Join our mailing list:         
Visit Marvellous Mouth on Facebook Marvellous Mouth on LinkedIn

mouthercise replication studies

Marvellous Mouth Children's Speech and Oral Language Therapy

Researchers needed:

Barbara Hallahan CCC-SLP has developed a preschool programme for speech sound development that is designed to be used in a mainstream setting and delivered by either a preschool teacher or SLP.

The pilot control study in Montessori settings in Bray, County Wicklow has indicated that statistically significant changes were seen in the test group as compared to the control group. These results will be presented as a poster at the RCSLT Mind The Gap convention in Leeds in September. (see abstract below)

Marvellous Mouth Ltd. will provide the materials necessary to qualified applicants for replication studies.

Contact for further information.


 AUTHOR: Barbara Hallahan CCC-SLP (developer of tested programme)

POST HELD: consultant speech and language pathologist


OTHER CONTRIBUTORS: Perrine Cahill, SLT; Susie Lloyd, SLT
POSTS HELD: private practice in the community, NHS Greater Glasgow & Clyde

 Keywords: teacher training, mainstream speech-sound intervention, control study


Background: Developmental speech sound errors can have a range of impacts on a child, causing frustration, affecting interaction or compromising academics. Van Daal et al. (2007) found phonological and language problems could affect behaviour.  Phonological awareness is related to the development of literacy, (Dodd and Gillon, 2001).  Unlike Education, Speech and Language Therapy is not a universal service. Children are only seen if they are identified, referred, and meet local criteria. In many areas focus is often on consultation rather than direct intervention (Palikara 2007). For those who are provided direct intervention, especially in Ireland, there can be a significant wait between identification and intervention (Hayes, N. et al. 2014). Timely intervention is important. Shriberg et al. (1994) identify age 4 as an optimal time for normalization. Many children with mild speech difficulties will be educated within mainstream schooling (Law et al., 2000). Evidence indicates that indirect therapy can be as effective as direct therapy (Boyle et al., 2009) and therapy delivered by non-clinical persons can be as effective as SLTs in delivering intervention (Law et al., 1998). Therefore there is a clear opportunity for a therapy program within the preschool and early years setting targeting children’s awareness of speech sounds.

Aims: To evaluate effectiveness of training a preschool teacher to provide a weekly group session in a mainstream Montessori that explores awareness of articulators, lingual and labial placement for consonant production and multi-syllable production.

Methods: Two closely matched Montessori schools were chosen for a control study. They were matched for age of children, (2;10 – 4;5) socio-economic status of the families,(middle class, some bilingual) school size (~15 children) and philosophy. All children were screened by an independent SLT using the Diagnostic Evaluation of Articulation and Phonology (DEAP) screen. The screens were audio recorded, coded and transcribed by two other SLTs to test for reliability. One school’s teacher received training and conducted 9 weeks of the Mouthercise programme. The other school was used as a control. After 9 weeks all children were rescreened and the control group availed of 9 weeks of Mouthercise provided by a speech therapist as a benefit of participating in the study.

Outcomes: A statistically significant improvement in two phonological processes was found in the test group v the controls: syllable deletion and gliding. Because of the small sample size and short duration of the study (< 10 twenty minute large group sessions over 10 weeks) other findings, though encouraging, are not statistically significant. The trained teacher, her director and parents of the test group responded positively to the information and strategies the programme provided and felt more confident about correcting speech sound errors the children exhibited.

Conclusion & Implications: The results from this small trial justify replication with a larger study sample and with different socio-economic profiles. Further evaluation of differences, if any, between provision of programme by a teacher and an SLT is appropriate. It would also be important to evaluate whether any improvements continue to be statistically significant when children enter school.


Boyle, J.M., McCartney, E., O’Hare, A. and Forbes, J. (2009) “Direct versus indirect and individual versus group modes of language therapy for children with primary language impairment: Principal outcomes from a randomised controlled

trial and economic evaluation”, International Journal of Language and Communication Disorders, Vol. 44, No. 6, pp. 826-46.

Dodd, B. and Gillon, G.  (2001).  Exploring the Relationship Between Phonological Awareness, Speech Impairment, and Literacy.  Advances in Speech-Language Pathology, Volume 3, Number 2, pp. 139-147

Hayes, N., Keegan, S. and Goulding, E. (2012) Evaluation of the Speech and Language   Therapy Service of Tallaght West Childhood Development Initiative. Dublin: Childhood Development Initiative (CDI).

Law, J., Boyle, J., Harris, F., Harkness, A. and Nye, C. (1998)  Screening for speech and language delay: a systematic review of the literature. Health Technology Assessment, 9 (2), pp. 1–184

Law, J., Lindsay, G., Peacey, N., Gascoigne, M., Soloff, N., Radford, J. and Band, S.  (2000)  Provision for Children with Speech and Language Needs in England and Wales: Facilitating Communication Between Education and Health Services London: Department for Education and Employment (DfEE)/Department of Health (DoH).

Palikara, O., Lindsay, G., Cullen, M., & Dockrell, J. (2007) Working together? The practice of Educational Psychologists and Speech and Language Therapists with children with specific speech and language difficulties.  Educational & Child Psychology Vol 24 No 4 pp.1-15

Shriberg, L.D., Gruber, F.A., Kwiakowski, J., 1994.Developmental Phonological Disorders III: Long Term Speech-Sound Normalization. Journal of Speech and Hearing Research, vol. 37, 1151-1177.

 Van Daal, J., Verhoeven, L., Van Balkom, H.  (2007).  Behaviour Problems in Children with Language Impairment.  The Journal of Child Psychology and Psychiatry, 48 (11), pp. 1139-1147.