Evaluation of speech and language therapy interventions for pre‐school children with specific language impairment: a comparison of outcomes following specialist intensive, nursery‐based and no intervention

Abstract

Background: Clinical services in the UK are increasingly delivering ‘consultative’ methods of intervention rather than ‘direct’ intensive input for children with receptive and expressive language difficulties, yet there has been little systematic evaluation of these different intervention models. Aims: To investigate the effectiveness of different models of therapy provision for children with specific language impairment between the ages of 4;00 and 4;06 years. Methods & Procedures: Twenty‐four children were selected from a specialist waiting list in the London Borough of Lambeth. They were assessed on a range of verbal and non‐verbal skills, and randomly assigned to three different intervention groups. Group 1 received direct intensive speech and language therapy weekly over an 8‐month period at a child development centre; Group 2 received a nursery‐based model of intervention; and Group 3 received review sessions at their local clinic. Outcome & Results: Statistical analysis before the intervention phase revealed no significant differences in scores between the three groups on a range of clinical and parental measures of language, non‐verbal skills, play and behaviour. At the end of the intervention period the Intensive group showed significantly greater improvement than the No Intervention group on all clinical and parental measures, and significantly greater improvement than the Nursery‐based group on all clinical and parental measures except for expressive grammar. Conclusions & Implications: The results of this small‐scale study demonstrate that intensive direct speech and language therapy delivered by speech and language therapists was a more effective model of intervention for this clinical group with severe speech and language impairment.

Evidence-based intervention for preschool children with primary speech and language impairments: Child Talk – an exploratory mixed-methods study

“…144 Twenty-three studies were undertaken in a clinic setting. 146,148,[151][152][153][154][155][156][157][158][159][161][162][163][164]168,[171][172][173][174][175] One was carried out in the home context, 143 one was split between the clinic and preschool 169 and another four were carried out purely in a preschool context. 141,154,160,171 The remaining four studies did not state where the intervention was undertaken.…”

“…Four studies used a RCT methodology, 32,169,174,175 two used a case series design with multiple baselines 172,173 and one was a cohort study with pre and post measures. 176 …”

“…Two interventions in this typology was delivered by a SLT, 169,172 two were delivered by both a SLT and parents, 174,176 one was delivered by a parent alone following parental training by SLTs, 175 one was delivered by trained research assistants 32 and one is reported to have been delivered by a clinician but it seems likely that this person was a SLT. 173 A range of settings was used across the studies.…”

“…The types of intervention varied across studies, for example two studies involved picture activities, 172,173 one involved a book-sharing activity, 32 two involved a range of games and therapy techniques 174,175 and one focused on parent-child interaction. 176 The remaining study was a pragmatic RCT and stated that the children in the therapy group 'received the one-to-one speech and language therapy routinely offered by the therapist .…”

“…Six of the seven studies saw improvements in comprehension 32,169,[173][174][175][176] and one reported evidence of generalisation from children's comprehension skills to production skills. 172 Comprehension was seen to improve when the intervention was delivered by parents and also when it was delivered through direct speech and language therapy; between-group differences were found when control groups consisted of 'no intervention' but when intervention groups were compared with groups receiving speech and language therapy in a different form then comprehension improvements tended to be comparable in both groups.…”