Language Delays & Disorders Intervention

Speech & Language Delays & Disorders

Intervention

Fey, M. E., Long, S. H., & Finestack, L. H. (2003). Ten principles of grammar facilitation for children with specific language impairments. American Journal of Speech-Language Pathology, 12, 3-15.

Usefulness to Clinical Practice

10 principles of grammatical
intervention planning

Clinical examples for practice

Characteristics of Review
Population	Specific language impairments
Review Type	Narrative
Country	USA
Number of studies	38 referenced

Although they often have significant difficulties in other areas, most children with specific language impairment (SLI) have special difficulties with the understanding and use of grammar. Therefore, most of these children will require an intervention program that targets comprehension or production of grammatical form. Language interventionists are faced with the difficult task of developing comprehensive intervention programs that address the children's grammatical deficits while remaining sensitive to their other existing and predictable social, behavioral, and academic problems. The purpose of this article is to present and justify 10 principles that we regard as essential for planning adequate interventions for children with language-learning problems. These principles are relevant for all children with problems in the use of grammar, but they are especially appropriate for 3- to 8-year-old children with SLI. Although all of our examples are from English, the principles we have chosen are sufficiently broad to cut across many linguistic and cultural boundaries. (Journal Abstract).

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Friel-Patti, S., Loeb, D. F., & Gillam, R. B. (2001). Looking ahead: An introduction to five exploratory studies of fast ForWord. American Journal of Speech-Language Pathology.Special Forum on Fast ForWord, 10, 195-202.

Usefulness to Clinical Practice

Theory underlining Fast ForWord
computer program

Evidence of Fast ForWord efficacy

Characteristics of Review
Population	Specific language impairments
Review Type	Narrative
Country	USA
Number of studies	52 included

In this paper, we provide an introductory overview of a novel approach to language intervention called Fast ForWord (FFW), developed by the Scientific Learning Corporation. More than 20,000 children have received FFW intervention, and many researchers, clinicians, educators, and parents are asking questions about the effectiveness of FFW. To date, there are few evaluations of the treatment other than those that have been published by the developers of the FFW program. This introductory paper will discuss the underlying hypotheses associated with FFW, the components of FFW, and the few studies that have been published regarding the efficacy of FFW. A clinical outcome model based on the work of R. R. Robey and M. C. Schultz (1998) is proposed as a way of understanding the contributions and limitations of previous intervention studies of FFW and as well as those presented in this issue. We end with a look at the questions that need to be asked by researchers and clincians who are interested in FFW. (Journal Abstract).

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Justice, L. M., & Ezell, H. K. (2004). Print referencing: An emergent literacy enhancement strategy and its clinical applications. Language, Speech, and Hearing Services in Schools, 35, 185-193.

Usefulness to Clinical Practice

Examples of print referencing for
clinicians & parents

Theory underlining print referencing

Recommendations for clinical
practice

Characteristics of Review
Population	At-risk children
Review Type	Narrative
Country	USA
Number of studies	35 included

Print referencing is an evidence-based strategy that may be used by speech-language pathologists and other early childhood specialists to enhance the emergent literacy skills of young children. Print referencing is a strategy implemented within the context of adult-child shared storybook reading interactions, and specifically refers to the use of verbal and nonverbal cues to encourage children’s attention to and interactions with print. Print referencing increases the metalinguistic focus of story book reading interactions. When print referencing is delivered within the children’s zone of proximal development, clinicians can foster children’s movement from dependent to independent mastery of key emergent literacy concepts. This clinical exchange provides suggestions for using print referencing as a clinical tool, including a theoretical overview of this approach and descriptions of clinical targets. (Journal Abstract).

FULL TEXT

Kaderavek, J., & Justice, L. M. (2002). Shared storybook reading as an intervention context: Practices and potential pitfalls. American Journal of Speech-Language Pathology, 11, 395-406.

Usefulness to Clinical Practice

Current preschool literacy
interventions

Limitations of using shared
storybook reading

Strategies for clinicians

Characteristics of Review
Population	Normally developing & specific impairments
Review Type	Narrative
Country	USA
Number of studies	82 included

Speech-language pathologists are increasingly using shared storybook reading as a context for providing language intervention to young children. This trend has also been observed in recent applied studies on intervention approaches. There are, however, potential pitfalls in using the shared book-reading context for intervention purposes. This article serves 3 purposes: (a) to describe how the use of shared book reading in clinical practice and research activities reflects contemporary trends in speech-language pathology, (b) to discuss potential pitfalls that may be associated with the use of storybook reading as an intervention context, and (c) to present recommendations for avoiding such pitfalls. (Journal Abstract).

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Kaderavek, J. N., & Justice, L. M. (2004). Embedded-explicit emergent literacy intervention II: Goal selection and implementation in the early childhood classroom. Language, Speech & Hearing Services in Schools, 35, 212-228.

Usefulness to Clinical Practice

3 principles of classroom
intervention

4 literacy domains of intervention

Therapy intervention plans

Characteristics of Review
Population	At-risk children
Review Type	Narrative
Country	USA
Number of studies	57 included

This article, the second in a two-part series, provides guidance to speech-language pathologists (SLPs) for implementing the explicit component of the embedded-explicit emergent literacy intervention model for at-risk preschool and kindergarten children. The explicit component refers to the provision of regular structured therapeutic interactions that intentionally target critical emergent literacy goals. This article describes fundamental principles of explicit literacy instruction, identifies literacy domains, targeted as part of explicit literacy instruction, and presents examples of how early childhood classrooms can be organized to implement the embedded-explicit model. (Journal Abstract).

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Law, J., Garrett, Z., & Nye, C. (2003). Speech and language therapy interventions for children with primary speech and language delay or disorder. The Cochrane Database of Systematic Reviews, Issue 3. Art. No.: CD004110. DOI: 10.1002/14651858.CD004110.

Usefulness to Clinical Practice

Evidence of effectiveness

Review inclusion & exclusion criteria

Characteristics of Review
Population	Language impairments
Review Type	Systematic; meta-analysis
Country	England
Number of studies	25 included

Background: It is thought that approximately 6% of children have speech and language difficulties in which the majority will not have any other significant developmental difficulties. Whilst most children’s difficulties resolve, children whose difficulties persist into primary school may have long-term problems concerning literacy, socialisation, behaviour and school attainment.
Objectives: To examine the effectiveness of speech and language interventions for children with primary speech and language delay/disorder.
Search strategy: The following databases were searched: The Cochrane Controlled Trials Register (Cochrane Library, CENTRAL: 2002/3), CINAHL (1982 – July 2002), EMBASE (1980 – Sept Week 4 2002), MEDLINE (1966- Sept Week 3 2002), PsycINFO (1972 – 2002/10 Week 2), The National Research Register (2002/3). In addition to this references were taken from reviews of the literature and reference lists from articles.
Selection criteria: The review considered randomised controlled trials of speech and language therapy interventions for children or adolescents with primary speech and language delay/disorder.
Data collection and analysis: Titles and abstracts were identified and assessed for relevance, before the full text version was obtained of all potentially relevant articles. The data were categorised depending on the nature of the control group and considered in terms of the effects of intervention on expressive and receptive phonology, syntax and vocabulary. The outcomes used in the analysis were dependent of the focus of the study with only the primary effects of therapy being considered in this review.
Main results: The results of twenty-five studies were used in the meta-analysis. The results suggest that speech and language therapy is effective for children with phonological (SMD=0.44, 95%CI: 0.01, 0.86) or vocabulary difficulties (SMD=0.89, 95%CI: 0.21, 1.56), but that there is less evidence that interventions are effective for children with receptive difficulties (SMD=-0.04,95%CI:-0.64,0.56). Mixed findings were found concerning the effectiveness of expressive syntax interventions (n=233; SMD=1.02, 95%CI: 0.04-2.01). No significant differences were shown between clinician administered intervention and intervention implemented by trained parents, and studies did not show a difference between the effects of group and individual interventions (SMD=0.01, 95%CL: -0.26, 1.17). The use of normal language peers in therapy was shown to have a positive effect on therapy outcome (SMD=2.29, 95%CI: 1.11, 3.48).
Authors’ conclusions: The review shows that overall there is a positive effect of speech and language therapy interventions for children with expressive phonological and expressive vocabulary difficulties. The evidence for expressive syntax difficulties is more mixed, and there is a need for further research to investigate intervention for receptive language difficulties. There is a large degree of heterogeneity in the results, and the sources of this need to be investigated. (Journal Abstract).

FULL TEXT

Law, J., Garrett, Z., & Nye, C. (2004). The efficacy of treatment for children with developmental speech and language delay/disorder: A meta-analysis. Journal of Speech, Language, and Hearing Research, 47, 924-943.

Usefulness to Clinical Practice

Evidence of syntactic, phonological,
& vocabulary intervention efficacy

Characteristics of Review
Population	Specific language impairments
Review Type	Systematic; meta-analysis
Country	England
Number of studies	25 included

A meta-analysis was carried out of interventions for children with primary developmental speech and language delays/disorders. The data were categorized depending on the control group used in the study (no treatment, general stimulation, or routine speech and language therapy) and were considered in terms of the effects of intervention on expressive and receptive phonology, syntax, and vocabulary. The outcomes used in the analysis were dependent on the aims of the study; only the primary effects of intervention are considered in this review. These were investigated at the level of the target of therapy, measures of overall linguistic development, and broader measures of linguistic functioning taken from parent report or language samples. Thirty-six articles reporting 33 different trials were found. Of these articles, 25 provided sufficient information for use in the meta-analyses; however, only 13 of these, spanning 25 years, were considered to be sufficiently similar to be combined. The results indicated that speech and language therapy might be effective for children with phonological or expressive vocabulary difficulties. There was mixed evidence concerning the effectiveness of intervention for children with expressive syntax difficulties and little evidence available considering the effectiveness of intervention for children with receptive language difficulties. No significant differences were found between interventions administered by trained parents and those administered by clinicians. The review identified longer duration (>8 weeks) of therapy as being a potential factor in good clinical outcomes. A number of gaps in the evidence base are identified. (Journal Abstract).

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