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

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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.

Search methods

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), ERIC (1965 ‐ 2002), MEDLINE (1966 ‐ Sept Week 3 2002), PsycINFO (1872 ‐ 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 on 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%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).

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.

PICOs

Population
Intervention
Comparison
Outcome

The PICO model is widely used and taught in evidence-based health care as a strategy for formulating questions and search strategies and for characterizing clinical studies or meta-analyses. PICO stands for four different potential components of a clinical question: Patient, Population or Problem; Intervention; Comparison; Outcome.

See more on using PICO in the Cochrane Handbook.

Plain language summary

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

Primary speech and language delay/disorder is a common developmental difficulty which, if unresolved, can cause difficulties of both learning and socialisation lasting into adolescence and beyond. This review examines the effectiveness of speech and language therapy interventions for children with primary speech and language delay/disorder.The review concludes that whilst there may be some support for the effectiveness of speech and language therapy for children with expressive phonological and expressive vocabulary difficulties, the evidence concerning the effectiveness of interventions for expressive syntax is mixed, and no evidence is available concerning interventions for children with receptive language difficulties.