Language Intervention Practices for School-Age Children With Spoken Language Disorders: A Systematic Review
Language, Speech, and Hearing Services in Schools
Cirrin, F. M., & Gillam, R. B. (2008).
Language, Speech, and Hearing Services in Schools, 39(1), S110-S137.
This systematic review investigates the effect of language interventions on spoken language outcomes (e.g., syntax and morphology, semantics and vocabulary, language processing) in school-aged children with primary spoken language disorders.
Office of Special Education Programs, U.S. Department of Education
From 1985
Randomized controlled trials; systematic reviews; meta-analyses; nonrandomized comparison studies; multiple baseline single subject designs
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"Clinicians who wish to improve children's expressive syntax can have some confidence that they will obtain moderately large to large effects from procedures that employ imitation, modeling, or modeling plus evoked production strategies" (p. S126).
"More research that compares the effects of a variety of treatments is needed before clinicians will have an evidence base on pragmatic and discourse treatment in which they can have confidence" (p. S129). "SLPs who serve [school-age] students with [pragmatics and conversational discourse-based] language problems need efficacy and effectiveness studies on intervention methods designed to teach topic initiation, topic maintenance and relevance, and other conversational discourse skills, including the use of language to form and enhance peer social interactions within and outside the classroom" (p. S132).
"Direct instruction on topic initiation and group entry behaviors can yield moderately large to large effects with students who present with social communication deficits" (p. S129).
"Clinicians can have a moderate degree of confidence in techniques designed to improve phonological awareness in school-age children" (p. S128).
"In sum, until the research base expands and confirms the efficacy and effectiveness of specific intervention practices for older students with [primary] language problems, clinicians working in school settings will need to select intervention approaches carefully, monitor students’ progress on a regular and frequent basis, and validate the effectiveness of specific interventions for each student to whom they are applied" (p. S130).
"Collectively, these results suggest that targeting children's language processing with proprietary computer programs is neither necessary nor sufficient to induce clinically significant changes in language processing or expressive and receptive language skills" (p. S129).
"The results of these studies give some direction to clinicians searching for evidence about methods for improving semantic processing and vocabulary" (p. S127). The methods include collaborating with teachers on large group instruction, slowed presentation rate, interactive conversational reading strategies, direct instruction, semantic elaboration, semantic retrieval, and phonologically-based treatments.
Only two studies evaluated evidence "pertaining to interventions designed to improve pragmatics and discourse in school-age children. Direct instruction on topic initiation ... and group entry behaviors ... can yield moderately large to large effects with students who present social communication deficits. More research that compares the effects of a variety of treatments is needed before clinicians will have an evidence base on pragmatic and discourse treatment in which they can have confidence" (p. s129).
"Without evidence from multiple, well-conducted clinical trials, clinicians can only have some confidence in the evidence base for procedures that are designed to improve semantic processing and vocabulary development with school-age children" (p. S127).
"Unfortunately, clinicians who work on syntax and grammatical morphology with school-age children have very little evidence available to draw on when selecting an intervention approach" (p. S126).
