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Does the duration and frequency of dummy (pacifier) use affect the development of speech?

Lookup NU author(s): Professor Ghada Khattab, Joe Willoughby



This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).


© 2021 The Authors. International Journal of Language & Communication Disorders published by John Wiley & Sons Ltd on behalf of Royal College of Speech and Language TherapistsBackground: The current literature suggests a link between dummy (or pacifier) use and a number of both positive and detrimental consequences. Positive consequences include soothing effect and protection from sudden infant death syndrome (SIDS), while negative ones include increased risk of otitis media and dental malformation. However, there is little research surrounding the impact of dummy use on the development of speech sounds. Aims: To investigate whether duration (in number of months) and frequency per day of dummy use have an individual or combined effect on the development of a child's speech, and if so, in what way. Methods & Procedures: A total of 100 British-English children aged 24–61 months and growing up in the UK were recruited through nurseries, playgroups and by word of mouth. Their parents were asked to complete a questionnaire about the duration and frequency of dummy use and factors known to influence the development of speech. Following this, the children's speech was assessed using the phonology section of the Diagnostic Evaluation of Articulation and Phonology (DEAP). Analysis of the DEAP was conducted to determine the percentage of consonants correct, number of age-appropriate, delayed and atypical errors. Dummy use and speech outcome measures were then analysed qualitatively and quantitatively using mean and median group comparisons alongside multivariate generalized least squares and generalized negative binomial modelling approaches to test for significant associations. Outcomes & Results: The results showed that the majority of speech outcomes are not significantly associated with dummy use, however measured, in bivariate or multivariate analyses. However, there is a significant association between increased atypical errors and greater frequency of daytime dummy use. This association is strengthened by restricted sampling within the younger members of the sample, with this association not observable within children older than 38 months, the median sample age. Conclusions & Implications: The evidence base for any effects of dummy use on speech is very small. Dummy use may increase the number of atypical speech errors a young child makes. However, only the frequency of daytime use seems relevant, not the duration or night-time use, and these errors may resolve over time. What this paper adds What is already known on this subject The use of a dummy with infants in Western countries is comparatively high (between 36-85%). A number of positive and detrimental consequences of dummy use have been documented in the literature; however, research on the effect of dummy use on speech development is significantly lacking. Past studies have included small sample sizes or used single measures of speech outcomes, which may not be specific enough to reveal how speech may be affected. Many speech and language therapists speculate that the use of a dummy could be contributing to many of the conditions they treat, yet this claim remains largely unsubstantiated. Clinical implications of this study The study suggests that only prolonged use of a dummy over several hours and during the day may start to show any impact on speech; even then, professionals need to be aware that the evidence base for any speech effects is very small. Clinicians and other professionals who parents consult on dummy use should make sure to provide both the pros and cons of dummy use, in order to enable parents to make an informed decision.

Publication metadata

Author(s): Strutt C, Khattab G, Willoughby J

Publication type: Article

Publication status: Published

Journal: International Journal of Language and Communication Disorders

Year: 2021

Issue: 3

Pages: 512-527

Print publication date: 01/06/2021

Online publication date: 03/05/2021

Acceptance date: 31/12/2020

Date deposited: 29/07/2021

ISSN (print): 1368-2822

ISSN (electronic): 1460-6984

Publisher: John Wiley and Sons Inc


DOI: 10.1111/1460-6984.12605


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