Evidence-Based Systematic Review: Effects of Different Service Delivery Models on Communication Outcomes for Elementary School-Age Children

• Published in: Language, speech & hearing services in schools Vol. 41; no. 3; pp. 233 - 264
• Main Authors: Cirrin, Frank M, Schooling, Tracy L, Nelson, Nickola W, Diehl, Sylvia F, Flynn, Perry F, Staskowski, Maureen, Torrey, T. Zoann, Adamczyk, Deborah F
• Format: Journal Article
• Language: English
• Published: United States American Speech-Language-Hearing Association (ASHA) 01.07.2010; American Speech-Language-Hearing Association
• Subjects: Child; Children & youth; Communication; Communication Disorders - therapy; Computer Uses in Education; Education; Educational aspects; Elementary School Students; Elementary schools; Evaluation Methods; Evidence-based medicine; Evidence-Based Practice; Health aspects; Humans; Individualized Education Programs; Intervention; Language Impairments; Language Therapy - methods; Outcomes of Treatment; Practice; Self Contained Classrooms; Services; Special Needs Students; Speech; Speech Language Pathology; Speech therapists; Speech Therapy - methods; Systematic review; Teaching Methods; Treatment Outcome; United States
• ISSN: 0161-1461; 1558-9129
• DOI: 10.1044/0161-1461(2009/08-0128)

Purpose: The purpose of this investigation was to conduct an evidence-based systematic review (EBSR) of peer-reviewed articles from the last 30 years about the effect of different service delivery models on speech-language intervention outcomes for elementary school-age students. Method: A computer search of electronic databases was conducted to identify studies that addressed any of 16 research questions. Structured review procedures were used to select and evaluate data-based studies that used experimental designs of the following types: randomized clinical trial, nonrandomized comparison study, and single-subject design study. Results: The EBSR revealed a total of 5 studies that met the review criteria and addressed questions of the effectiveness of pullout, classroom-based, and indirect-consultative service delivery models with elementary school-age children. Some evidence suggests that classroom-based direct services are at least as effective as pullout intervention for some intervention goals, and that highly trained speech-language pathology assistants, using manuals prepared by speech-language pathologists to guide intervention, can provide effective services for some children with language problems. Conclusion: Lacking adequate research-based evidence, clinicians must rely on reason-based practice and their own data until more data become available concerning which service delivery models are most effective. Recommendations are made for an expanded research agenda.