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Meta-Analysis
. 2003;2003(3):CD004110.
doi: 10.1002/14651858.CD004110.

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

J Law  1 , Z Garrett, C Nye
Affiliations
Meta-Analysis

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

J Law et al. Cochrane Database Syst Rev. 2003.

Abstract

Background: It is thought that approximately 6% of children have speech and language difficulties of which the majority will not have any other significant developmental difficulties. Whilst most children's difficulties resolve, children whose difficulties persist into primary school may have long-term problems concerning literacy, socialisation, behaviour and school attainment.

Objectives: To examine the effectiveness of speech and language interventions for children with primary speech and language delay/disorder.

Search strategy: The following databases were searched: The Cochrane Controlled Trials Register (Cochrane Library, CENTRAL: 2002/3), CINAHL (1982 - July 2002), EMBASE (1980 - Sept Week 4 2002), ERIC (1965 - 2002), MEDLINE (1966 - Sept Week 3 2002), PsycINFO (1872 - 2002/10 Week 2), The National Research Register (2002/3). In addition to this references were taken from reviews of the literature and reference lists from articles.

Selection criteria: The review considered randomised controlled trials of speech and language therapy interventions for children or adolescents with primary speech and language delay/disorder.

Data collection and analysis: Titles and abstracts were identified and assessed for relevance, before the full text version was obtained of all potentially relevant articles. The data were categorised depending on the nature of the control group and considered in terms of the effects of intervention on expressive and receptive phonology, syntax and vocabulary. The outcomes used in the analysis were dependent on the focus of the study with only the primary effects of therapy being considered in this review.

Main results: The results of twenty-five studies were used in the meta-analysis. The results suggest that speech and language therapy is effective for children with phonological (SMD=0.44, 95%CI: 0.01,0.86) or vocabulary difficulties (SMD=0.89, 95%CI: 0.21,1.56), but that there is less evidence that interventions are effective for children with receptive difficulties (SMD=-0.04, 95%CI: -0.64,0.56). Mixed findings were found concerning the effectiveness of expressive syntax interventions (n=233; SMD=1.02, 95%CI: 0.04-2.01). No significant differences were shown between clinician administered intervention and intervention implemented by trained parents, and studies did not show a difference between the effects of group and individual interventions (SMD=0.01, 95%CI: -0.26,1.17). The use of normal language peers in therapy was shown to have a positive effect on therapy outcome (SMD=2.29, 95%CI: 1.11,3.48).

Reviewer's conclusions: The review shows that overall there is a positive effect of speech and language therapy interventions for children with expressive phonological and expressive vocabulary difficulties. The evidence for expressive syntax difficulties is more mixed, and there is a need for further research to investigate intervention for receptive language difficulties. There is a large degree of heterogeneity in the results, and the sources of this need to be investigated.

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Conflict of interest statement

James Law is an author on one of the included studies and one of the excluded studies in this review, and has published a non‐Cochrane review in this area.

Figures

1.1
1.1. Analysis
Comparison 1 Speech and language intervention vesus delayed or no treatment, Outcome 1 Expressive phonology outcomes.
1.2
1.2. Analysis
Comparison 1 Speech and language intervention vesus delayed or no treatment, Outcome 2 Receptive phonology outcomes.
1.3
1.3. Analysis
Comparison 1 Speech and language intervention vesus delayed or no treatment, Outcome 3 Expressive syntax outcomes.
1.4
1.4. Analysis
Comparison 1 Speech and language intervention vesus delayed or no treatment, Outcome 4 Receptive syntax outcomes.
1.5
1.5. Analysis
Comparison 1 Speech and language intervention vesus delayed or no treatment, Outcome 5 Expressive vocabulary outcomes.
1.7
1.7. Analysis
Comparison 1 Speech and language intervention vesus delayed or no treatment, Outcome 7 Composite language measures.
1.8
1.8. Analysis
Comparison 1 Speech and language intervention vesus delayed or no treatment, Outcome 8 Subgroup analysis (clinician only data).
1.9
1.9. Analysis
Comparison 1 Speech and language intervention vesus delayed or no treatment, Outcome 9 Subgroup analysis (trials of longer than eight weeks).
1.10
1.10. Analysis
Comparison 1 Speech and language intervention vesus delayed or no treatment, Outcome 10 Subgroup Analysis (excluding data from children with receptive and expressive difficulties).
1.11
1.11. Analysis
Comparison 1 Speech and language intervention vesus delayed or no treatment, Outcome 11 Sensitivity analysis (excluding studies not reporting attrition).
1.12
1.12. Analysis
Comparison 1 Speech and language intervention vesus delayed or no treatment, Outcome 12 Sensitivity analysis (excluding studies not reporting blinding).
2.3
2.3. Analysis
Comparison 2 Speech and language intervention versus general stimulation programmes, Outcome 3 Expressive syntax outcomes.
2.5
2.5. Analysis
Comparison 2 Speech and language intervention versus general stimulation programmes, Outcome 5 Expressive vocabulary outcomes.
3.1
3.1. Analysis
Comparison 3 Speech and language interventions versus traditional speech and language programmes, Outcome 1 Expressive phonology outcomes.
3.2
3.2. Analysis
Comparison 3 Speech and language interventions versus traditional speech and language programmes, Outcome 2 Receptive phonology outcomes.
3.3
3.3. Analysis
Comparison 3 Speech and language interventions versus traditional speech and language programmes, Outcome 3 Expressive syntax outcomes.
3.4
3.4. Analysis
Comparison 3 Speech and language interventions versus traditional speech and language programmes, Outcome 4 Receptive syntax outcomes.
3.5
3.5. Analysis
Comparison 3 Speech and language interventions versus traditional speech and language programmes, Outcome 5 Expressive vocabulary outcomes.
3.6
3.6. Analysis
Comparison 3 Speech and language interventions versus traditional speech and language programmes, Outcome 6 Receptive vocabulary outcomes.
3.8
3.8. Analysis
Comparison 3 Speech and language interventions versus traditional speech and language programmes, Outcome 8 Subgroup analysis (clinician versus parent).
3.9
3.9. Analysis
Comparison 3 Speech and language interventions versus traditional speech and language programmes, Outcome 9 Subgroup analysis (excluding data from children with expressive and receptive difficulties).
See this image and copyright information in PMC

References

References to studies included in this review

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References to studies excluded from this review

Allen 1986 {published data only}
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Christensen, 1981 {published data only}
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References to ongoing studies

Boyle, Ongoing {unpublished data only}
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Broomfield, FC {unpublished data only}
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