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Screening: Speech and Language Delay in Preschool Children
Table 7. Randomized Controlled Trials of Interventions
| Author/ Year |
Speech & language domains | N | Age (months) | Interventions | Speech and language outcomes | Function and health outcomes | Study quality rating |
|---|---|---|---|---|---|---|---|
| Up to 2 years* | |||||||
| Glogowska, 200072 | Expressive and receptive language and phonology | 159 in 2 groups | 18-42 | Clinician-directed individual intervention routinely offered by the therapist for 12 months vs. none | Improved auditory comprehension in intervention vs. control group; no differences for expressive language, phonology error rate, language development, or improvement on entry criterion | No differences in well being, attention level, play level, or socialization skills | Good |
| 2 to 3 years | |||||||
| Gibbard, 199477 Study 1 |
Expressive language | 36 in 2 groups | 27-39 | Parent-directed individual therapy 60-75 minutes every other week for 6 months vs. none | Improved scores on several measures for intervention vs. control group | Not reported | Fair |
| Girolametto, 199678 | Expressive language | 25 in 2 groups | 23-33 | Parent-directed individual focused stimulation intervention 150 minutes per week for 11 weeks vs. none | Larger vocabularies, use of more different words, more structurally complete utterances and multiword utterances in intervention group vs. control; no differences in several other measures | Not reported | Fair |
| Law, 199985 | Expressive and receptive language | 38 in 3 groups | 33-39 | Clinician-directed 450 minutes per week for 6 weeks vs. parent-directed 150 minutes per week for 10 weeks vs. none | No differences between groups | Improved parent perception of child's behavior and positivity towards child, improved child self-esteem | Fair |
| Robertson, 199980 | Expressive and receptive language | 21 in 2 groups | 21-30 | Clinician-directed individual therapy 150 minutes per week for 12 weeks vs. none | Improved mean length of utterances, total number of words, lexical diversity, vocabulary size, and percentage of intelligible utterances in intervention group vs. control | Improved socialization skills, decreased parental stress for intervention group | Fair |
| Gibbard, 199477 Study 2 |
Expressive language | 25 in 3 groups | 27-39 | Clinician-directed individual therapy 60-75 minutes every other week for 6 months vs. parent-directed 60-75 minutes every other week for 6 months vs. none | Improved scores on all 5 measures for parent-directed group vs. control; improvement on 2 measures for clinician-directed group vs. control; improvement on 1 measure for parent vs. clinician group | Not reported | Poor |
| Girolametto, 199693 | Expressive and receptive language | 16 in 2 groups | 22-38 | Parent-directed individual therapy 150 minutes per week for 10 weeks vs. none | More target words used in intervention group vs. control; no differences in vocabulary development | Increased symbolic play gestures, decreased aggressive behavior in intervention group | Poor |
| Schwartz, 198591 | Expressive language and lexical acquisition | 10 in 2 groups | 32-39 | Clinician-directed individual therapy for 3 weeks vs. none | Improved multiword utterances from baseline in intervention group; no between group differences reported | Not reported | Poor |
| Wilcox, 199184 | Lexical acquisition | 20 in 2 groups | 20-47 | Clinician-directed individual intervention 90 minutes per week for 3 months vs. classroom intervention 360 minutes per week for 3 months | No differences between groups in use of target words; more use of words at home in classroom group vs. individual group | Not reported | Fair |
| Girolametto, 199779 | Lexical acquisition and phonology | 25 in 2 groups | 23-33 | Parent-directed individual therapy eight 150-minute sessions and 3 home sessions for 11 weeks vs. none | Improved level of vocalizations and inventory of consonants for intervention group vs. control; no differences in the number of vocalizations | Not reported | Fair |
| 3 to 5 years | |||||||
| Barratt, 199274 | Expressive and receptive language | 39 in 2 groups | 37-43 | Clinician-directed interactive language therapy for 40 minutes weekly for 6 months (traditional group) vs. 40 minutes for 4 days per week for 3 weeks in two 3 month blocks (intensive group) | Improved expression score on Reynell scale for intensive group vs. weekly (or traditional) therapy group; no difference in comprehension scores, both improved | Not reported | Fair |
| Courtright, 197976 | Expressive language | 36 in 3 groups | 47-83 | 3 clinician-directed approaches are compared for 5 months: mimicry, clinician modeling, 3rd person modeling for 5 months | Increased number of correct responses in modeling groups vs. mimicry group | Not reported | Fair |
| Robertson, 199781 | Expressive and receptive language | 30 in 3 groups | 44-61 | 2 clinician-directed play groups with language impairments (treatment vs control) with normal peers for 20 minutes per week for 3 weeks | More words used, greater verbal productivity, more lexical diversity, and more use of linguistic markers by normal peer play group (not normal group, treatment group with language impairment) vs. control | Play-theme-related acts increased for the normal peer play group (not normal group, treatment group with language impairment) | Fair |
| Glogowska, 200272 | Expressive and receptive language and phonology | 159 in 2 groups | ≤42 | Clinician-directed for 12 months vs. none | Improved receptive language in intervention group vs. control; no differences between groups for 4 other measures | Improved family response to child in intervention group | Poor |
| Almost, 199873 | Phonology | 26 in 2 groups | 33-61 | Clinician-directed individual therapy two 30-minute sessions per week for 4 months vs. none | Higher scores on 3 of 4 measures for intervention vs. control group | Not reported | Fair |
| Rvachew, 200182 | Phonology | 48 in 2 groups | 50 (mean) |
Clinician-directed individual therapy 30-40 minutes per week for 12 weeks; compares interventions for phonemes that differ (most knowledge/early developing group vs. least knowledge/latest developing group) | Improved scores on measures from baseline for both intervention groups; greater improvement for most knowledge/early developing phonemes group vs. comparison (least knowledge/latest developing) group | Not reported | Fair |
| Shelton, 1978813 | Phonology and articulation | 45 in 3 groups | 27-55 | Parent-directed individual therapy 5 minutes per day (listening group) vs. 15 minutes per day (reading and talking group) for 57 days vs. none | No improvements for intervention groups vs. control | Not reported | Fair |
| Fey, 199486 | Phonology and syntax | 26 in 3 groups | 44-70 | Clinician-directed sessions (individual and group) for 3 hours per week for 20 weeks vs. parent-directed sessions for 8 hours per week for weeks 1-12 (includes intensive parent training) then 4 hours per week for weeks 13-20 vs. none | Improved grammatical output (developmental sentence scores) for both intervention groups vs. control; no significant difference between groups for phonological output (percentage consonants correct) | Not reported | Poor |
| Reid, 199695 | Phonology | 30 in 2 groups | 42-66 | Clinician-directed individual therapy 30 minutes per week for 6-10 weeks vs. none | Improved scores on some measures from baseline for intervention and control groups; no between group comparisons reported | Not reported | Poor |
| Ruscello, 199389 | Phonology | 12 in 2 groups | 49-68 | Clinician-directed vs. clinician & parent-directed individual therapy 120 minutes per week for 8 weeks | Improved scores on measures from baseline for both intervention groups; no between group comparisons reported | Not reported | Poor |
| Rvachew, 199490 | Phonology | 27 in 3 groups | 42-66 | Clinician-directed individual therapy 45 minutes per week for 6 weeks; compares 3 groups listening to different sets of words | Improved scores on measures for 2 intervention groups vs. third group | Not reported | Poor |
| Cole, 198675 | Syntax | 44 in 2 groups | 38-69 | Clinician-directed individual directive approach vs. interactive approach for 600 minutes per week for 8 months | Improved scores on 6 of 7 measures from baseline for both intervention groups; no significant differences between groups | Not reported | Fair |
| Fey, 199392 First phase |
Syntax | 29 in 3 groups | 44-70 | Clinician-directed sessions (individual and group) for 3 hours per week for 20 weeks vs. parent-directed sessions for 8 hours per week for weeks 1-12 (includes intensive parent training) then 4 hours per week for weeks 13-20 vs. none | Improved scores on 3 of 4 measures for both intervention groups vs. control; no differences between intervention groups | Not reported | Poor |
| Fey, 199787 Second phase |
Syntax | 28 in 3 groups | 44-70 | Clinician-directed vs. parent-directed vs. none for 5 months continuing from prior study | Improved some developmental sentence scores from baseline in both intervention groups vs. control; no between group comparisons reported, except that clinician-directed treatment groups had larger and more consistent gains than parent-directed treatment groups or control | Not reported | Poor |
| Mulac, 197788 | Syntax | 9 in 3 groups | 52-75 | Clinician-directed individual Monteray language program vs. Monteray language program with extended transfer training for 67 minutes per week for 4 weeks vs. none | Improved scores for both intervention groups vs. control; no significant differences between intervention groups | Not reported | Poor |
Key
* Studies with a range of ages are not repeated across categories in the table.
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