Toward a paradigm shift from deficit-based to proactive speech and language treatment: Randomized pilot trial of the babble boot camp in infants with classic galactosemia.

Beate Peter, Nancy Potter, Jennifer Davis, Inbal Donenfeld-Peled, Lizbeth Finestack, Carol Stoel-Gammon, Kari Lien, Laurel Bruce, Caitlin Vose, Linda Eng, Hanako Yokoyama, Daniel Olds, Mark VanDam

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Background: Speech or language therapy is typically initiated reactively after a child starts showing delays. Infants with classic galactosemia (CG), an inborn error of metabolism with a known high risk for both speech and language disorders, hold the keys towards evaluating whether preventive treatment is effective when the risks are known at birth. We present pilot data from a randomized parallel trial of an innovative proactive speech and language intervention program, the Babble Boot Camp (BBC). Method: Five children with CG, otherwise healthy, participated in the BBC from approximately 2 to 24 months of age. One of these was randomly selected as control receiving conventional management. A pediatric speech-language pathologist met weekly via telepractice with the parents in the treatment cohort. Parents implemented the prespeech, speech, and language stimulation and expansion activities according to the protocol. The control child was still too young for conventional treatment. Primary outcome measures were speech sound production complexity in babble and speech and expressive vocabulary size. Secondary outcome measures were developmental milestones in communication, motor, and cognition. Outcomes in the treatment cohort were compared to typical children and the control child. The trial is ongoing. Results: All four treated children had higher speech sound skills in babble, three had higher speech sound skills in meaningful speech, two had higher expressive vocabularies, and three had higher communication and personal-social skills, compared to the control child with CG. Discussion: Given the high risk for speech and language delays in children with CG, finding on-schedule abilities in two or more of the treated children but not the untreated child is unexpected under random conditions. The trends toward beneficial effects of the BBC on speech sound production, expressive language, and communication milestones warrant appropriately powered larger clinical trials with full randomization.

Original languageEnglish (US)
Article number271
StatePublished - 2019


  • Genetic risk
  • Infant
  • Language impairment
  • Prevention
  • Speech disorder
  • Very early intervention

ASJC Scopus subject areas

  • General Biochemistry, Genetics and Molecular Biology
  • General Immunology and Microbiology
  • Pharmacology, Toxicology and Pharmaceutics(all)


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