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Speech and language therapy interventions for children with primary speech and language delay or disorder

Lookup NU author(s): Professor James Law

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Abstract

Background:It is thought that approximately 6% of children have speech and language difficulties of 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. 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 on the focus of the study with only the primary effects of therapy being considered in this review. 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%CI: -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). Author's 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


Publication metadata

Author(s): Law J, Garrett Z, Nye C

Publication type: Review

Publication status: Published

Journal: Cochrane Database of Systematic Reviews

Year: 2010

Volume: 2010

Issue: 5

Print publication date: 12/05/2010

ISSN (electronic): 1469-493X

URL: http://dx.doi.org/10.1002/14651858.CD004110

DOI: 10.1002/14651858.CD004110


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