Improving comprehension in adolescents with severe receptive language impairments: a randomized control trial of intervention for coordinating conjunctions
Improving comprehension in adolescents with severe receptive language impairments: a randomized control trial of intervention for coordinating conjunctions
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DOI：
10.1111/1460-6984.12047
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发表时间：
2014-01-01
影响因子：
2.4
通讯作者：
Turner, Gail
中科院分区：
文献类型：
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作者：
Ebbels, Susan H.;Maric, Natasa;Turner, Gail
背景：对于接受性语言障碍儿童，特别是那些接受性语言障碍严重且持续存在的儿童，几乎没有证据表明治疗的有效性。目的通过一项随机对照试验，验证视觉支持下显性言语和语言治疗对中学龄语言障碍儿童协调连词理解的有效性。方法与程序14名严重RELI（平均标准得分：CELF4 ELS = 48, CELF4 RLS = 53, TROG-2 = 57），但非语言（矩阵= 83）和视觉感知技能（视觉感知技能测试(TVPS) = 86）较高的参与者（11岁；3-16岁；1）随机分为两组：治疗组和等待对照组。在第一阶段，治疗组接受8次30分钟的单独显性教学，并使用他们通常的SLT进行视觉支持（形状编码）。在第二阶段，等待对照组接受同样的治疗。在第一阶段治疗前后和第二阶段治疗后，对参与者的理解能力进行测试，测试内容包括：(1)目标连词的特定测试，(2)TROG-2测试和(3)被动语态测试。1期结束后，治疗组在靶向结合体（d = 1.6）和TROG-2总标准评分（d = 1.4）方面的进展明显大于等待对照组。两组在被动测试上没有差异。在第二阶段之后，等待对照组取得了与原始治疗组相似的进展，原始治疗组保持了之前的进展。两组在被动语态上都没有进步。两组联合治疗时，在特定连词（d = 1.3）、TROG-2 raw （d = 1.1）和标准评分（d = 0.9）方面均有显著进展。相关性表明，所采取的措施（包括矩阵和TVPS）与目标连词或TROG-2的进展没有显著相关性。结论与意义4小时的形状编码治疗可显著提高患者对协调连词的理解能力，并可维持4个月。鉴于在小组一级取得的重大进展和缺乏可靠的进展预测指标，这种方法可以提供给与参与者有类似困难的其他儿童。然而，干预是由言语和语言治疗师一对一提供的，因此这种治疗方法与其他提供方法的有效性仍有待评估。
BackgroundLittle evidence exists for the effectiveness of therapy for children with receptive language difficulties, particularly those whose difficulties are severe and persistent.AimsTo establish the effectiveness of explicit speech and language therapy with visual support for secondary school-aged children with language impairments focusing on comprehension of coordinating conjunctions in a randomized control trial with an assessor blind to group status.Methods & ProceduresFourteen participants (aged 11;3-16;1) with severe RELI (mean standard scores: CELF4 ELS = 48, CELF4 RLS = 53 and TROG-2 = 57), but higher non-verbal (Matrices = 83) and visual perceptual skills (Test of Visual Perceptual Skills (TVPS) = 86) were randomly assigned to two groups: therapy versus waiting controls. In Phase 1, the therapy group received eight 30-min individual sessions of explicit teaching with visual support (Shape Coding) with their usual SLT. In Phase 2, the waiting controls received the same therapy. The participants' comprehension was tested pre-, post-Phase 1 and post-Phase 2 therapy on (1) a specific test of the targeted conjunctions, (2) the TROG-2 and (3) a test of passives.Outcomes & ResultsAfter Phase 1, the therapy group showed significantly more progress than the waiting controls on the targeted conjunctions (d = 1.6) and overall TROG-2 standard score (d = 1.4). The two groups did not differ on the passives test. After Phase 2, the waiting controls made similar progress to those in the original therapy group, who maintained their previous progress. Neither group showed progress on passives. When the two groups were combined, significant progress was found on the specific conjunctions (d = 1.3) and TROG-2 raw (d = 1.1) and standard scores (d = 0.9). Correlations showed no measures taken (including Matrices and TVPS) correlated significantly with progress on the targeted conjunctions or the TROG-2.Conclusions & ImplicationsFour hours of Shape Coding therapy led to significant gains on comprehension of coordinating conjunctions which were maintained after 4 months. Given the significant progress at a group level and the lack of reliable predictors of progress, this approach could be offered to other children with similar difficulties to the participants. However, the intervention was delivered one-to-one by speech and language therapists, thus the effectiveness of this therapy method with other methods of delivery remains to be evaluated.