllable structure level.
Figure 3.
Figure 3.
Selected treatment activities and routines and their intended effects on child behaviors and skills. Curved arrows pointing back to the element of origin under “Parent Treatment Activities and Routines”: feedback loops. Curved arrows pointing to a different element under “Effects on Child Skills”: indirect treatment effects.
Figure 4.
Figure 4.
Mean babbling level scores for 12 children with classic galactosemia (CG) who received the Babble Boot Camp (BBC) intervention and one child with CG who did not receive the BBC intervention (bolded black line). CTR = untreated control with CG; SLE = speech-language early intervention.
Figure 5.
Figure 5.
Averaged mean babbling level (MBL) scores across ages 7–9 months in six typically developing children, 17 children with classic galactosemia (CG) who underwent the Babble Boot Camp (BBC) intervention, and five children with CG who did not undergo the BBC intervention during this age span.
Figure 6.
Figure 6.
Syllable structure level scores for 12 children with classic galactosemia (CG) who received the Babble Boot Camp (BBC) intervention and one child (CTR01) with CG who did not receive the BBC intervention. CTR = untreated control with CG; SLE = speech-language early intervention.
Figure 7.
Figure 7.
Expressive vocabulary size based on MacArthur–Bates Communicative Development Inventories–Second Edition (CDI) percentiles in 13 children with classic galactosemia (CG) who underwent the Babble Boot Camp (BBC) intervention and one child with CG who did not. Horizontal lines at the seventh and 93rd percentiles = ±1.5 SDs. CTR = untreated control with CG; SLE = speech-language early intervention.
Figure 8.
Figure 8.
Receptive vocabulary size based on MacArthur–Bates Communicative Development Inventories–Second Edition (CDI) percentiles in 13 children with classic galactosemia (CG) who underwent the Babble Boot Camp (BBC) intervention and one child with CG who did not. Horizontal lines at the seventh and 93rd percentiles = ±1.5 SDs. CTR = untreated control with CG; SLE = speech-language early intervention.
Figure 9.
Figure 9.
Follow-up test scores for articulation, expressive language, and receptive language for 12 children with classic galactosemia (CG) who completed the early speech and language intervention (SLE) and three untreated children with CG (CTR), ordered by Goldman-Fristoe Test of Articulation–Third Edition (GFTA-3) standard score. Horizontal lines at standard scores 78 and 123 = ±1.5 SDs. PLS-5 = Preschool Language Scales–Fifth Edition.

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