Exploring the impact of babble training for parents of children born with cleft palate: A mixed-method evaluation.

Background Cleft palate with or without cleft lip (CP+/-L) occurs in approximately one in 850 births. Despite early surgical intervention, children with CP+/-L commonly face challenges with speech development. Research has demonstrated that these early deficits can have can have a detrimental impact on academic and social development in later childhood. Babble training, which aims to empower parents to promote early speech development, is being provided by several Cleft Centres in the UK. This intervention is based on clinical rationale, expert opinion and positive clinician feedback. However, no major research has been undertaken to understand and validate babble intervention, meaning the evidence for its clinical use is scientifically weak. This means that provision is often resource-led rather than evidence-led, highlighting the need for research to inform care pathways. Furthermore, the demand placed on the parents to attend the training and implement the strategies raises questions around the accessibility and acceptability of this intervention. The purpose of this research is to explore and evaluate the current provision of babble training through an exploratory mixed-methods study. Research question What babble training is currently offered to parents of children born with CP+/-L in the UK, and what are the outcomes of this training? Aim To determine the format, content, effectiveness and accessibility of babble training offered to parents of children with CP+/-L. Objectives To describe the current babble training offered to parents To evaluate the outcomes of current babble training on the babble of children with CP+/-L To explore parents' perceptions and experiences of babble training Methods Stage 1: A survey will be distributed to the lead Speech and Language Therapists at the 14 UK Cleft Centres to collate information on the current delivery of babble training. The participants will then be asked to participate in a follow up focus group to further understand the content of the babble training and to validate the findings of the survey. The information will be mapped onto the TIDIER framework and shared with clinical teams. Stage 2: Data from the Cleft Collective Study, a large prospective cohort study with speech data on over 400 children born with CP+/-L from across the UK, will be used to compare 13-month speech outcomes of children whose parents received babble training and those whose parents did not. Stage 3: Parents who have received babble training will be asked to participate in semi-structured interviews, to capture their views and experiences. Anticipated impact and dissemination The anticipated impact of this study is to inform care pathways and support cleft services to plan effective intervention. By developing clear, evidence-based guidelines, there is the potential to improve care pathways and in the long term, improve the speech and language outcomes and quality of life for children with CP+/-L. Key stakeholders, such as parents of children with CP+/-L, will be involved throughout to ensure that the research is ethical, relevant and impactful. The findings of this study will be published in peer-reviewed journals and presented at national and international conferences.