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Nelson HD, Nygren P, Walker M, et al. Screening for Speech and Language Delay in Preschool Children [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2006 Feb. (Evidence Syntheses, No. 41.)

  • This publication is provided for historical reference only and the information may be out of date.

This publication is provided for historical reference only and the information may be out of date.

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Screening for Speech and Language Delay in Preschool Children [Internet].

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Appendix 9. Evidence Table: Randomized Controlled Trials of Interventions

Author, Year TitleObjectivesArea of InterventionSettingNSubjectsScreening Criteria/Diagnostic EvaluationTime from Screen to InterventionInterventionsLength of InterventionOutcome MeasuresSpeech and Lanuage OutcomesNon Speech and Language Outcomes
Almost, 1998*, † To examine effectiveness of treatment for children with severe phonological disorders as typically seen in an ambulatory care speech-language-pathology clinic in a community hospitalPhonologySpeech and language pathology department clinic in a community hospital in SW Ontario, Canada26 Group 1: mean age 42.5 months (33–61)Severe phonological disorder as determined by the phonological deviancy score on the Assessment of Phonological Processes - Revised (AAP-R) Group 1: immediate treatment implied Group 1: 4 months treatment followed by 4 months no treatment. Group 2: 4 months no treatment followed by 4 months treatment. Assessments at baseline, 4, and 8 months. Treatment: remediation for phonological disorders. Individual 30 minute sessions 2× per week. 4 – 6 target phonological deviations chosen for each child at treatment cycle initiation. Each target repeated 2 – 3 times or until correct in conversation4 monthsAPP-R (Assessment of Phonological Processes-Revised) score 4 month assessment: Group 1- scores of phonological measures reflect improvement: APP-R (p=0.05), GFTA (p=0.05), PCC (p=0.01)None.
Effectiveness of speech intervention for phonological disorders: a randomized controlled trial Assessment from 5/93 to 5/94Male: 12Receptive language skills >1 SD below the mean on the Reynell Developmental Language Scales - Revised Group 2: 4 monthsGFTA (Goldman-Fristoe Test of Articulation) score 8 month assessment: Group 1- higher measures for speech intelligibility (PCC, p=0.05), but no statistically significant difference on single- word phonological skills
Female: 1PCC (Percentage Consonants Correct) score Expressive language measure (MLU): no significant differences between groups at any assessment point. Group 1 had consistently higher (improved) scores than Group 2
Group 2: mean age 41.4 months (33–55)MLU (Mean Length of Utterance) score
Male: 9
Female: 4
Barratt, 1992 To compare the benefits of intensive individual speech therapy with the more traditional once weekly approachExpressive and receptive languageDay nurseries, special play groups and nursery classes attached to schools in SW London, UK39Male: 27At least one SD below the mean for age on the Reynell Developmental Language Scales in comprehension, expression or bothImmediate treatment impliedClinician administered interactive language therapy focusing on expressive and receptive skillsProvided over 6 months either weekly (40 min), or as 2 intensive therapy blocks (40 min 4 days a week for 3 weeks in each 3 month block).Reynell Expressive and Receptive scalesBoth groups showed improvement in comprehension (p=0.07 for intensive group, p=0.02 for weekly group). Both groups showed improvement in expression scores, but the intensive therapy showed significantly greater improvement (p≤ 0.01 for intensive group, p=0.18 for weekly group)The children in the intensive therapy group built up a relationship with the clinician quicker than those in the weekly group
Trial of intensive compared with weekly speech therapy in preschool children Female: 1221 participants received weekly therapy and 18 received intensive
Age range: 37–43 months
Cole, 1986 To examine effectiveness of two intervention techniquesSyntax, semantics, and pragmaticsClassrooms in the Experimental Education Unit at the University of Washington44Male: 34A score of 1.5 SD below the mean for age on either the Peabody Picture Vocabulary Test-Revised (PPVT-R), Form L; the Northwestern Syntax Screening Test, receptive section (NSST-R); the Preschool Language Scale (PLS), verbal ability or auditory comprehension subtests; or a Developmental Sentence Score (DSS) one full point below the 10th percentileImmediate treatment impliedClinician administered intervention using either a directive or an interactive approach600 minutes a week given for 8 months.MLU (Mean Length of Utterance) scoreThere was little difference between the effectiveness of the direct-instruction program and the interactive programNone
Direct language instruction and interactive language instruction with language delayed preschool children: a comparison study Female: 1019 participants received directive approach, 25 participants received an interactive approachPreschool language scale: overall scores
Age range: 38–69 monthsBasic language concepts test
Peabody Picture Vocabulary Test-Revised (PPVT-R)
Courtright, 1979 To determine the effectiveness of a third-person modeling approach.Expressive languageChildren were seen in speech and language therapy clinics36Male: 24All subjects fell below the 10th percentile rank for age on the Developmental Sentence Score (DSS)Immediate treatment impliedClinician administered syntax intervention looking at effectiveness of mimicry and modeling approaches:5 monthsUtterances correct on 20 unusual sentencesScores improved on the Preschool Language Scale (PLS) (p<0.001) for all childrenNone
Imitative modeling as a language intervention strategy: The effects of two mediating variables To determine the amount imitative modeling increases the efficacy of interventionsFemale: 1212 participants in mimicry condition
Age range: 47–83 months12 participants in modeling condition
12 participants in 3rd person modeling condition
Evans (unpublished)†, ‡ Not reportedNot reportedNot reported60Children from middle class areaAt baseline children had to have Receptive Expressive Emergent Language (REEL) scores 1 SD below meanNot reportedParent administered general language intervention with training from clinician, WILSTAAR intervention:Not reportedREEL Language QuotientsAll children improved regardless of therapy (p<0.01). The Visualising and Verbalising technique was not a significantly better intervention than the traditional method usedNone
The Kenilworth project: A randomised controlled trial of WILSTAAR Age: 8 months24 participants assigned to WILSTAAR condition
Gender mix not stated36 participants assigned to no treatment condition
Fey, 1993*, † To test the effectiveness of two broadly based grammar facilitation programs, one administered by a speech-language pathologist and the other by parentsSyntax and morphologyChildren were recruited through advertisements and referrals from physicians and seen at a research clinic29Participants do not meet all criteria usually stipulated for specific language impairment.Developmental Sentence Score (DSS) below the 10th percentile for the lower of chronological or mental ageImmediate (N=21)All treatment sessions were conducted by a speech-language pathologist and included focused simulation procedures and cyclical goal-attack strategies. Each child had 4 specific treatment goals. Goals were presented in a cyclical manner, with one targeted each week. When a child began to use a target productively in the group sessions in clinician treatment or in monthly clinic sessions in parent treatment, the goal was dropped or combined with another existing related goal20 weeksPrimary: DSS (Developmental Sentence Score) Clinician Group vs. Delayed-Treatment Group: The clinician group's DDS scores, Main Verb scores, and percentage of grammatically well-formed sentences were significantly higher (p=0.0005, p=0.004, and p=0.0005, respectively) than the delayed-treatment groupNone
Two approaches to the facilitation of grammar in children with language impairment: An experimental evaluation Clinician Treatment Group: mean age 54.7 months (SD 6.1)Delayed 4.5 months (N=8) Clinician Treatment: 1-hour individual session and two 1-hour group sessions per week for 20 weeks. Each individual session began with a highly structured activity with imitation of the target for that week and of a language form contrastive with the targetMean Main Verb score per sentence Parent Group vs. Delayed-Treatment Group: The parent group's DDS scores, Main Verb scores, and percentage of grammatically well-formed sentences were significantly higher (p=0.0001, p=0.04, and p=0.03, respectively) than the delayed-treatment group
Male: 6 Female: 5 Parent Treatment: 2-hour group session per week for parents (12 weeks) then once per month (8 weeks). 3 home visits by pathologist during first 12 weeks. 1 hour monthly clinic visit with individual sessions for parent and child (final 8 weeks)Mean Personal Pronoun score per sentence Clinician Group vs. Parent Group: There were no differences between the clinician group and the parent group on DDS scores, Main Verb scores and percentage of grammatically well-formed sentences
Parent Treatment Group: mean age 56.2 months (SD 7.2)Percentage of sentences awarded a Sentence Point
Male: 7 Female: 3
Delayed Treatment Group: mean age 55.8 months (SD 6.3)
Male: 8 Female: 1
Fey, 1994 To determine if a clinician-administered intervention produces better gains in phonologyPhonologyChildren were recruited through advertisements and referrals from physicians and seen at a research clinic (from pool from Fey, 1993)26Male: 17Subjects from Fey, 1993 studyImmediate in Subgroup 1 and Subgroup 3 (N=21)Parent or clinician administered expressive syntax intervention based on focused stimulation:10 months for Subgroups 1 and 2Percentage of consonants correct derived from the Assessment of Phonological Processes - Revised (AAP-R)Both the clinician and parent groups performed better than the control group (p=0.0006)None
Effects of grammar facilitation on the phonological performance of children with speech and language impairments Female: 9Developmental Sentence Score (DSS) below the 10th percentile for the lower of chronological or mental ageDelayed 5 months in Subgroup 2 (N=9)10 received clinician therapy5 months for Subgroup 3
Age range: 44–70 months8 received parent therapy
8 received delayed therapy
Fey, 1997 To evaluate the effects of either 5 months of intervention or 5 months of no intervention following completion of the first 5-month phasePhonologyChildren were recruited through advertisements and referrals from physicians and seen at a research clinic (from pool from Fey, 1993)28Age range: 44–70 monthsSubjects from Fey, 1993 studyImmediate treatment implied.Parent or clinician administered expressive syntax intervention based on focused stimulation provided in addition to that which was provided in Fey 1993:10 months for two groupsDevelopmental Sentence Scores (DSS): composite, verbs, sentence pointsThe clinician group had higher DSSs and main verb scores at the end of Phase 2 than at the end of Phase 1 (p=0.01 and p=0.03, respectively). The parent group had higher DSSs at the end of Phase 2 than at the end of Phase 1 (p=0.04). The reduction in DSS gains for the dismissal group over Phase 2 compared to those over Phase 1 was statistically significant (p=0.02). The clinician group had a smaller improvement in well-formed sentences over Phase 2 than over Phase 1 (p=0.03)None
Two models of grammar facilitation in children with language impairments: Phase 2 Developmental Sentence Score (DSS) below the 10th percentile for the lower of chronological or mental age9 had further parent treatment as Fey 19935 months for one dismissal group
9 had further clinician treatment as Fey 1993
10 had no more treatment except the 4.5 month treatment received in Fey 1993
Gibbard, 1994*, † To examine the effectiveness of a parent trained intervention versus no interventionExpressive languageLocal health center where children were referred for speech and language therapy36Male: 25Vocabulary of <30 single wordsImmediateParental administered expressive syntax intervention emphasizing how to maximize language use in everyday environment:An average of 40 minutes per week over 6 monthsReynell Expressive measureThe mean scores improved for both the experimental and the no-intervention control groups, but the experimental group had larger gains on all measures (p=0.008 for language sample one word scores and p=0.000 for all other measures)None
Study 1Female: 1118 received parental interventionLanguage sample one word scores and total scores
Parental-based intervention with pre-school language-delayed children Age range: 27–39 months18 received delayed interventionRenfrew Action Picture Test information
Majority of participants in social classes I, II, or IIIMMother's description of vocabulary and phrase complexity
Mean mother age: 30MLU (mean length of utterances) from language sample
Mean father age: 33
Gibbard, 1994 To examine the effectiveness of a parent trained intervention versus a direct interventionExpressive languageLocal health center where children were referred for speech and language therapy25Male: 19Vocabulary of ≤30 single wordsImmediateClinician or parent administered expressive syntax interventionClinician therapy 30 minutes per week for 6 monthsReynell expressive measureThe parental involved approach made more gains than the direct approach on all measures, but only the mean length of utterances was statistically significant (p=0.008). The gains made by the parent involved group was statistically significant compared to the control group on all the measures (Reynell, p=0.018; Derbyshire one word scores, p=0.004, Derbyshire total scores, p=0.000; Renfrew, p=0.005; and mean length of utterances, p=0.000). The gains made by the direct approach group were statistically significant compared to the control group on two measures (Derbyshire total scores, p=0.007 and mean length of utterances, p=0.000)None
Study 2Female: 6Controls received a cognitive parent therapy based on Portage:Parent therapy an average of 40 minutes per week for 6 monthsLanguage sample one word scores and total scores and MLU (mean length of utterances)
Parental-based intervention with pre-school language-delayed children Age range: 27–39 months8 received clinician therapyParent report of vocabulary and phrase complexity
Majority of participants in social classes II, IIIM, and IIIN9 received parent therapyRenfrew Action Picture Test information
Average mother age: 28 and 298 received control therapy
Average father age: 29 and 33.5
Girolametto, 1996*, † bTo examine the effects of a focused stimulation language intervention on children's' vocabulary and language developmentExpressive vocabularyChildren were recruited from waiting lists for parent programs offered at two agencies in metropolitan Toronto, Canada25Age range: 23–35 monthsVocabulary size in the lower 5th percentile for age measured by McArthur Communicative Development Inventories (CDI)ImmediateParental administered expressive vocabulary intervention based on HANEN principles and adapted for focused stimulation:150 minutes per week for 11 weeksVocabulary and phrase complexity as determined by the McArthur Communicative Development Inventories (CDI)Children who received treatment had larger vocabularies (p<0.02) and used a greater number of different words (p<0.01) compared to the control group. Those who received treatment used more structurally complete utterances and more multiword utterances than those in the control group (p<0.04 and p<0.01, respectively)Mother's language interactions with child changed (language input slower, less complex, and more focused after treatment)
Interactive focused stimulation for toddlers with expressive vocabulary delays No gender details given12 received parent interventionNumber of different words and utterances from a language sampleFew words/minute p≤0.01
13 received delayed interventionPost test probes for target wordsShorter utterances p<0.01
Control word measures, target words in interaction, multi-word utterancesUsed more target words and focused stimulation of target words p<0.01
Girolametto, 1996*aTo examine whether children in an experimental group would learn more words than children on a waiting list (control group)Expressive and receptive vocabularyChildren were recruited from waiting lists for parent programs offered at two agencies in metropolitan Toronto, Canada16Male: 11Delayed in the acquisition of vocabulary as measured by the Communicative Development Inventory (CDI)ImmediateParental administered expressive vocabulary intervention based on HANEN principles and adapted for focused stimulation:150 minutes per week for 10 weeksParent report of vocabulary sizeThose in the experimental group produced significantly more target words at post-test than the control group (p<0.02). Those in the experimental group used an average of twice as many target words as those in the control group at post-test Treatment group: use of symbolic play gestures increased p<0.03.
The effects of focused stimulation for promoting vocabulary in young children with delays: a pilot study Female: 58 received parent therapyNumber of target words in probe exerciseExternalizing aggressive/destructive behavior decreased p<0.02.
Age range: 22–38 months8 received delayed therapyInternalizing aggressive/destructive behavior no effect
Girolametto, 1997 To examine the impact of a focused stimulation intervention on the vocabulary, language, and emerging phonological skills of late talkersPhonologyChildren were recruited from waiting lists for parent programs offered at two agencies in metropolitan Toronto, Canada.25Male: 22Vocabulary size in the lower 5th percentile for age measured by McArthur Communicative Development Inventories (CDI)ImmediateParental administered expressive vocabulary intervention based on HANEN principles and adapted for focused stimulation:11 weeksDifferent vocalizationThere was no difference between groups on the number of vocalizations made. Children who received treatment used Level 3 vocalizations more than the controls (p<0.01). Those that received treatment also used a greater inventory of consonants in all three classesNone
Effects of lexical intervention on the phonology of late talkers Female: 312 received parent intervention8 2.5 hour evening sessionsSyllable structure at level 1, 2, 3
Age range: 23–35 months13 received delayed intervention3 home sessionsConsonants inventory: early, middle, late
Consonant position: initial and final
Proportion of consonants correct
Glogowska, 2000 To compare routine speech and language therapy against 12 months of “watchful waiting”Expressive and receptive language and phonology16 community clinics in Bristol. Children were enrolled between December 1995 and March 1998159Male: 120Standardized score <1.2 SD below the mean on the auditory comprehension part of the Preschool Language Scale (PLS). Standardized score >1.2 SD below the mean on auditory comprehension, but <1.2 SD below the mean on the expressive language part of the PLS. Auditory and expressive language scores >1.2 SD below the mean but with an error rate of at least 40% in production of fricative consonants and /or velar consonants and/or sounds occurring after a vowel among the 22 words included in the phonological analysisImmediate treatment impliedClinician administered intervention focusing on a variety of language areas.Therapy continued for an average of 10 minutes per week for 8.4 monthsPreschool Language Scale (PLS): auditory comprehension and expressive languageAlthough all outcome measures were in favor of the therapy group only one measure reached the significant level (auditory comprehension, p=0.025)No significant difference for play level or attention level
Randomised controlled trial of community based speech and language therapy in preschool children Female: 3971 received clinician interventionPhonological errors
Age range: 18–42 months88 received delayed intervention
Just over half of the children were receiving child care.
Most mothers had completed “O” level education.
A minority either had no qualifications or had “A” levels.
Glogowska, 2002To examine the effectiveness and acceptability of community speech and language therapy provisionExpressive and receptive language and phonologyChildren were referred to their local speech and language therapist and seen at these clinics159Age range: 42 months or youngerAll subjects had slow speech/language development and were referred by their local speech and language therapy clinic. No measures were specifiedImmediateClinician administered intervention focusing on a variety of language areas.12 monthsNot reportedOnly one of the five outcomes showed significantly more improvement in the therapy group versus the control group (receptive language, p=0.025)The treatment group showed improvement in family's response to child (p=0.14). The therapist made parent feel better (p=0.045) in the treatment group
A multimethod approach to the evaluation of community preschool speech and language therapy provision Children received either clinician intervention or delayed intervention, N not specified for each group.
Lancaster, 1991*, †, ‡ To examine the effectiveness of a parent administered interventionPhonologyChildren were referred to a speech and language clinic and subjects were selected from them15Males: 12Children needed to have a standard score of below 80 on the Edinburgh Articulation Test (EAT)Immediate treatment impliedClinician administered phonology interventionAverage of 17 minutes of therapy per week for 6 monthsComposite Deviancy ScoreThose in the treatment group made significantly more gains than those in the control (p<0.05). There was no difference between the direct therapy or the parent administered therapyNone
The effectiveness of parent administered input training for children with phonological disorders Females: 3Clinician provided an eclectic approach, parent therapy was based on auditory bombardment therapyParents were trained an average of 9 minutes per week for 6 months
Age range: 40–53 months5 received clinician therapy
Majority had family history of speech difficulties5 received parent therapy
5 received delayed therapy
Law, 1999†, ‡ To compare two intervention: a clinician lead and a parent lead approachExpressive and receptive languageNot reported38Males: 24Children were below 1.5 SD on comprehension measuresNot reportedClinician or parent administered expressive and receptive language intervention Clinician therapy: 450 minutes per week for 6 weeksPreschool Language Scale (PLS): expressive and receptiveThere were no differences between groups on speech and language measuresParent's rating of child's behavior and positivity towards their child went up as well as child's rating of their sense of self-esteem (p=0.03, p=0.04, p=0.05; respectively)
A comparison of two methods for providing intervention to three year old children with expressive/receptive language impairment Females: 14Clinician therapy focused on auditory processing and word mapping Parent therapy: 150 minutes per week for 10 weeksParent report: vocabulary, phrase complexity, language sample: total communication acts, MLU (mean length of utterances)
Age range: 33–39 monthsParent therapy used HANEN principles
Majority were of lower SES and ethnic minorities17 received clinician therapy
11 received parent therapy
10 received delayed therapy
Mulac, 1977 To determine the extent to which clinically acquired syntax skills generalize to extraclinic stimulus settingsSyntaxChildren were seen in speech and language therapy clinics and parents completed some activities at home9Males: 6Failure to pass the “is interrogative” item on the Programmed Conditioning Language Test (PCLT)Immediate treatment impliedClinician administered Monterey operant language program with additional outdoor and home activities for the children in the program and additional lessons conditionAverage of 67 minutes per week for 4 weeksExtra clinic measures of “is” interrogativeOnly the group that received the language program plus extended transfer made a significant improvement (p<0.01)None
Generalization of an operant remediation program for syntax with language delayed children Females: 33 received articulation therapy
Age range: 52- 75 months3 received Monterey language program
3 received Monterey language program and additional exercises to facilitate generalization
Munro, 1998 To assess the efficacy of therapy for children have articulation deficits (word-initial velar plosives)ArticulationChildren were seen in general pediatric services13Male: 6Over 1.5 SD below the mean for age on the Renfrew Action Picture TestImmediate for treatment group Delayed group received treatment later, but not reported in this studyClinician administered intervention for phonology /k/ and /g/60 minutes per week for 6 weeksEdinburgh Articulation Test (EAT)Preliminary data, no results were presentedNot reported
Efficacy of speech and language therapy for particular speech sounds in children Female: 57 received immediate therapyTarget sounds in initial position
Age range: 47–65 months4 received delayed therapyRe-telling a story with target sounds
Repetition of five lexical items four times each
Reid, 1996*, †, ‡ To assess the efficacy of the Metaphon approachPhonology and receptive vocabularyNot reported30Age range: 42–66 monthsChildren had to get less than 85SS on the Edinburgh Articulation Test (EAT)Immediate treatment is impliedClinician administered phonology intervention using Metaphon30 minutes per week for 10 weeksEAT Occurrence of phonological process: subtest from Metaphon resourcesThere was a significant improvement in gains on the EAT for the Phase 1 plus Phase 2 group (p<0.02). The 10-week intervention group made significant gains on test of phoneme awareness (p<0.03) onlyNone
The effectiveness of therapy for child phonological disorders: the Metaphon approach No information on genderThis is a sub-group analysis of an on-going trial; groups acknowledged to be unequal and median figures reported8 received metaphon stage 1 only
7 received metaphon stages 1 and 2
15 received delayed therapy
Robertson, 1997To examine the effects of peer modeling using the same peer throughout the intervention on children with speech and language impairmentsExpressive and receptive languageChildren were enrolled in a language-based early childhood classroom6Male: 4Performance at or near 2 SD below the mean on standardized measures of receptive and expressive language; measures not reportedImmediatePlay intervention for expressive narrative language:15 minutes per week for 3 weeksLanguage sample: number of words in script, number of different words, number of play related themesBoth children in the experimental group showed significant gains in number of words used, number of different words used, and number of linguistic markers usedBoth children in the experimental group showed significant increases in the number of play-theme-related acts
Study 2Female: 24 participants played with each other in pairs
The influence of peer models on the play scripts of children with specific language impairment Mean age: 54 months (range 48–57 months)2 participants were paired with a normal peer
Robertson, 1997 To examine the effects of peer modeling on children with speech and language impairmentsExpressive and receptive languageChildren were enrolled in a language-based early childhood classroom20Male: 13Performance at or near 2 SD below the mean on standardized measures of receptive and expressive language; measures not reportedImmediatePlay intervention for expressive narrative language:20 minutes per week for 3 weeksLanguage sample: number of words in script, number of different words, number of play related themesThose in the experimental group produced significantly more words than those in the control group immediately after treatment and at follow-up (p<0.0001). The experimental group demonstrated greater verbal productivity and employed more lexical diversity than the control group. Also, the experimental group made significantly more gains in the use of linguistic markers than the control group (p<0.0001)Play-theme-related acts increased (p<0.0001) for the treatment group
Study 1Female: 710 participants played with each other in pairs
The influence of peer models on the play scripts of children with specific language impairment Mean age: 50 months (range 36–60 months)10 participants were paired with a normal peer
Mean maternal education: 14 years
Robertson, 1999 To examine the effects of early language intervention on the development of late-talking toddlersExpressive and receptive language and phonologyChildren were recruited from the community and seen at a research clinic21Male: 12Demonstrated significant delays in the acquisition of language measured by the Preschool Language Scale - 3 and the Bayley Scales of Infant Development (BSID-II)≤1 weekClinician administered intervention for expressive vocabulary and syntax150 minutes per week for 12 weeksLanguage sample: MLU (mean length of utterances), total number of wordsCompared to children in the control group children in the treatment group demonstrated significantly greater increases in mean length of utterances (p=0.003), the total number of words used (p=0.000), lexical diversity (p=0.000), in their reported vocabulary size (p=0.000) and percentage of intelligible utterances (p=0.000)Treatment group had an increase in socialization skills (p=0.003) not merely reflective of the language increases; parental stress decreased (p=0.000) for the treatment group
Effects of treatment on linguistic and social skills in toddlers with delayed language development Female: 9Child-centered approach to provide general stimulationParent report of vocabulary (MacArthur Communicative Developmental Invetory-Words and Sentences (CDI))
Age range: 21–30 months11 received clinician intervention
All participants from middle class households10 received delayed intervention
Ruscello, 1993 To develop and implement a service delivery model which incorporates parental involvement and computer-based instructionPhonologyChildren were seen at the Allen Hall Speech and Hearing Center12Male: 8A composite score at the 15th percentile or lower for age on the Khan-Lewis Phonological AnalysisImmediate treatment impliedClinician administered phonology intervention with additional intervention from parents using Speech Viewer software120 minutes per week for 8 weeks30-item naming sample including words, phrases, and sentencesBoth groups showed significant improvement between baseline and follow-up (p≤0.001 for both Group 1 and Group 2)Parents indicated that their children enjoyed using the computer-based program
The use of different service delivery models for children with phonological disorders Female: 4 Group 1 received clinician interventionKhan Lewis Phonological Assessment
Age range: 49–68 months Group 2 received half of treatment from parent and half from clinician
Rvachew, 1994 To demonstrate that speech perception training can facilitate sound production learningPhonologyChildren were referred by a speech and language pathologist who diagnosed them27Males: 21Children were referred by a speech and language pathologist who had assessed the child and diagnosed a significant phonological delay≤1 weekClinician administered phonological therapy with additional auditory discrimination task45 minutes per week for 6 weeksAuditory word discrimination testBoth Groups 1 and 2 performed significantly better at post-test than Group 3 (p=0.03 and p=0.01, respectively). Group 1 and Group 2 were not significantly different at post-test (p=0.52). Children in Groups 1 and 2 progressed further during production training than children in Group 3None.
Speech perception training can facilitate sound production learning Females: 6 Group 1: 10 received experimental auditory discrimination taskObject naming speech sample
Age range: 42–66 months Group 2: 9 received a tradition auditory discrimination task
Group 3: 8 received a discrimination game not based on minimal pairs
Rvachew, 2001 To investigate the effectiveness of two different sets of target-selection criteriaPhonologyChildren were referred to a research clinic by clinician48Mean age: 50 monthsModerate to severe phonologic delays, 39 fell below the 1st percentile whereas all fell below the 9th percentile≤1 weekClinician administered phonological intervention with traditional therapy targeting the early developing sounds was compared to intervention that targeted later developing sounds:30 minutes per week for 12 weeksProbes for each target soundChildren in the ME group improved more at final assessment than those in the LL group (p=0.004). Generalization of learning for treated phonemes from the first assessment to the final assessment was significantly greater for the ME group than the LL group (p=0.001). Both the ME and the LL groups performed better than a control group of children who didn't receive any treatment (p=0.009)Parents were more satisfied with treatment progress in the ME group (p=0.035)
The effect of target-selection strategy on phonological learning 24 received treatment for early developing sounds (ME group)Productive phonological knowledge profile
24 received treatment for late developing sounds (LL group)Percentage of consonants correct in conversation
Schwartz, 1985*, † To examine the effects of intensively engaging language-impaired children at the one-word utterance level in vertical structuresLexical acquisitionPre-testing was conducted in the home and treatment administered in clinic10All maleExpressive vocabularies ranged from 25–60 words and all children exhibited specific language impairments. Comprehension was 6–9 months below mental age measured by the Test for Auditory Comprehension of Language or the Auditory Comprehension subtest of the Preschool Language ScaleImmediate treatment impliedClinician administered syntax intervention:Therapy administered over 3 weeksMultiword utterances used with the target stimuliChildren in the experimental group improved significantly from pre-test to post-test (p<0.05)None.
Facilitating word combination in language-impaired children through disclosure structure Age range: 32–40 months8 received experimental intervention
2 served as control group receiving intervention without target utterances
Shelton, 1978*, † To compare two parent-administered listening treatments and a control groupArticulation/PhonologyChildren were from nursery schools or pediatric offices; they were seen either at their school or in their home60Age range: 36–54 monthsBelow the cutoff score for age on the Templin-Darley Articulation Screening TestImmediate treatment impliedParent administered speech programs57 days (listening for 5 minutes per day, and reading and talking for 15 minutes per day)Auditory association subtest of the Illinois Test of Psycholinguistic AbilitiesOnly the noise subtest of the Test of Auditory Discrimination showed a significant improvement for the listening and control groups compared to the reading-talking group (p=0.03). There were no other significant differences between groupsNone.
Study 1Bilingual children were included with 2 in each conditionListening therapy based on auditory discrimination compared to more traditional reading and talking therapy and delayed treatmentMcDonald Screening Articulation test
Assessment of parent-administered listening training for preschool children with articulation deficits 20 received experimental listening therapy
20 received a reading and talking therapy
20 received delayed treatment
Sutton, 1999†, ‡ Not reportedNot reportedNot reported22Age: 7 monthsChildren had to fail WILSTAAR screen and have a standard score of below 85 on Receptive Expressive Emergent Language (REEL)Not reportedWILSTAAR: Parent administered general language intervention designed to facilitate language development in the first year of lifeExperimental group received 5 home visitsReceptive Expressive Emergent Language (REEL) language quotientsNot reportedNot reported
Investigating WILSTAAR 13 received WILSTAAR interventionControl group received 2 visits over four months
9 were assigned to no treatment control
Wilcox, 1991 To examine the effectiveness of classroom versus individual interventionsLexical acquisitionChildren were recruited from a speech and hearing clinic and community early intervention program20Age range: 20–47 monthsChildren had to score 1.5 SD below mean on both expressive and receptive scales of the sequenced inventory of communication development (SICD)Immediate treatment impliedClinician administered expressive vocabulary intervention:90 minutes per week for 3 months individually and 360 minutes per week for 3 months in groupsOverall use of target words in clinic sessionsChildren in the classroom treatment group used more words in the home setting (M=5.00) than those in the individual treatment group (M=2.80), and used more at home than in the treatment setting (M=3.00)None.
Early language intervention: A comparison of classroom and individual treatment 10 received individual intervention
10 received classroom based group intervention

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