Assessment of parent-administered listening training for preschool children with articulation deficits. The effectiveness of group and individual therapy. Parental-based intervention with pre-school language-delayed children. Effects of treatment on linguistic and social skills in toddlers with delayed language development. The influence of peer models on the play scripts of children with specific language impairment. Effectiveness of speech intervention for phonological disorders: a randomized controlled trial. Direct language instruction and interactive language instruction with language delayed preschool children: a comparison study. The effect of target-selection strategy on phonological learning. Speech remediation of children involved in two different physical education programs. EFFECTS OF MATERNAL ATTITUDES UPON IMPROVEMENT IN ARTICULATION WHEN MOTHERS ARE TRAINED TO ASSIST IN SPEECH CORRECTION. Facilitating word combination in language-impaired children through discourse structure. Effects of grammar facilitation on the phonological performance of children with speech and language impairments. Two models of grammar facilitation in children with language impairments: phase 2. Two approaches to the facilitation of grammar in children with language impairment: an experimental evaluation. Trial of intensive compared with weekly speech therapy in preschool children. Randomised controlled trial of community based speech and language therapy in preschool children. Effectiveness of trained parents as speech therapists. Effects of lexical intervention on the phonology of late talkers. The use of different service delivery models for children with phonological disorders. Factors in the effectiveness of mothers trained to aid in speech correction. Utilization of parents in a speech correction program. Speech perception training can facilitate sound production learning. Interactive focused stimulation for toddlers with expressive vocabulary delays. Generalization of an operant remediation program for syntax with language delayed children.
Two studies concerning preschool misarticulating children are reported. The first study was concerned with direct effects of two varieties of parent-administered listening training. The second study focused on the influence of that same training on children's responses to sound-production training. Subjects were assigned to one of three conditions: listening, reading-talking, and control. Children in the first group were provided training by their parents that was intended to focus the child's attention on consonants in syllables or words and to teach discrimination between correctly and incorrectly articulated consonants. Parents of children in the second group read to and talked with them about the material. Neither treatment group surpassed the control group in gains made on any auditory processing or articulatory measure employed, and some parents found the listening training frustrating. In the second study, a subset of the children in each of the three groups was given sound-production training. The data obtained did not show any effect from earlier listening experiences on sound-production performance. nan Mothers of children randomly allocated to an experimental group attended fortnightly group parental language training sessions, over a 6-month period. Mothers of children allocated to a matched no intervention control group received no special attention. The results showed significantly greater gains in the expressive language skills of the experimental group compared to the control group. A second experiment was designed to compare the parental involvement approach with direct, individual treatment and to clarify the role of non-specific 'Hawthorne-type' effects. The experimental group mothers attended parental language training sessions, as above. The parental control group mothers also attended training sessions, with the emphasis on general learning skills rather than language. A third group of children received individual, direct speech and language therapy. Results showed significantly greater language gains in the parental language training group and in the individual group in comparison with the non-specific training group. The two former groups did not differ significantly, indicating that, for these groups and this methodology, parental language training is as effective as individual speech and language therapy. The results also indicate that the effectiveness of the parental involvement approach cannot be accounted for by non-specific factors. The research findings are discussed, together with the professional implications of the study and recommendations for further research. This study investigated the effects of early language intervention on various linguistic and social skills of late-talking toddlers. The 21 children who participated in the investigation were randomly assigned to an experimental group (n = 11) or a control (delayed-treatment) group (n = 10). The experimental group participated in a 12-week clinician-implemented language intervention program. Groups were compared at pretest and posttest on five linguistic variables: Mean Length of Utterance, Total Number of Words, Number of Different Words, Lexical Repertoire, and Percentage of Intelligible Utterances, as well as on Socialization and Parental Stress. Significant group differences were found for each of the variables, indicating facilitative effects of the treatment. Notably, increases were observed in areas that were not specifically targeted by the intervention. Implications of these results are discussed with respect to considerations regarding clinical management decisions for toddlers with delayed language development. This investigation included two phases of inquiry that examined the effects of peer modeling upon the play scripts of children with specific language impairment (SLI). The first study employed a pretest-posttest control group design involving two groups of children with SLI (10 who participated in the experimental treatment and 10 controls) and a group of peer models (10 children with normal language development). The treatment involved dyadic play sessions in which children with SLI were paired with a normal language peer model. Significant differences were found between the play script reports of the experimental (SLI-E) and control groups (SLI-C) of children with specific language impairment. The second study, utilizing single-case methodology, involved 6 children with SLI who participated in the control group of Study 1, plus 2 peer models. Play dyads consisted of either two children with SLI or one child with SLI and a normal language peer. Results of this study provided support for the contention that play interactions with normal language peers facilitates increases in the play-script reports of children with SLI. Thirty children of preschool age with severe phonological disorders were randomly assigned to two treatment groups. Group 1 received treatment for 4 months followed by 4 months without treatment while group 2 underwent 4 months without treatment followed by 4 months of treatment. The outcome measures used were the Assessment of Phonological Processes-Revised (APP-R), the Goldman-Fristoe Test of Articulation (GFTA), the Percentage Consonants Correct (PCC), and Mean Length of Utterance (MLU). Group 1 showed significant differences on scores of phonological measures (APP-R, GFTA, and PCC) after the first 4 months of the study. At the 8-month assessment point the measures for conversational speech intelligibility continued to be significantly different, with group 1 scores higher than those of group 2. The expressive language measure did not detect a difference between groups at any time; however group 1 scores were consistently higher than group 2 scores. Direct language instruction and interactive language instruction are based on highly distinct theoretical positions and incorporate very different behavioral techniques. A purpose of the present study was to evaluate the relative effectiveness of direct and interactive language instruction in promoting a variety of language skills. A second purpose was to determine if an aptitude and treatment interaction influenced the outcome of intervention. Forty-four children of preschool age were randomly assigned to classrooms using either direct instruction or interactive instruction. After 8 months, children in both settings improved significantly and substantially on syntactic and semantic measures. There were no differences between the two groups at posttest, nor were there any significant aptitude by treatment interactions for either cognitive or language pretest measures. The results of this study, and a careful examination of previously reported interactions, suggest that such an interaction has yet to be demonstrated. In this study, 48 children with moderate or severe delays in phonological ability received treatment for four phonemes, selected in accordance with either traditional or nontraditional target-selection criteria. Children who received treatment for phonemes that are early developing and associated with greater productive phonological knowledge showed greater progress toward acquisition of the target sounds than did children who received treatment for late-developing phonemes that were associated with little or no productive phonological knowledge. Between-group differences in generalization learning were not observed. Child enjoyment of therapy did not differ between groups, but parental satisfaction with treatment progress was greater for children in the traditional group than for children in the nontraditional group. 25 children with severe speech defects and receiving specialized therapy in a camp were randomly assigned to either a physical education program with an emphasis on recreational games or perceptual-motor instruction. All children were administered 6 pre- and posttests of language and speech proficiency. The recreation games group achieved slightly more statistically significant improvements. nan The influence of an adult-child discourse structure on the production of early word combinations was examined in language-impaired children. The subjects were 10 children (2:8-3:4) at the single-word utterance level. Eight of the children were engaged in 10 experimental sessions utilizing vertical structures (e.g., Adult: "Who's this?" Child: "Daddy." Adult: "What's Daddy throwing?" Child: "Ball." Adult: "Yeah, Daddy's throwing the ball."), while the remaining children, serving as controls, were engaged in an alternate activity. Examination of pretest and posttest data as well as session data revealed a substantial increase in the number of multiword productions for most of the children in the experimental group but not for the children serving as controls. These findings indicate that vertical structures have a facilitating effect on the multiword productions of language-impaired children comparable to that found in an identical procedure with normally developing children. The use of a naturally occurring adult-child discourse structure as an intervention procedure is discussed. Although there is a great deal of evidence for a significant developmental relationship between grammar and phonology, the nature of this relationship and its implications for the intervention of children with impairments in both grammar and phonology are unclear. The purpose of this investigation was to determine whether two approaches to grammar facilitation that placed no emphasis on phonology would have indirect effects on the phonological output of preschoolers with speech and language impairments. All 26 subjects, ages 44-70 months, had impairments both in grammar and in phonology. Ten subjects took part in a clinician-administered intervention program, eight subjects received a similar intervention program implemented by their parents, and eight children served as delayed intervention controls (Fey, Cleave, Long, & Hughes, 1993). The results indicated that despite a strong effect for the intervention on the children's grammatical output, there were no indirect effects on the subjects' phonological production. It is concluded that despite a close relationship between the development of grammar and phonology, language intervention approaches for children approximately 4 to 6 years of age should address phonological problems directly if significant effects on phonology are to be expected. Fey, Cleave, Long and Hughes (1993) demonstrated the effectiveness of two 5-month interventions for preschoolers with problems in expressive grammar. This article reports the results of an additional 5-month intervention phase for 18 of the original participants. Results indicated that although participants improved during Phase 2, improvements generally were not as strong as those noted for Phase 1. Gains were larger and more consistent for children who received the relatively costly clinician-administered approach than for those who received a less expensive parent-administered intervention. The parent intervention was successful in helping parents to use sentence recasts, and especially so for parents of children at relatively early stages of grammatical development, Finally, children who were dismissed after a highly successful treatment Phase 1 generally exhibited no gains over the no-treatment Phase 2. Two approaches to grammar facilitation in preschool-age children with language impairment were evaluated. One approach was administered by a speech-language pathologist and the other was presented by the subjects' parents, who were trained by the speech-language pathologist. Both treatment packages ran for 4 1/2 months and made use of focused stimulation procedures and a cyclical goal-attack strategy. Subjects were 30 children between the ages of 3:8 and 5:10 (years:months) who had marked delays in grammatical development. Children who served in a delayed-treatment control group averaged no gains over their no-treatment period. In contrast, large treatment effects were observed for both treatment groups on three of four measures of grammatical expression. However, closer inspection of the data revealed that the effects for the clinician treatment were more consistent across treatment administrations than were those for the parent treatment. Although the specific contributions of the focused stimulation procedures and the cyclical goal attack strategy were not evaluated, the results support the viability of these components as parts of larger treatment packages. The results also support the participation of parents as primary intervention agents in grammar facilitation programs. When parents take such a large role in the intervention process, however, it is imperative that the children's progress be monitored carefully and that program adjustments be made whenever gains are smaller than expected. Forty two preschool children referred to a speech therapy department were randomly allocated to receive intensive individual speech therapy or the more traditional once weekly approach. Boys and minority ethnic groups were referred most frequently. Speech therapy improved expression more than comprehension, as measured on Reynell scales. The mean improvements were 0.5 SDs (95% confidence intervals (CI) 0.3 to 0.7) and 0.3 (95% CI 0.1 to 0.5) respectively. There was a greater improvement in children receiving intensive compared with weekly therapy in the expression scores (0.8 SDs (95% CI 0.5 to 1.1) v 0.2 SDs (95% CI -0.1 to 0.5]. White and non-white children had similar improvements in comprehension scores but white children had greater improvement in expression scores (1.1 SDs v 0.3 SDs). This difference was seen in both therapy groups. Randomised trials are useful in the evaluation of speech therapy in children. To compare routine speech and language therapy in preschool children with delayed speech and language against 12 months of "watchful waiting."
                Pragmatic randomised controlled trial. Setting: 16 community clinics in Bristol.
                159 preschool children with appreciable speech or language difficulties who fulfilled criteria for admission to speech and language therapy.
                Four quantitative measures of speech and language, assessed at 6 and 12 months; a binary variable indicating improvement, by 12 months, on the trial entry criterion.
                Improvement in auditory comprehension was significant in favour of therapy (adjusted difference in means 4.1, 95% confidence interval 0.5 to 7.6; P=0.025). No significant differences were observed for expressive language (1.4, -2.1 to 4.8; P=0.44); phonology error rate (-4.4, -12.0 to 3.3; P=0.26); language development (0.1, -0.4 to 0.6; P=0.73); or improvement on entry criterion (odds ratio 1.3, 0.67 to 2.4; P=0.46). At the end of the trial, 70% of all children still had substantial speech and language deficits.
                This study provides little evidence for the effectiveness of speech and language therapy compared with watchful waiting over 12 months. Providers of speech and language therapy should reconsider the appropriateness, timing, nature, and intensity of such therapy in preschool children. Continued research into more specific provision to subgroups of children is also needed to identify better treatment methods. The lack of resolution of difficulties for most of the children suggests that further research is needed to identify effective ways of helping this population of children. nan The purpose of this investigation is to determine whether a focused stimulation intervention focusing on lexical training has indirect, secondary effects on children's phonological abilities. Twenty-five toddlers with expressive vocabulary delays and their mothers were randomly assigned to intervention and control groups. The children were between 23 and 33 months of age at entry into the study and were at the single-word stage of language development. Parents of late talkers in the experimental group were trained to employ frequent, highly concentrated presentations of target words without requiring responses. Two measures of phonological diversity (i.e., syllable structure level and consonant inventory) and one measure of accuracy of production (i.e., percent consonants correct) were measured prior to and following intervention within the context of mother-child interactions. The toddlers who received intervention made treatment gains in two areas of phonological ability. They used a greater variety of complex syllable shapes and expanded their speech sound inventories to include more consonant sounds in both initial and final position. In contrast, there were no effects of language treatment on the accuracy of correct production when compared to the adult phonological system. A group of 12 preschool children with phonological process errors was selected, and individual subjects were randomly assigned to one of two treatments that differed in relation to service delivery. Group I received a treatment that was administered exclusively by the clinician. Group II received a combination that included clinician administered treatment and parent administered instruction with the Speech Viewer system. Results indicate that both groups improved significantly, but they did not differ significantly from each other in the degree of change. Implications with respect to the service delivery options and their respective components are discussed. nan nan This study examined the role of speech perception training in the correction of phonological errors. Twenty-seven preschoolers with phonological impairment who misarticulated /integral of/ were randomly assigned to one of three groups: Group 1 children listened to a variety of correctly and incorrectly produced versions of the word "shoe"; Group 2 children listened to the words "shoe" and "moo"; Group 3 children listened to the words "cat" and "Pete." A computer game was used to provide reinforcement for correct identification of the words. All children received the same traditional sound production training program for correction of their /integral of/ error, concurrently with speech perception training, during six weekly treatment sessions. On post-testing, Group 1 and 2 children demonstrated a superior ability to articulate the target sound in comparison to Group 3 children. The results are interpreted in relation to previous research on this topic. This study explores the effects of training parents to administer focused stimulation intervention to teach specific target words to their toddlers with expressive vocabulary delays. Twenty-five mothers and their late-talking toddlers were randomly assigned to treatment and delayed-treatment (control) groups. Vocabulary targets were individually selected for each toddler based on the child's phonetic repertoire and parent report of vocabulary development. Following treatment, mothers' language input was slower, less complex, and more focused than mothers in the control group. Concomitantly, their children used more target words in naturalistic probes, used more words in free-play interaction, and were reported to have larger vocabularies overall as measured by parent report. In addition, the treatment had an effect on language development-children in the experimental group used more multiword combinations and early morphemes than children in the control group. The implications of these results are discussed with regard to the role of focused stimulation intervention for children with expressive vocabulary delays. Generalization of the Monterey Behavioral Sciences Institute operant language program was assessed. Six male and three female children (4 years, 4 months to 6 years, 3 months) receiving language remediation were randomly assigned to (I) the Monterey program for the syntactic structure "is interrogative" (including the home carryover phase) plus an extended transfer program devised by the investigators (II) the Monterey "is interrogative" program alone (including the home carryover), or (III) a control activity (articulation training). Language samples evoked by a variety of language tasks were collected outside the treatment settling preceding and following treatment. Standard within-clinic measures indicated that groups I and II improved a significant, equal amount. However, the extraclinic language measures showed that group I demonstrated significantly greater improvement than group II; neither group II nor group III showed significant extraclinic improvement. Extraclinic generalization occurred, therefore, only for the group receiving the special extended transfer training.
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.