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Feltner C, Wallace IF, Nowell SW, Orr CJ, Raffa B, Middleton JC, Vaughan J, Baker C, Chou R, Kahwati L. Screening for Speech and Language Delay and Disorders in Children 5 Years or Younger: Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA 2024; 331:335-351. [PMID: 38261038 DOI: 10.1001/jama.2023.24647] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Importance Children with speech and language difficulties are at risk for learning and behavioral problems. Objective To review the evidence on screening for speech and language delay or disorders in children 5 years or younger to inform the US Preventive Services Task Force. Data Sources PubMed/MEDLINE, Cochrane Library, PsycInfo, ERIC, Linguistic and Language Behavior Abstracts (ProQuest), and trial registries through January 17, 2023; surveillance through November 24, 2023. Study Selection English-language studies of screening test accuracy, trials or cohort studies comparing screening vs no screening; randomized clinical trials (RCTs) of interventions. Data Extraction and Synthesis Dual review of abstracts, full-text articles, study quality, and data extraction; results were narratively summarized. Main Outcomes and Measures Screening test accuracy, speech and language outcomes, school performance, function, quality of life, and harms. Results Thirty-eight studies in 41 articles were included (N = 9006). No study evaluated the direct benefits of screening vs no screening. Twenty-one studies (n = 7489) assessed the accuracy of 23 different screening tools that varied with regard to whether they were designed to be completed by parents vs trained examiners, and to screen for global (any) language problems vs specific skills (eg, expressive language). Three studies assessing parent-reported tools for expressive language skills found consistently high sensitivity (range, 88%-93%) and specificity (range, 88%-85%). The accuracy of other screening tools varied widely. Seventeen RCTs (n = 1517) evaluated interventions for speech and language delay or disorders, although none enrolled children identified by routine screening in primary care. Two RCTs evaluating relatively intensive parental group training interventions (11 sessions) found benefit for different measures of expressive language skills, and 1 evaluating a less intensive intervention (6 sessions) found no difference between groups for any outcome. Two RCTs (n = 76) evaluating the Lidcombe Program of Early Stuttering Intervention delivered by speech-language pathologists featuring parent training found a 2.3% to 3.0% lower proportion of syllables stuttered at 9 months compared with the control group when delivered in clinic and via telehealth, respectively. Evidence on other interventions was limited. No RCTs reported on the harms of interventions. Conclusions and Relevance No studies directly assessed the benefits and harms of screening. Some parent-reported screening tools for expressive language skills had reasonable accuracy for detecting expressive language delay. Group parent training programs for speech delay that provided at least 11 parental training sessions improved expressive language skills, and a stuttering intervention delivered by speech-language pathologists reduced stuttering frequency.
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Affiliation(s)
- Cynthia Feltner
- RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center
- Department of Medicine, University of North Carolina at Chapel Hill
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill
| | - Ina F Wallace
- RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center
- RTI International, Research Triangle Park, North Carolina
| | - Sallie W Nowell
- Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill
| | - Colin J Orr
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill
- Department of Pediatrics, University of North Carolina at Chapel Hill
| | - Brittany Raffa
- Department of Pediatrics, University of North Carolina at Chapel Hill
| | - Jennifer Cook Middleton
- RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill
| | - Jessica Vaughan
- RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill
| | - Claire Baker
- RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill
| | - Roger Chou
- The Pacific Northwest Evidence-Based Practice Center, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University
- School of Medicine, Division of General Internal Medicine, Oregon Health & Science University
| | - Leila Kahwati
- RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center
- RTI International, Research Triangle Park, North Carolina
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Donolato E, Toffalini E, Rogde K, Nordahl-Hansen A, Lervåg A, Norbury C, Melby-Lervåg M. Oral language interventions can improve language outcomes in children with neurodevelopmental disorders: A systematic review and meta-analysis. CAMPBELL SYSTEMATIC REVIEWS 2023; 19:e1368. [PMID: 38024782 PMCID: PMC10680434 DOI: 10.1002/cl2.1368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
Background Young people who fail to develop language as expected face significant challenges in all aspects of life. Unfortunately, language disorders are common, either as a distinct condition (e.g., Developmental Language Disorder) or as a part of another neurodevelopmental condition (e.g., autism). Finding ways to attenuate language problems through intervention has the potential to yield great benefits not only for the individual but also for society as a whole. Objectives This meta-analytic review examined the effect of oral language interventions for children with neurodevelopmental disorders. Search Methods The last electronic search was conducted in April 2022. Selection Criteria Intervention studies had to target language skills for children from 2 to 18 years of age with Developmental Language Disorder, autism, intellectual disability, Down syndrome, Fragile X syndrome, and Williams syndrome in randomised controlled trials or quasi-experimental designs. Control groups had to include business-as-usual, waiting list, passive or active conditions. However, we excluded studies in which the active control group received a different type, delivery, or dosage of another language intervention. Eligible interventions implemented explicit and structured activities (i.e., explicit instruction of vocabulary, narrative structure or grammatical rules) and/or implicit and broad activities (i.e., shared book reading, general language stimulation). The intervention studies had to assess language skills in receptive and/or expressive modalities. Data Collection and Analysis The search provided 8195 records after deduplication. Records were screened by title and abstract, leading to full-text examinations of 448 records. We performed Correlated and Hierarchical Effects models and ran a retrospective power analysis via simulation. Publication bias was assessed via p-curve and precision-effect estimate. Main Results We examined 38 studies, with 46 group comparisons and 108 effects comparing pre-/post-tests and eight studies, with 12 group comparisons and 21 effects at follow-up. The results showed a mean effect size of d = 0.27 at the post-test and d = 0.18 at follow-up. However, there was evidence of publication bias and overestimation of the mean effects. Effects from the meta-analysis were significantly related to these elements: (1) receptive vocabulary and omnibus receptive measures showed smaller effect sizes relative to expressive vocabulary, grammar, expressive and receptive discourse, and omnibus expressive tests; and (2) the length of the intervention, where longer sessions conducted over a longer period of time were more beneficial than brief sessions and short-term interventions. Neither moderators concerning participants' characteristics (children's diagnosis, diagnostic status, age, sex, and non-verbal cognitive ability and severity of language impairment), nor those regarding of the treatment components and implementation of the language interventions (intervention content, setting, delivery agent, session structure of the intervention or total number of sessions) reached significance. The same occurred to indicators of study quality. The risk of bias assessment showed that reporting quality for the studies examined in the review was poor. Authors’ Conclusions In sum, the current evidence base is promising but inconclusive. Pre-registration and replication of more robust and adequately powered trials, which include a wider range of diagnostic conditions, together with more long-term follow-up comparisons, are needed to drive evidence-based practice and policy.
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Affiliation(s)
| | - Enrico Toffalini
- Department of General Psychology University of Padova Padova Italy
| | - Kristin Rogde
- Department of Special Needs Education University of Oslo Oslo Norway
| | | | | | - Courtenay Norbury
- Division of Psychology & Language Sciences University College London London UK
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Singer I, de Wit E, Gorter JW, Luinge M, Gerrits E. A systematic scoping review on contextual factors associated with communicative participation among children with developmental language disorder. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023; 58:482-515. [PMID: 36239148 DOI: 10.1111/1460-6984.12787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 08/12/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Variations in communicative participation of children with developmental language disorder (DLD) cannot be wholly explained by their language difficulties alone and may be influenced by contextual factors. Contextual factors may support or hinder communicative participation in children, which makes their identification clinically relevant. AIMS To investigate which contextual (environmental and personal) factors in early childhood are protective, risk or neutral factors for communicative participation among school-aged children with DLD, and to identify possible gaps in knowledge about this subject. METHODS & PROCEDURES A scoping review was conducted based on a systematic search of studies published from January 2007 to March 2022 in Pubmed, Embase (without MEDLINE), CINAHL and PsycINFO. In total, 8802 studies were reviewed using predefined eligibility criteria, of which 32 studies were included for data extraction and critically appraised using the Critical Appraisal Skills Programme (2021) tools. MAIN CONTRIBUTION The methodological quality of included studies was adequate to strong. Personal protective factors identified are being a preschool girl, reaching school age and being prosocial, while personal risk factors are becoming a teenager or adolescent, having low socio-cognitive skills and experiencing comorbid mobility impairment or behavioural problems. Gender after the preschool years and non-verbal abilities were not found to be of influence, and the role of socio-emotional skills is inconclusive. Receiving therapy is an environmental protective factor, while the association between socio-economical family characteristics with communicative participation is inconclusive. CONCLUSIONS & IMPLICATIONS Limited research has been conducted on which risk and protective factors present in early childhood are associated with later communicative participation of children with DLD. The influence of co-occurring health conditions, social background variables, individual psychological assets, interpersonal relationships and attitudes of other people represent knowledge gaps. In addition, knowledge about the comparative effectiveness of different types of interventions and service delivery models, and the impact of administrative control, organizational mechanisms and standards established by governments on children's communicative participation is lacking. More longitudinal research is needed focusing on the identification of relevant personal and environmental factors and the interactions between them in relation to communicative participation outcomes. WHAT THIS PAPER ADDS What is already known on this subject Children with DLD experience varying degrees of communicative participation restrictions. Insight into contextual factors that influence communicative participation can help to identify children at risk and inform family and child-centred therapy. Systematic research on contextual factors that facilitate or hinder communicative participation in children with DLD is currently lacking. What this paper adds to existing knowledge Knowledge of protective factors can guide the development of interventions for children and young people with DLD that boost resilience and facilitate communicative participation, while insight into the risk factors can help professionals identify the most vulnerable children and develop interventions that can lift or neutralize barriers present in the life of these children. Specific groups potentially at risk are young boys, children with co-morbid mobility impairment, children with conduct problems, and children reaching adolescence. In contrast, potentially protective factors are reaching school age and being prosocial. In addition, the development of socio-cognitive skills may be beneficial for the communicative participation of children with DLD. What are the potential or actual clinical implications of this work? To support communicative participation, it is important that professionals who work with children with DLD understand which groups are at risk for communicative participation restrictions, and which factors can foster resilience. In the absence of evidence-based instruments for the systematic assessment of personal and environmental factors, consulting parents and children on the contextual factors that they perceive as important remains critical.
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Affiliation(s)
- Ingrid Singer
- Research group Speech and Language Therapy, HU University of Applied Sciences Utrecht, the Netherlands
- Utrecht University, Utrecht, the Netherlands
| | - Ellen de Wit
- Hanze University of Applied Sciences Groningen, Groningen, the Netherlands
| | | | - Margreet Luinge
- Hanze University of Applied Sciences Groningen, Groningen, the Netherlands
| | - Ellen Gerrits
- Research group Speech and Language Therapy, HU University of Applied Sciences Utrecht, the Netherlands
- Utrecht University, Utrecht, the Netherlands
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Fan S, Ma B, Song X, Wang Y. Effect of language therapy alone for developmental language disorder in children: A meta-analysis. Front Psychol 2022; 13:922866. [PMID: 36262431 PMCID: PMC9574219 DOI: 10.3389/fpsyg.2022.922866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 08/19/2022] [Indexed: 11/27/2022] Open
Abstract
Despite numerous studies on the treatment of developmental language disorder (DLD), the intervention effect has long been debated. Systematic reviews of the effect of language therapy alone are rare. This evidence-based study investigated the effect of language therapy alone for different expressive and receptive language levels in children with DLD. Publications in databases including PubMed, the Cochrane Library, the Wanfang Database and the China National Knowledge Infrastructure were searched. Randomized controlled trials were selected. The methodological quality of the included trials was assessed using the modified Jadad method. RevMan 5.3 software was used for the data analysis. Fifteen trials were included in this study. Compared with the control (no or delayed intervention) group, the intervention group showed significant differences in overall expressive language development [standard mean differences (SMD), 0.46; 95% confidence interval (CI), 0.12–0.80], mean length of utterances in a language sample (SMD, 2.16; 95% CI, 0.39–3.93), number of utterances in a language sample (SMD, 0.52; 95% CI, 0.21–0.84), parent reports of expressive phrase complexity (SMD, 1.24; 95% CI, 0.78–1.70), overall expressive vocabulary development (SMD, 0.43; 95% CI, 0.17–0.69) and different words used in a language sample (SMD, 0.62; 95% CI, 0.35–0.88). However, language therapy did not show satisfactory long-term effects on DLD. Although language therapy is helpful in improving the performance of children with DLD, its long-term effect is unsatisfactory.
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Affiliation(s)
- Shengfu Fan
- Department of Foreign Languages, Changzhi Medical College, Changzhi, China
- *Correspondence: Shengfu Fan
| | - Bosen Ma
- School of International Studies, Zhejiang University, Hangzhou, China
| | - Xuan Song
- Emergency Department, Dongying Honggang Hospital, Dongying, China
| | - Yuhong Wang
- Department of Foreign Languages, Changzhi Medical College, Changzhi, China
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Jensen de López KM, Kraljević JK, Struntze ELB. Efficacy, model of delivery, intensity and targets of pragmatic interventions for children with developmental language disorder: A systematic review. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2022; 57:764-781. [PMID: 35445482 PMCID: PMC9544814 DOI: 10.1111/1460-6984.12716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 02/23/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND It is widely acknowledged that children with developmental language disorder (DLD) predominantly have difficulties in the areas of grammar and vocabulary, with preserved pragmatic skills. Consequently, few studies focus on the pragmatic skills of children with DLD, and there is a distinct lack of studies examining the effectiveness of pragmatic interventions. AIMS To carry out a systematic review of the literature on pragmatic interventions for children with DLD. METHODS & PROCEDURES This systematic review was registered with PROSPERO (ID = CRD42017067239). A systematic search in seven databases yielded 1031 papers, of which 11 met our inclusion criteria. The included papers focused on interventions for children with DLD (mean = 3-18 years), enhancing oral language pragmatic skills, published between January 2006 and May 2020, and were based on a group-study design such as randomized control trial or pre-post-testing. Study participants were monolingual speakers. The quality of papers was appraised using the Cochrane Risk of bias tool for randomized controlled trials. OUTCOMES & RESULTS There was a high degree of variability between the included intervention studies, especially regarding intensity, intervention targets and outcomes. The evidence suggested that pragmatic intervention is feasible for all models of delivery (individual, small and large group) and that interventions for pragmatic language are mostly focused on encouragement of conversation and narrative skills observed through parent-child interaction or shared book-reading activities. CONCLUSIONS & IMPLICATIONS This study highlights the importance of promoting and explicitly teaching pragmatic skills to children with DLD in structured interventions. A narrative synthesis of the included studies revealed that in addition to direct intervention, indirect intervention can also contribute to improving oral pragmatic skills of children with DLD. WHAT THIS PAPER ADDS What is already known on the subject? An increasing number of studies have shown that difficulties in acquiring pragmatic language is not only present in children with autism. What this study adds to existing knowledge? Interventions for pragmatic language in children with DLD are mostly focused on encouragement of conversation and narrative skills, very often through parent-child interaction or shared book-reading activities. Interventions that target language pragmatic are feasible for all models of delivery (individual, small and large group). What are the potential or actual clinical implications of this work? The efficacy of the existing studies varies, and it is difficult to give recommendations regarding the intensity and duration of the specific intervention. In addition to offering pragmatic intervention directly from a specialist, pragmatic interventions can also be carried out indirectly if the intervention is under the continuous supervision of a specialist.
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Affiliation(s)
- Kristine M. Jensen de López
- Clinic for Developmental Communication DisordersInstitute of Communication and PsychologyAalborg UniversityAalborgDenmark
| | - Jelena Kuvač Kraljević
- Department of Speech and Language PathologyFaculty of Education and Rehabilitation SciencesUniversity of ZagrebZagrebCroatia
| | - Emilie L. Bang Struntze
- Clinic for Developmental Communication DisordersInstitute of Communication and PsychologyAalborg UniversityAalborgDenmark
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Kwok E, Cermak CA, Hatherly K, Cunningham BJ. Intervention Goals for Preschoolers With Language Difficulties and Disorders: A Scoping Review Using the International Classification of Functioning, Disability and Health Framework. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:1-70. [PMID: 35302873 DOI: 10.1044/2021_ajslp-21-00226] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE The primary aim of this scoping review was to categorize language therapy goals reported in intervention studies for preschoolers (i.e., children from birth to 5;0 [years;months]) with language difficulties and disorders within the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework. A secondary aim was to determine whether different therapy goals were reported for two language difficulty/disorder subtypes (i.e., comparing language difficulty/disorder associated with a biomedical condition to those without an associated biomedical condition). METHOD The scoping review followed Arksey and O'Malley (2005) guidelines. Articles were retrieved from speechBITE, with age (under 5 years), intervention area (language), and study design (all but systematic reviews and clinical practice guidelines) specified as inclusion criteria. Language goals were extracted and categorized into the ICF components, and the distribution of goals across ICF components was compared for studies involving children with the two language difficulty/disorder subtypes. RESULTS A total of 287 articles were identified; 140 met inclusion criteria. Of the 293 goals extracted, 48% aligned with the activities component of the ICF framework, followed by participation (26%), environmental factors (20%), body functions and structures (3%), and personal factors (3%). Most participation-focused goals were reported from intervention studies involving preschoolers with a language difficulty/disorder associated with a biomedical condition. CONCLUSIONS Few participation-focused goals were reported in intervention studies for preschoolers with language difficulty/disorder without an associated condition. Future work is needed to support integrating the ICF framework in goal setting for both research and practice.
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Affiliation(s)
- Elaine Kwok
- CanChild, McMaster University, Institute of Applied Health Sciences, Hamilton, Ontario, Canada
- Richard and Roxelyn Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
| | - Carly A Cermak
- School of Communication Sciences and Disorders, London, Ontario, Canada
| | - Kathryn Hatherly
- School of Communication Sciences and Disorders, London, Ontario, Canada
| | - Barbara Jane Cunningham
- CanChild, McMaster University, Institute of Applied Health Sciences, Hamilton, Ontario, Canada
- School of Communication Sciences and Disorders, London, Ontario, Canada
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Crowe K, Cuervo S, Guiberson M, Washington KN. A Systematic Review of Interventions for Multilingual Preschoolers With Speech and Language Difficulties. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:4413-4438. [PMID: 34554866 DOI: 10.1044/2021_jslhr-21-00073] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose There is a shortage of information on evidence-based interventions for supporting young multilingual children. The purpose of this review was to identify interventions that have been evaluated with preschool-age multilingual children with a speech and/or language disorder or who are at risk of poor speech, language, literacy, and/or educational outcomes. Method This review considered speech, language, and early literacy interventions evaluated with preschool-age multilingual children with a speech and/or language disorder or who have been identified as being at risk of language difficulties (PROSPERO ID: 165892). The following electronic databases were searched: EBSCO (CINAHL Plus, ERIC, PsycINFO, Medline, Education) and Linguistics, Language, and Behavior Abstracts. Data were extracted describing article, participant, methodological, and intervention variables, and effect sizes. The Council for Exceptional Children's (CEC) standards for evidence-based practice were used to examine the quality of studies. Results Fifty-six relevant studies were identified in 52 articles and these studies described 4,551 participants who had speech sound disorder (six articles), developmental language disorder (11 articles), or were considered to be at risk (36 articles). The interventions targeted speech production (seven studies), language (45 studies), and early literacy (11 studies) skills. Most studies reported positive effects. Only 15 studies met all quality indicators specified by the CEC (2014) and these described 18 interventions targeting language and literacy skills. The only intervention with sufficient evidence to be considered an evidence-based practice was Nuestros Niños [Our Children] for children's early literacy and phonological awareness skills. Conclusions A number of high-quality studies exist that describe speech, language and/or literacy interventions for preschool-age multilingual children with a speech and/or language disorder, or who have been identified as being at risk of language difficulties. However, there remains limited evidence for specific interventions as to their ability to inform evidence-based practices. Supplemental Material https://doi.org/10.23641/asha.16632649.
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Affiliation(s)
- Kathryn Crowe
- School of Teacher Education, Charles Sturt University, Bathurst, Australia
- School of Health Sciences, Reykjavík, University of Iceland
| | - Sisan Cuervo
- Department of Communication Sciences and Disorders, University of Cincinnati, OH
| | - Mark Guiberson
- College of Health Sciences, University of Wyoming, Laramie
| | - Karla N Washington
- Department of Communication Sciences and Disorders, University of Cincinnati, OH
- Department of Communicative Sciences and Disorders, New York University, NY
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Horner SL, Shaffer SA. Evaluating the Reporting Quality of Researcher-Developed Alphabet Knowledge Measures: How Transparent and Replicable Is It? Front Psychol 2021; 12:601849. [PMID: 33935857 PMCID: PMC8085332 DOI: 10.3389/fpsyg.2021.601849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 03/16/2021] [Indexed: 11/13/2022] Open
Abstract
The American Educational Research Association and American Psychological Association published standards for reporting on research. The transparency of reporting measures and data collection is paramount for interpretability and replicability of research. We analyzed 57 articles that assessed alphabet knowledge (AK) using researcher-developed measures. The quality of reporting on different elements of AK measures and data collection was not related to the journal type nor to the impact factor or rank of the journal but rather seemed to depend on the individual author, reviewers, and journal editor. We propose various topics related to effective reporting of measures and data collection methods that we encourage the early childhood and literacy communities to discuss.
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Affiliation(s)
- Sherri L. Horner
- School of Educational Foundations & Inquiry, Bowling Green State University, Bowling Green, OH, United States
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Rinaldi S, Caselli MC, Cofelice V, D’Amico S, De Cagno AG, Della Corte G, Di Martino MV, Di Costanzo B, Levorato MC, Penge R, Rossetto T, Sansavini A, Vecchi S, Zoccolotti P. Efficacy of the Treatment of Developmental Language Disorder: A Systematic Review. Brain Sci 2021; 11:brainsci11030407. [PMID: 33806938 PMCID: PMC8005159 DOI: 10.3390/brainsci11030407] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/05/2021] [Accepted: 03/16/2021] [Indexed: 01/08/2023] Open
Abstract
Background. Language disorder is the most frequent developmental disorder in childhood and it has a significant negative impact on children’s development. The goal of the present review was to systematically analyze the effectiveness of interventions in children with developmental language disorder (DLD) from an evidence-based perspective. Methods. We considered systematic reviews, meta-analyses of randomized controlled trials (RCTs), control group cohort studies on any type of intervention aimed at improving children’s skills in the phono-articulatory, phonological, semantic-lexical, and morpho-syntactic fields in preschool and primary school children (up to eight years of age) that were diagnosed with DLD. We identified 27 full-length studies, 26 RCT and one review. Results. Early intensive intervention in three- and four-year-old children has a positive effect on phonological expressive and receptive skills and acquisitions are maintained in the medium term. Less evidence is available on the treatment of expressive vocabulary (and no evidence on receptive vocabulary). Intervention on morphological and syntactic skills has effective results on expressive (but not receptive) skills; however, a number of inconsistent results have also been reported. Only one study reports a positive effect of treatment on inferential narrative skills. Limited evidence is also available on the treatment of meta-phonological skills. More studies investigated the effectiveness of interventions on general language skills, which now appears as a promising area of investigation, even though results are not all consistent. Conclusions. The effectiveness of interventions over expressive and receptive phonological skills, morpho-syntactic skills, as well as inferential skills in narrative context underscores the importance that these trainings be implemented in children with DLD.
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Affiliation(s)
- Sara Rinaldi
- Developmental Neurorehabilitation Service, UOC Infancy, Adolescence, Family Counseling, AULSS 6 Euganea—Padua Bacchiglione District, Via Dei Colli 4/6, 35143 Padua, Italy
- Federazione Logopedisti Italiani, Via Daniello Bartoli, 00152 Rome, Italy; (A.G.D.C.); (T.R.)
- Correspondence: ; Tel.: +39-0498217670
| | | | | | - Simonetta D’Amico
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, P.le S. Tommasi, 1, 67100 Coppito, Italy;
- CLASTA—Communication & Language Acquisition Studies in Typical & Atypical Population, Piazza Epiro 12D, 00183 Rome, Italy; (M.C.L.); (A.S.)
| | - Anna Giulia De Cagno
- Federazione Logopedisti Italiani, Via Daniello Bartoli, 00152 Rome, Italy; (A.G.D.C.); (T.R.)
| | | | - Maria Valeria Di Martino
- Health Professions Integrated Service, Azienda Ospedaliera dei Colli di Napoli, 80131 Napoli, Italy;
| | - Brigida Di Costanzo
- Division of Phoniatrics and Audiology, Department of Mental and Physical Health, and Preventive Medicine, Luigi Vanvitelli University, Largo Madonna delle Grazie 1, 80138 Naples, Italy;
- Cinetic Center, Neuromotor Rehabilitation Centre, Via Santella 26, 81025 Marcianise, Italy
| | - Maria Chiara Levorato
- CLASTA—Communication & Language Acquisition Studies in Typical & Atypical Population, Piazza Epiro 12D, 00183 Rome, Italy; (M.C.L.); (A.S.)
- Department of Developmental Psychology and Socialization, University of Padua, Via Venezia, 8, 35131 Padova, Italy
| | - Roberta Penge
- Department of Human Neuroscience, Sapienza University of Rome, Via dei Sabelli 108, 00185 Rome, Italy;
| | - Tiziana Rossetto
- Federazione Logopedisti Italiani, Via Daniello Bartoli, 00152 Rome, Italy; (A.G.D.C.); (T.R.)
| | - Alessandra Sansavini
- CLASTA—Communication & Language Acquisition Studies in Typical & Atypical Population, Piazza Epiro 12D, 00183 Rome, Italy; (M.C.L.); (A.S.)
- Department of Psychology “Renzo Canestrari”, University of Bologna, Viale Berti Pichat 5, 40127 Bologna, Italy
| | - Simona Vecchi
- Department of Epidemiology, Lazio Regional Health Service, Via Cristoforo Colombo, 112, 00154 Rome, Italy;
| | - Pierluigi Zoccolotti
- Department of Psychology, Sapienza University of Rome, Via Dei Marsi 78, 00185 Rome, Italy;
- Neuropsychology Unit, IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy
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Zhang Z, Xu Q, Joshi RM. A meta-analysis on the effectiveness of intervention in children with primary speech and language delays/disorders: Focusing on China and the United States. Clin Psychol Psychother 2020; 28:585-605. [PMID: 33068068 DOI: 10.1002/cpp.2522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 08/31/2020] [Accepted: 10/05/2020] [Indexed: 10/23/2022]
Abstract
The purpose of this meta-analysis was to investigate the immediate and long-term effects of intervention for children with primary speech and language delays/disorders and to explore whether some characteristics of interventions, specifics of the study and research participants moderate the magnitude of the effectiveness of interventions. Using the random effect model, we pooled the effect size and conducted a publication bias evaluation, a moderating effect analysis in CMA 2.0. Results of a random effects model analysis demonstrated a moderate immediate effect (g = 0.70), whereas the long-term efficacy was small (g = 0.23). Additionally, type of measure, language of intervention, parental involvement, intervention content and study quality, as well as the duration of intervention, significantly moderated the effect size of intervention effectiveness.
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Affiliation(s)
- Zhigang Zhang
- Jiangsu Provincial Key Constructive Laboratory of Special Children's Impairment and Intervention, Nanjing Normal University of Special Education, Nanjing, China
| | - Qinfang Xu
- Jiangsu Provincial Key Constructive Laboratory of Special Children's Impairment and Intervention, Nanjing Normal University of Special Education, Nanjing, China.,School of Languages, Nanjing Normal University of Special Education, Nanjing, China
| | - R Malatesha Joshi
- College of Education and Human Development, Texas A&M University, College Station, TX, USA
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Le HND, Le LKD, Nguyen PK, Mudiyanselage SB, Eadie P, Mensah F, Sciberras E, Gold L. Health-related quality of life, service utilization and costs of low language: A systematic review. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2020; 55:3-25. [PMID: 31556211 DOI: 10.1111/1460-6984.12503] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 09/02/2019] [Accepted: 09/08/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Low language (LL) is a common childhood condition affecting 7-17% of children. It is associated with life-long adverse outcomes and can affect various aspects of a child's life. However, the literature on its impact on health-related quality of life (HRQoL), service use and costs are limited. To date, there has been no systematic review of the overall economic burden of LL. A systematic review regarding the economic burden of LL is important for clinical, educational, policy decision-making and theoretical aspects. We adopted the term 'low language' to refer to children whose language performance falls below well-recognized cut-points regardless of known or unknown aetiology. AIMS To review the literature systematically on how LL is associated with HRQoL, service utilization and costs. METHODS & PROCEDURES A systematic search was conducted across various databases, including MEDLINE, Embase, PsycINFO, CINAHL, up to July 2017. Data on study design, population and outcomes were extracted and screened by two pairs of reviewers with the revision of other experts in the panel on any discrepancies. The Effective Public Health Practice Project tool was used to assess the risk of bias of the included studies. The findings of the included studies were summarized in a narrative synthesis. OUTCOMES & RESULTS We identified 22 relevant articles, of which 12 reported HRQoL and 11 reported service utilization and costs associated with LL. Preference-based instruments, which include the relative importance attached to different aspects of HRQoL, were less employed in the literature. Most studies found poorer HRQoL in children with LL compared with their peers. About half the families having children with LL did not actively seek professional help, and many families felt they did not receive sufficient services when needed. Healthcare costs associated with LL were substantial. Non-healthcare costs were largely unexplored. CONCLUSIONS & IMPLICATIONS LL was associated with reduced children's HRQoL, higher service use and costs. Under-servicing was evident in children with LL. LL also imposed large costs on the healthcare system. Further research is required to examine (1) the overall HRQoL of children with LL, in particular studies using and testing the performance of preference-based instruments; and (2) the service use and costs specific to LL, especially non-healthcare costs.
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Affiliation(s)
- Ha N D Le
- School of Health and Social Development, Deakin University, Geelong, VIC, Australia
- Murdoch Children's Research Institute, Parkville, Melbourne, VIC, Australia
| | - Long K D Le
- School of Health and Social Development, Deakin University, Geelong, VIC, Australia
| | - Phuong K Nguyen
- School of Health and Social Development, Deakin University, Geelong, VIC, Australia
| | | | - Patricia Eadie
- Melbourne Graduate School of Education, The University of Melbourne, Melbourne, VIC, Australia
| | - Fiona Mensah
- Murdoch Children's Research Institute, Parkville, Melbourne, VIC, Australia
- Royal Children's Hospital, Parkville, Melbourne, VIC, Australia
- Department of Pediatrics, The University of Melbourne, Parkville, Melbourne, VIC, Australia
| | - Emma Sciberras
- Murdoch Children's Research Institute, Parkville, Melbourne, VIC, Australia
- School Psychology, Deakin University, Geelong, VIC, Australia
| | - Lisa Gold
- School of Health and Social Development, Deakin University, Geelong, VIC, Australia
- Murdoch Children's Research Institute, Parkville, Melbourne, VIC, Australia
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12
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Tarvainen S. Oral language comprehension interventions in 1-8-year-old children with language disorders or difficulties: A systematic scoping review. AUTISM & DEVELOPMENTAL LANGUAGE IMPAIRMENTS 2020; 5:2396941520946999. [PMID: 36381544 PMCID: PMC9620463 DOI: 10.1177/2396941520946999] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND AND AIMS The most severe problems in language manifest as difficulties in comprehending oral language. These difficulties are persistent and expose individuals to several risk factors. There is a lack of intervention research in the area of oral language comprehension, and no reviews have focused solely on oral language comprehension interventions in young children. The aim of this review was to identify interventions targeting oral language comprehension in children 8 years or younger with language disorders or difficulties. The review also examined the possible intervention foci, efficacy, and level of evidence of these interventions. METHODS A systematic scoping review of eight databases was carried out. Twenty of 2399 articles met the inclusion criteria and a further six articles were identified through reference lists of sourced articles. These 26 articles described 25 studies. Altogether 2460 children aged 1-8 years participated in the 25 studies. The data from these studies were extracted and analysed, and the intervention foci, efficacy, and level of evidence were evaluated.Main contribution: The reviewed interventions focused on three aspects: modifying the communicative environment of the child; targeting aspects of the child's language; or targeting the child's language processing. Of the included studies, 80% indicated positive effects on participants' oral language comprehension. The level of evidence of the included studies varied. With few exceptions, researchers and practitioners can have moderate confidence in the results of the included studies indicating that it is possible to ameliorate difficulties in oral language comprehension. CONCLUSIONS This review summarises the existing evidence on oral language comprehension interventions in young children with language disorders or difficulties. The evidence base is still limited, and more research is urgently needed. The results suggest that though not all interventions seem to provide desired outcomes, there are several interventions indicating efficacy to target problems in oral language comprehension in 1-8-year-old children with language disorders or difficulties. A careful choice of therapy technique and collaboration with people in the child's environment is required to maximize outcomes.Implications: The results suggest that young children's oral language comprehension skills can be improved by guiding parents and clinicians in their communication strategies, and by clinician-implemented interventions targeting aspects of the child's language. The research on interventions targeting children's language processing is limited, and the results mixed. The present study provides information on different oral language comprehension interventions and their outcomes. The findings are readily applicable for clinical use.
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Affiliation(s)
- Sirpa Tarvainen
- Sirpa Tarvainen, Department of Psychology
and Logopedics, University of Helsinki, Haartmaninkatu 3, Helsinki 00014,
Finland. Emails: ;
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13
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Law J, Levickis P, Rodríguez-Ortiz IR, Matić A, Lyons R, Messarra C, Kouba Hreich E, Stankova M. Working with the parents and families of children with developmental language disorders: An international perspective. JOURNAL OF COMMUNICATION DISORDERS 2019; 82:105922. [PMID: 31425855 DOI: 10.1016/j.jcomdis.2019.105922] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 07/04/2019] [Accepted: 07/14/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The relationship between parental input and child language development has had a complex history. It has become clear that indirect parent training for the parents of children with delayed language development is an important feature of interventions offered by speech and language therapists in the anglophone countries. Yet we know less about how this type of approach is realised in other countries. METHODS In this paper we report the results of a survey of practice undertaken as part of the work of COST Action IS1406, a European Union (EU) funded research network. The focus of this paper is specifically on parent-related questions and responses referring to children under the age of twelve. The survey was devised by members of the Action and circulated electronically during the summer of 2017. In all, 4024 practitioners responded from 60 countries, the majority of whom came from EU member countries. FINDINGS Respondents to the survey indicated that indirect therapy is commonly carried out via the parent in the early years and via teachers later. A range of professional groups, in addition to speech and language therapists, is likely to adopt this approach; including teachers, pedagogues and psychologists. A variety of interventions is reported, some of which have a reasonable evidence-base underpinning them. It is interesting to see the widespread involvement of fathers and other family members in interventions. Finally, the fact that practitioner characteristics (age, experience, location of practice etc.) are not related to the use of indirect techniques points to the universal recognition of the value of these approaches. CONCLUSIONS Despite the very different traditions in the practice of intervention across countries, there is clearly a widespread recognition of the importance of indirect approaches to intervention and specifically those focusing on parents. The mixture of family members being involved in interventions is a very promising indication of the role sharing commonly associated with the contemporary family. Yet the number of specific intervention approaches identified is relatively small given the number of respondents. There is a need for a better understanding of what exactly practitioners are doing when they involve parents in intervention or carry out parent-child interaction interventions and how well these interventions work in routine practice. This also has implications for the application of evidence-based practice and the precise nature of the interventions concerned (advice to parents, video interaction training etc.).
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Affiliation(s)
- James Law
- School of Education, Communication & Language Sciences, Newcastle University, Newcastle upon Tyne, UK.
| | - Penny Levickis
- School of Education, Communication & Language Sciences, Newcastle University, Newcastle upon Tyne, UK; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, VIC, Australia.
| | | | - Ana Matić
- Department of Speech and Language Pathology, University of Zagreb, Croatia.
| | - Rena Lyons
- Discipline of Speech and Language Therapy, National University of Galway, Ireland.
| | - Camille Messarra
- Institut Supérieur d'Orthophonie, Université Saint Joseph Beyrouth, Lebanon.
| | - Edith Kouba Hreich
- Institut Supérieur d'Orthophonie, Université Saint Joseph Beyrouth, Lebanon.
| | - Margarita Stankova
- Department of Health and Social Work, New Bulgarian University, Bulgaria.
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Xie QW, Chan CHY, Ji Q, Chan CLW. Psychosocial Effects of Parent-Child Book Reading Interventions: A Meta-analysis. Pediatrics 2018; 141:peds.2017-2675. [PMID: 29588337 DOI: 10.1542/peds.2017-2675] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/25/2018] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Parent-child book reading (PCBR) is effective at improving young children's language, literacy, brain, and cognitive development. The psychosocial effects of PCBR interventions are unclear. OBJECTIVE To systematically review and synthesize the effects of PCBR interventions on psychosocial functioning of children and parents. DATA SOURCES We searched ERIC, PsycINFO, Medline, Embase, PubMed, Applied Social Sciences Index and Abstracts, Social Services Abstracts, Sociological Abstracts, Family and Society Studies Worldwide, and Social Work Abstracts. We hand searched references of previous literature reviews. STUDY SELECTION Randomized controlled trials. DATA EXTRACTION By using a standardized coding scheme, data were extracted regarding sample, intervention, and study characteristics. RESULTS We included 19 interventions (3264 families). PCBR interventions improved the psychosocial functioning of children and parents compared with controls (standardized mean difference: 0.185; 95% confidence interval: 0.077 to 0.293). The assumption of homogeneity was rejected (Q = 40.010; P < .01). Two moderator variables contributed to between-group variance: method of data collection (observation less than interview; Qb = 7.497; P < .01) and rater (reported by others less than self-reported; Qb = 21.368; P < .01). There was no significant difference between effects of PCBR interventions on psychosocial outcomes of parents or children (Qb = 0.376; P = .540). LIMITATIONS The ratio of moderating variables to the included studies limited interpretation of the findings. CONCLUSIONS PCBR interventions are positively and significantly beneficial to the psychosocial functioning of both children and parents.
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Affiliation(s)
- Qian-Wen Xie
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong; and
| | - Celia H Y Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong; and
| | - Qingying Ji
- Shanghai Children's Medical Center, Shanghai, China
| | - Cecilia L W Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong; and
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Guiraud H, Bedoin N, Krifi-Papoz S, Herbillon V, Caillot-Bascoul A, Gonzalez-Monge S, Boulenger V. Don't speak too fast! Processing of fast rate speech in children with specific language impairment. PLoS One 2018; 13:e0191808. [PMID: 29373610 PMCID: PMC5786310 DOI: 10.1371/journal.pone.0191808] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 01/11/2018] [Indexed: 11/23/2022] Open
Abstract
Background Perception of speech rhythm requires the auditory system to track temporal envelope fluctuations, which carry syllabic and stress information. Reduced sensitivity to rhythmic acoustic cues has been evidenced in children with Specific Language Impairment (SLI), impeding syllabic parsing and speech decoding. Our study investigated whether these children experience specific difficulties processing fast rate speech as compared with typically developing (TD) children. Method Sixteen French children with SLI (8–13 years old) with mainly expressive phonological disorders and with preserved comprehension and 16 age-matched TD children performed a judgment task on sentences produced 1) at normal rate, 2) at fast rate or 3) time-compressed. Sensitivity index (d′) to semantically incongruent sentence-final words was measured. Results Overall children with SLI perform significantly worse than TD children. Importantly, as revealed by the significant Group × Speech Rate interaction, children with SLI find it more challenging than TD children to process both naturally or artificially accelerated speech. The two groups do not significantly differ in normal rate speech processing. Conclusion In agreement with rhythm-processing deficits in atypical language development, our results suggest that children with SLI face difficulties adjusting to rapid speech rate. These findings are interpreted in light of temporal sampling and prosodic phrasing frameworks and of oscillatory mechanisms underlying speech perception.
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Affiliation(s)
- Hélène Guiraud
- Laboratoire Dynamique Du Langage, CNRS/Université de Lyon UMR5596, Lyon, France
- * E-mail: (HG); (VB)
| | - Nathalie Bedoin
- Laboratoire Dynamique Du Langage, CNRS/Université de Lyon UMR5596, Lyon, France
| | - Sonia Krifi-Papoz
- Service de Neurologie Pédiatrique, Hôpital Femme Mère Enfant, Bron, France
| | - Vania Herbillon
- Service Épilepsie, Sommeil et Explorations Fonctionnelles Neuropédiatriques, Hôpital Femme Mère Enfant, Bron, France
- Centre de Recherche en Neurosciences de Lyon, DYCOG, INSERM U1028 / CNRS UMR5292, Bron, France
| | - Aurélia Caillot-Bascoul
- Service ORL chirurgie cervico-faciale, Centre Hospitalier Universitaire Gabriel Montpied, Clermont-Ferrand, France
| | - Sibylle Gonzalez-Monge
- Centre de Référence Troubles des Apprentissages, Service de Rééducation pédiatrique, Hôpital Femme Mère Enfant, Bron, France
| | - Véronique Boulenger
- Laboratoire Dynamique Du Langage, CNRS/Université de Lyon UMR5596, Lyon, France
- * E-mail: (HG); (VB)
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16
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Tosh R, Arnott W, Scarinci N. Parent-implemented home therapy programmes for speech and language: a systematic review. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2017; 52:253-269. [PMID: 27943521 DOI: 10.1111/1460-6984.12280] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 07/10/2016] [Accepted: 07/11/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Parent-delivered home programmes are frequently used to remediate speech and language difficulties in young children. However, the evidence base for this service delivery model is limited. AIMS The aim of this systematic review is to investigate the effectiveness of parent-implemented home programmes in facilitating the development of children's speech and language skills, and to evaluate the cost-effectiveness and feasibility of this service delivery method. METHODS & PROCEDURES A systematic search of the PsycINFO, CINAHL and ERIC databases was conducted. Quality appraisal of individual studies was conducted. Findings from each of the studies were then integrated to report on outcomes for the child, the parent and the service. OUTCOMES & RESULTS There is preliminary evidence that home programmes can lead to growth in a child's speech and language skills and are more effective than no intervention, provided the home programmes are used with high dosage rates and direct parent training. CONCLUSIONS & IMPLICATIONS Home programmes are a potentially useful service delivery model, but caution should be exercised when considering their use to address broader service delivery challenges. Further high-level evidence is needed across all facets of this service delivery model.
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Affiliation(s)
- Rachel Tosh
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Wendy Arnott
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia
- The Hear and Say Centre, Brisbane, QLD, Australia
| | - Nerina Scarinci
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia
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17
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Gillon G, Macfarlane AH. A culturally responsive framework for enhancing phonological awareness development in children with speech and language impairment. SPEECH LANGUAGE AND HEARING 2017. [DOI: 10.1080/2050571x.2016.1265738] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Gail Gillon
- College of Education Health and Human Development, University of Canterbury, Christchurch, New Zealand
| | - Angus Hikairo Macfarlane
- College of Education Health and Human Development, University of Canterbury, Christchurch, New Zealand
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18
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Rosati P, Porzsolt F, Ricciotti G, Testa G, Inglese R, Giustini F, Fiscarelli E, Zazza M, Carlino C, Balassone V, Fiorito R, D'Amico R. Major discrepancies between what clinical trial registries record and paediatric randomised controlled trials publish. Trials 2016; 17:430. [PMID: 27659549 PMCID: PMC5034459 DOI: 10.1186/s13063-016-1551-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Accepted: 08/04/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Whether information from clinical trial registries (CTRs) and published randomised controlled trial (RCTs) differs remains unknown. Knowing more about discrepancies should alert those who rely on RCTs for medical decision-making to possible dissemination or reporting bias. To provide help in critically appraising research relevant for clinical practice we sought possible discrepancies between what CTRs record and paediatric RCTs actually publish. For this purpose, after identifying six reporting domains including funding, design, and outcomes, we collected data from 20 consecutive RCTs published in a widely read peer-reviewed paediatric journal and cross-checked reported features with those in the corresponding CTRs. METHODS We collected data for 20 unselected, consecutive paediatric RCTs published in a widely read peer-reviewed journal from July to November 2013. To assess discrepancies, two reviewers identified and scored six reporting domains: funding and conflict of interests; sample size, inclusion and exclusion criteria or crossover; primary and secondary outcomes, early study completion, and main outcome reporting. After applying the Critical Appraisal Skills Programme (CASP) checklist, five reviewer pairs cross-checked CTRs and matching RCTs, then mapped and coded the reporting domains and scored combined discrepancy as low, medium and high. RESULTS The 20 RCTs were registered in five different CTRs. Even though the 20 RCTs fulfilled the CASP general criteria for assessing internal validity, 19 clinical trials had medium or high combined discrepancy scores for what the 20 RCTs reported and the matched five CTRs stated. All 20 RCTs selectively reported or failed to report main outcomes, 9 had discrepancies in declaring sponsorship, 8 discrepancies in the sample size, 9 failed to respect inclusion or exclusion criteria, 11 downgraded or modified primary outcome or upgraded secondary outcomes, and 13 completed early without justification. The CTRs for seven trials failed to index automatically the URL address or the RCT reference, and for 12 recorded RCT details, but the authors failed to report the results. CONCLUSIONS Major discrepancies between what CTRs record and paediatric RCTs publish raise concern about what clinical trials conclude. Our findings should make clinicians, who rely on RCT results for medical decision-making, aware of dissemination or reporting bias. Trialists need to bring CTR data and reported protocols into line with published data.
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Affiliation(s)
- Paola Rosati
- G.A.L.I.L.E.O. Gruppo per l'Apprezzamento della Letteratura e l'Implementazione dei Livelli di Evidenza in Ospedale, Bambino Gesù Children's Hospital IRCCS, Rome, 00165, Italy. .,Unit of Clinical Epidemiology, Bambino Gesù Children's Hospital IRCCS, Rome, 00165, Italy.
| | - Franz Porzsolt
- G.A.L.I.L.E.O. Gruppo per l'Apprezzamento della Letteratura e l'Implementazione dei Livelli di Evidenza in Ospedale, Bambino Gesù Children's Hospital IRCCS, Rome, 00165, Italy.,Health Care Research, General and Visceral Surgery, University Hospital Ulm, President Institute of Clinical Economics (ICE) e.V., Ulm, 89070, Germany
| | - Gabriella Ricciotti
- G.A.L.I.L.E.O. Gruppo per l'Apprezzamento della Letteratura e l'Implementazione dei Livelli di Evidenza in Ospedale, Bambino Gesù Children's Hospital IRCCS, Rome, 00165, Italy
| | - Giuseppina Testa
- G.A.L.I.L.E.O. Gruppo per l'Apprezzamento della Letteratura e l'Implementazione dei Livelli di Evidenza in Ospedale, Bambino Gesù Children's Hospital IRCCS, Rome, 00165, Italy
| | - Rita Inglese
- G.A.L.I.L.E.O. Gruppo per l'Apprezzamento della Letteratura e l'Implementazione dei Livelli di Evidenza in Ospedale, Bambino Gesù Children's Hospital IRCCS, Rome, 00165, Italy
| | - Ferruccio Giustini
- G.A.L.I.L.E.O. Gruppo per l'Apprezzamento della Letteratura e l'Implementazione dei Livelli di Evidenza in Ospedale, Bambino Gesù Children's Hospital IRCCS, Rome, 00165, Italy
| | - Ersilia Fiscarelli
- G.A.L.I.L.E.O. Gruppo per l'Apprezzamento della Letteratura e l'Implementazione dei Livelli di Evidenza in Ospedale, Bambino Gesù Children's Hospital IRCCS, Rome, 00165, Italy
| | - Marco Zazza
- G.A.L.I.L.E.O. Gruppo per l'Apprezzamento della Letteratura e l'Implementazione dei Livelli di Evidenza in Ospedale, Bambino Gesù Children's Hospital IRCCS, Rome, 00165, Italy
| | - Cecilia Carlino
- G.A.L.I.L.E.O. Gruppo per l'Apprezzamento della Letteratura e l'Implementazione dei Livelli di Evidenza in Ospedale, Bambino Gesù Children's Hospital IRCCS, Rome, 00165, Italy.,Faculty of Medicine and Surgery, La Sapienza University, Rome, 00185, Italy
| | - Valerio Balassone
- G.A.L.I.L.E.O. Gruppo per l'Apprezzamento della Letteratura e l'Implementazione dei Livelli di Evidenza in Ospedale, Bambino Gesù Children's Hospital IRCCS, Rome, 00165, Italy
| | - Roberto Fiorito
- General Surgery and Transplantation Department, University Tor Vergata, Rome, 00133, Italy
| | - Roberto D'Amico
- G.A.L.I.L.E.O. Gruppo per l'Apprezzamento della Letteratura e l'Implementazione dei Livelli di Evidenza in Ospedale, Bambino Gesù Children's Hospital IRCCS, Rome, 00165, Italy.,Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, 41124, Italy
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Wake M, Levickis P, Tobin S, Gold L, Ukoumunne OC, Goldfeld S, Zens N, Le HND, Law J, Reilly S. Two-Year Outcomes of a Population-Based Intervention for Preschool Language Delay: An RCT. Pediatrics 2015; 136:e838-47. [PMID: 26347428 DOI: 10.1542/peds.2015-1337] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/27/2015] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE We have previously shown short-term benefits to phonology, letter knowledge, and possibly expressive language from systematically ascertaining language delay at age 4 years followed by the Language for Learning intervention. Here, we report the trial's definitive 6-year outcomes. METHODS Randomized trial nested in a population-based ascertainment. Children with language scores >1.25 SD below the mean at age 4 were randomized, with intervention children receiving 18 1-hour home-based therapy sessions. Primary outcome was receptive/expressive language. Secondary outcomes were phonological, receptive vocabulary, literacy, and narrative skills; parent-reported pragmatic language, behavior, and health-related quality of life; costs of intervention; and health service use. For intention-to-treat analyses, trial arms were compared using linear regression models. RESULTS Of 1464 children assessed at age 4, 266 were eligible and 200 randomized; 90% and 82% of intervention and control children were retained respectively. By age 6, mean language scores had normalized, but there was little evidence of a treatment effect for receptive (adjusted mean difference 2.3; 95% confidence interval [CI] -1.2 to 5.7; P = .20) or expressive (0.8; 95% CI -1.6 to 3.2; P = .49) language. Of the secondary outcomes, only phonological awareness skills (effect size 0.36; 95% CI 0.08-0.65; P = .01) showed benefit. Costs were higher for intervention families (mean difference AU$4276; 95% CI: $3424 to $5128). CONCLUSIONS Population-based intervention targeting 4-year-old language delay was feasible but did not have lasting impacts on language, possibly reflecting resolution in both groups. Long-term literacy benefits remain possible but must be weighed against its cost.
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Affiliation(s)
- Melissa Wake
- Centre for Community Child Health, Royal Children's Hospital, Parkville, Melbourne, Australia; Murdoch Childrens Research Institute, Parkville, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Melbourne, Australia;
| | - Penny Levickis
- Centre for Community Child Health, Royal Children's Hospital, Parkville, Melbourne, Australia; Murdoch Childrens Research Institute, Parkville, Melbourne, Australia
| | - Sherryn Tobin
- Centre for Community Child Health, Royal Children's Hospital, Parkville, Melbourne, Australia; Murdoch Childrens Research Institute, Parkville, Melbourne, Australia
| | - Lisa Gold
- Deakin Health Economics, Deakin University, Burwood, Australia
| | - Obioha C Ukoumunne
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care, South West Peninsula (PenCLAHRC), University of Exeter Medical School, University of Exeter, Exeter, United Kingdom; and
| | - Sharon Goldfeld
- Centre for Community Child Health, Royal Children's Hospital, Parkville, Melbourne, Australia; Murdoch Childrens Research Institute, Parkville, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Melbourne, Australia
| | - Naomi Zens
- Centre for Community Child Health, Royal Children's Hospital, Parkville, Melbourne, Australia; Murdoch Childrens Research Institute, Parkville, Melbourne, Australia
| | - Ha N D Le
- Deakin Health Economics, Deakin University, Burwood, Australia
| | - James Law
- Institute of Health and Society, School of Education, Communication and Language Sciences, University of Newcastle, United Kingdom
| | - Sheena Reilly
- Murdoch Childrens Research Institute, Parkville, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Melbourne, Australia
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Wallace IF, Berkman ND, Watson LR, Coyne-Beasley T, Wood CT, Cullen K, Lohr KN. Screening for Speech and Language Delay in Children 5 Years Old and Younger: A Systematic Review. Pediatrics 2015; 136:e448-62. [PMID: 26152671 DOI: 10.1542/peds.2014-3889] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/11/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES No recommendation exists for or against routine use of brief, formal screening instruments in primary care to detect speech and language delay in children through 5 years of age. This review aimed to update the evidence on screening and treating children for speech and language since the 2006 US Preventive Services Task Force systematic review. METHODS Medline, the Cochrane Library, PsycInfo, Cumulative Index to Nursing and Allied Health Literature, ClinicalTrials.gov, and reference lists. We included studies reporting diagnostic accuracy of screening tools and randomized controlled trials reporting benefits and harms of treatment of speech and language. Two independent reviewers extracted data, checked accuracy, and assigned quality ratings using predefined criteria. RESULTS We found no evidence for the impact of screening on speech and language outcomes. In 23 studies evaluating the accuracy of screening tools, sensitivity ranged between 50% and 94%, and specificity ranged between 45% and 96%. Twelve treatment studies improved various outcomes in language, articulation, and stuttering; little evidence emerged for interventions improving other outcomes or for adverse effects of treatment. Risk factors associated with speech and language delay were male gender, family history, and low parental education. A limitation of this review is the lack of well-designed, well-conducted studies addressing whether screening for speech and language delay or disorders improves outcomes. CONCLUSIONS Several screening tools can accurately identify children for diagnostic evaluations and interventions, but evidence is inadequate regarding applicability in primary care settings. Some treatments for young children identified with speech and language delays and disorders may be effective.
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Affiliation(s)
- Ina F Wallace
- RTI International, Research Triangle Park, North Carolina; and
| | - Nancy D Berkman
- RTI International, Research Triangle Park, North Carolina; and
| | | | - Tamera Coyne-Beasley
- Departments of Pediatrics, and Internal Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | | | | | - Kathleen N Lohr
- RTI International, Research Triangle Park, North Carolina; and
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Reilly S, Tomblin B, Law J, McKean C, Mensah FK, Morgan A, Goldfeld S, Nicholson JM, Wake M. Specific language impairment: a convenient label for whom? INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2014; 49:416-51. [PMID: 25142091 PMCID: PMC4303922 DOI: 10.1111/1460-6984.12102] [Citation(s) in RCA: 124] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Accepted: 03/01/2013] [Indexed: 05/22/2023]
Abstract
BACKGROUND The term 'specific language impairment' (SLI), in use since the 1980s, describes children with language impairment whose cognitive skills are within normal limits where there is no identifiable reason for the language impairment. SLI is determined by applying exclusionary criteria, so that it is defined by what it is not rather than by what it is. The recent decision to not include SLI in DSM-5 provoked much debate and concern from researchers and clinicians. AIMS To explore how the term 'specific language impairment' emerged, to consider how disorders, including SLI, are generally defined and to explore how societal changes might impact on use the term. METHODS & PROCEDURES We reviewed the literature to explore the origins of the term 'specific language impairment' and present published evidence, as well as new analyses of population data, to explore the validity of continuing to use the term. OUTCOMES & RESULTS AND CONCLUSIONS & IMPLICATIONS We support the decision to exclude the term 'specific language impairment' from DSM-5 and conclude that the term has been a convenient label for researchers, but that the current classification is unacceptably arbitrary. Furthermore, we argue there is no empirical evidence to support the continued use of the term SLI and limited evidence that it has provided any real benefits for children and their families. In fact, the term may be disadvantageous to some due to the use of exclusionary criteria to determine eligibility for and access to speech pathology services. We propose the following recommendations. First, that the word 'specific' be removed and the label 'language impairment' be used. Second, that the exclusionary criteria be relaxed and in their place inclusionary criteria be adopted that take into account the fluid nature of language development particularly in the preschool period. Building on the goodwill and collaborations between the clinical and research communities we propose the establishment of an international consensus panel to develop an agreed definition and set of criteria for language impairment. Given the rich data now available in population studies it is possible to test the validity of these definitions and criteria. Consultation with service users and policy-makers should be incorporated into the decision-making process.
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Affiliation(s)
- Sheena Reilly
- Murdoch Children’s Research Institute, Royal Children’s HospitalParkville, VIC, Australia
- Department of Paediatrics, University of MelbourneParkville, VIC, Australia
| | | | - James Law
- Murdoch Children’s Research Institute, Royal Children’s HospitalParkville, VIC, Australia
- Newcastle University, Newcastle upon TyneUK
| | - Cristina McKean
- Murdoch Children’s Research Institute, Royal Children’s HospitalParkville, VIC, Australia
- Newcastle University, Newcastle upon TyneUK
| | - Fiona K Mensah
- Murdoch Children’s Research Institute, Royal Children’s HospitalParkville, VIC, Australia
- Department of Paediatrics, University of MelbourneParkville, VIC, Australia
| | - Angela Morgan
- Murdoch Children’s Research Institute, Royal Children’s HospitalParkville, VIC, Australia
- Department of Paediatrics, University of MelbourneParkville, VIC, Australia
| | - Sharon Goldfeld
- Murdoch Children’s Research Institute, Royal Children’s HospitalParkville, VIC, Australia
- Department of Paediatrics, University of MelbourneParkville, VIC, Australia
| | - Jan M Nicholson
- Parenting Research Centre, Victoria ParadeEast Melbourne, VIC, Australia
| | - Melissa Wake
- Murdoch Children’s Research Institute, Royal Children’s HospitalParkville, VIC, Australia
- Department of Paediatrics, University of MelbourneParkville, VIC, Australia
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