Smith Clare, Williams Emma, Bryan Karen
Clinical Academic-Speech and Language Therapy, Children's Therapy Services, Solent NHS Trust, Better Care Centre (formally The Orchard Centre), Southampton, UK.
Department of Psychology, University of Surrey, Guildford, UK.
Int J Lang Commun Disord. 2017 Jul;52(4):407-425. doi: 10.1111/1460-6984.12299. Epub 2016 Dec 29.
There have been calls for speech and language therapists (SLTs) to work within a public-health framework to support language development. Innovative practice is reported, but the range of services remains unknown. Furthermore, the potential impact of public health practice in speech and language therapy on early child development is also currently unknown. A new method in SLT research, systematic scoping reviews enable greater breadth of focus than traditional systematic reviews when identifying innovative practice.
To report scope and critically appraise evidence of family-focused health-promotion practice for early language development in this area.
METHODS & PROCEDURES: Using the Cochrane Public Health Group scoping review framework, data from reports of health-promotion practice with families of children aged 0-3 years were extracted and critically appraised on service delivery, information, reach and evaluation.
Group-based service delivery was the most popular form of service delivery. There were limited reports on the information given in services and on their reach. Questionnaires were the most popular reported evaluation method. Quality of evaluations was poor due to lack of replicability and experimental control in the studies reported.
CONCLUSIONS & IMPLICATIONS: This method of systematic review has highlighted the scope of health-promotion practice in speech and language therapy and also demonstrated the lack of evidence for its effectiveness on child language development. It is argued that systematic scoping reviews are valuable for scoping innovative practice in areas where either there is a lack of robust evidence or there is a high level of heterogeneity in practice or evaluation. To support clinician appraisal of available evidence, recommendations are given for development of questionnaire appraisal and for categorization of evidence levels on summary databases.
一直有人呼吁言语和语言治疗师（SLT）在公共卫生框架内开展工作，以支持语言发展。虽然有创新实践的报道，但服务范围仍不明确。此外，言语和语言治疗中的公共卫生实践对儿童早期发展的潜在影响目前也不清楚。SLT研究中的一种新方法——系统综述，在识别创新实践时比传统的系统综述能更广泛地聚焦。
报告该领域以家庭为重点促进健康以支持早期语言发展的实践范围，并对相关证据进行批判性评价。
使用Cochrane公共卫生小组的系统综述框架，提取了针对0至3岁儿童家庭的健康促进实践报告中的数据，并从服务提供、信息、覆盖范围和评估等方面进行了批判性评价。
基于小组的服务提供是最常见的服务形式。关于服务中提供的信息及其覆盖范围的报告有限。问卷调查是最常报告的评估方法。由于所报告研究缺乏可重复性和实验控制，评估质量较差。
这种系统综述方法突出了言语和语言治疗中健康促进实践的范围，也表明缺乏其对儿童语言发展有效性的证据。有人认为，系统综述对于在缺乏有力证据或实践或评估中存在高度异质性的领域确定创新实践很有价值。为支持临床医生对现有证据的评估，针对问卷评估的发展以及汇总数据库中证据水平的分类给出了建议。
