Speech and language therapy interventions for children with primary speech and language delay or disorder.
Speech and language therapy interventions for children with primary speech and language delay or disorder.
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DOI：
10.1002/14651858.cd004110
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发表时间：
2003-01-01
期刊：
影响因子：
--
通讯作者：
Nye, C
中科院分区：
文献类型：
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作者：
Law, J;Garrett, Z;Nye, C
背景：据认为，大约6%的儿童有言语和语言困难，其中大多数不会有任何其他显着的发展困难。研究策略：检索以下数据库：Cochrane对照试验登记册(Cochrane Library，CENTAL：2002/3)，CINAHL(1982-2002年7月)，EMBASE(1980-2002年9月4日)，Eric(1965-2002)，MEDLINE(1966-2002 9月3日)，QicINFO(1872-2002/10 Week 2)，《国家研究登记册》(2002/3)。此外，参考文献来自文献综述和文献参考文献列表。选择标准：该综述考虑了针对患有原发言语和语言延迟/障碍的儿童或青少年的言语和语言治疗干预的随机对照试验。数据收集和分析：在获得所有潜在相关文章的全文之前，识别标题和摘要并评估其相关性。这些数据根据控制组的性质进行了分类，并根据干预对表达和接受语音、句法和词汇的影响进行了考虑。分析中使用的结果取决于研究的重点，在这篇综述中只考虑了治疗的主要效果。主要结果：荟萃分析使用了25项研究的结果。结果表明，言语语言治疗对语音障碍(SMD=0.44，95%CI：0.01，0.86)或词汇障碍(SMD=0.89，95%CI：0.21，1.56)儿童有效，但对接受困难儿童干预有效的证据较少(SMD=-0.04，95%CI：-0.64，0.56)。关于表达句法干预的有效性，研究结果喜忧参半(n=233；SMD=1.02，95%CI：0.04-2.01)。临床医生干预与家长培训后实施的干预效果差异无统计学意义(SMD=0.01，95%CI：-0.26，1.17)。在治疗中使用正常语言同伴对治疗结果有积极影响(SMD=2.29，95%CI：1.11，3.48)。综述结论：总体而言，言语和语言治疗干预对有表达语音和表达词汇困难的儿童有积极效果。表达句法困难的证据更加复杂，需要进一步的研究来调查对接受性语言困难的干预。结果存在很大程度的异质性，这种异质性的来源需要调查。
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.