Effectiveness of community based rehabilitation in preschool children with language speech delay

Abstract

Background: In Honduras, 28% of children with a disability have a functional alteration related to voice and speech. The Community Based Rehabilitation (CBR) is a strategy to improve the access to rehabilitation Objective: Compare the effectiveness of language therapies with CBR focus versus conventional therapy in children with Language Speech Delay (LSD) in Specialized Center for Physical Medicine and Rehabilitation, Instituto Hondureño de Seguridad Social (IHSS), Honduras in June 2019 – January 2020. Methods: Randomized controlled trial. Children of 2 to 5 years of age with LSDwere randomized to intervention group (CBR) and control group. Intervention consisted in training the parents so they could do the therapies to their children at home. Study population was characterized, and a Cox regression model was performed. Results: 48 children completed 2 evaluations. Median age of 3 years, 77.1% between 2 and 3 years, male predominance with 79.2%, urban provenance with 82.9%, high education level of the mother of 47.9%. Children in CBR had 4.7% more probability of improving unadjusted Hazard Ratio (HR)(1.047, p= 0.889, CI 95% 0.5434 – 2.0194); when adjusted the probability of improving was 10.2% (adjusted HR 1.1016, p= 0.783, CI 95% 0.55 – 2.1966); none of the models reached statistical significance. Conclusions:No difference was found in the effectiveness between the groups; the use of CBR therapies may decrease costs for the patient´s parents and for the IHSS.