Law James, Garrett Zoe, Nye Chad
Department of Language and Communication Science, City University, London, UK.
J Speech Lang Hear Res. 2004 Aug;47(4):924-43. doi: 10.1044/1092-4388(2004/069).
A meta-analysis was carried out of interventions for children with primary developmental speech and language delays/disorders. The data were categorized depending on the control group used in the study (no treatment, general stimulation, or routine speech and language therapy) and were 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 aims of the study; only the primary effects of intervention are considered in this review. These were investigated at the level of the target of therapy, measures of overall linguistic development, and broader measures of linguistic functioning taken from parent report or language samples. Thirty-six articles reporting 33 different trials were found. Of these articles, 25 provided sufficient information for use in the meta-analyses; however, only 13 of these, spanning 25 years, were considered to be sufficiently similar to be combined. The results indicated that speech and language therapy might be effective for children with phonological or expressive vocabulary difficulties. There was mixed evidence concerning the effectiveness of intervention for children with expressive syntax difficulties and little evidence available considering the effectiveness of intervention for children with receptive language difficulties. No significant differences were found between interventions administered by trained parents and those administered by clinicians. The review identified longer duration (>8 weeks) of therapy as being a potential factor in good clinical outcomes. A number of gaps in the evidence base are identified.
对患有原发性发育性言语和语言延迟/障碍的儿童的干预措施进行了一项荟萃分析。数据根据研究中使用的对照组(无治疗、一般刺激或常规言语和语言治疗)进行分类,并从干预对表达性和接受性语音、句法和词汇的影响方面进行考量。分析中使用的结果取决于研究目的;本综述仅考虑干预的主要效果。这些效果在治疗目标、整体语言发展测量以及从家长报告或语言样本中获取的更广泛的语言功能测量层面进行了研究。共找到36篇报告33项不同试验的文章。在这些文章中,25篇提供了可用于荟萃分析的充分信息;然而,其中只有13篇,跨越25年,被认为足够相似可以合并。结果表明,言语和语言治疗可能对有语音或表达性词汇困难的儿童有效。关于对有表达性句法困难的儿童进行干预的有效性存在混合证据,而关于对有接受性语言困难的儿童进行干预的有效性几乎没有证据。在由受过训练的家长实施的干预和由临床医生实施的干预之间未发现显著差异。该综述确定治疗持续时间较长(>8周)是良好临床结果的一个潜在因素。同时也指出了证据基础中的一些空白。