Randomised Controlled Trial Evaluating Active versus Passive Waiting for Speech-Language Pathology

Shared characteristics of intervention techniques for oral vocabulary and speech comprehensibility in preschool children with co-occurring features of developmental language disorder and speech sound disorder: a systematic review with narrative synthesis

OBJECTIVES

To descriptively compare and contrast intervention techniques for preschool children with features of developmental language disorder (outcome: oral vocabulary) and speech sound disorder (outcome: speech comprehensibility) and analyse them in relation to effectiveness and theory.

DESIGN

This is a systematic review with narrative synthesis. The process was supported by an expert steering group consisting of relevant professionals and people with lived experience.

DATA SOURCES

Ovid Emcare, MEDLINE Complete, CINAHL, APA PsycINFO, ERIC, and Communication Source from January 2012 were searched. Relevant studies were obtained from an initial published review (up to January 2012).

ELIGIBILITY CRITERIA

Interventions for preschool children (80% aged 2:0-5:11 years) with idiopathic speech or language needs; outcomes relating to either oral vocabulary or speech comprehensibility.

DATA EXTRACTION AND SYNTHESIS

Searches were conducted on 27 January 2023. Two independent researchers screened at abstract and full-text levels. Data regarding intervention content (eg, techniques) and format/delivery (eg, dosage, location) were extracted. Data were synthesised narratively according to the methods of Campbell et al.

RESULTS

24 studies were included: 18 for oral vocabulary and 6 for speech comprehensibility. There were 11 randomised controlled trials, 2 cohort studies and 11 case series. Similarities included a focus on input-related techniques and similar therapy activities. Speech studies were more likely to be professional-led and clinic-led, rather than at home and through a parent. Analysis was restricted by heterogeneity in study design and terminology, as well as gaps within intervention reporting. Information deemed important to the expert steering group was missing.

CONCLUSIONS

Similarities and differences between intervention techniques for oral vocabulary and speech comprehensibility have been identified and synthesised. However, analysis of effectiveness was limited due to issues with study design and heterogeneity within studies. This has implications for the progression of the evidence base within the field.

PROSPERO REGISTRATION NUMBER

CRD42022373931.

Comparing in-Person and Telepractice Service Delivery for Spoken Language Production and Comprehension Using the National Outcomes Measurement System

The American Speech-Language-Hearing Association (ASHA) developed the National Outcomes Measurement System for aggregating standardized patient outcomes. Outcomes are standardized using Functional Communication Measures (FCM), scales designed to describe communicative function across specific areas of clinical need. This investigation compared in-person and telepractice service delivery for children in elementary school settings who received treatment targeting the FCM categories of either “spoken language production” or “spoken language comprehension.” De-identified cases were secured from ASHA's NOMS database and the database of a private e-learning provider that implemented the NOMS format. There were minimal significant differences in the median change scores between the traditional and telepractice interventions. These results support comparable treatment outcomes between in-person service delivery and telepractice for treatment of children exhibiting impaired spoken language production or spoken language comprehension in an elementary school setting.

Supporting Children With Speech Sound Disorders During COVID-19 Restrictions: Technological Solutions

Purpose

“Children are the hidden victims of the COVID-19 pandemic” (United Nations Children's Fund, 2020). Timely and effective speech intervention is important to reduce the impact on children's school achievement, ability to make friends, mental health, future life opportunities, and government resources. Prior to the coronavirus disease (COVID-19) pandemic, many Australian children did not receive sufficient speech-language pathology (SLP) services due to long waiting lists in the public health system. COVID-19 restrictions exacerbated this issue, as even children who were at the top of lengthy SLP waiting lists often received limited services, particularly in rural areas. To facilitate children receiving speech intervention remotely during the COVID-19 pandemic, evidence from randomized controlled trials regarding three technological solutions are examined: (a) Phoneme Factory Sound Sorter (Sound Start Study), (b) Waiting for Speech Pathology website, and (c) Apraxia World.

Conclusions

For the first two technological solutions, there were similar gains in speech production between the intervention and control groups, whereas, for the third solution, the average magnitude of treatment effect was comparable to face-to-face SLP therapy. Automated therapy management systems may be able to accelerate speech development and support communication resilience to counteract the effects of the COVID-19 restrictions on children with speech sound disorders. Technology-based strategies may also provide a potential solution to the chronic shortage of SLP services in rural areas into the future.