最近的证据表明,与孤立地患有这些困难的儿童相比,同时发生语音语音障碍(SSD)和表达语言障碍的学龄前儿童面临持续交流和识字需求的风险更高。然而,迄今为止,还没有针对这种双重特征儿童的干预措施的系统或范围审查文献.
为了探索对同时发生语音SSD和表达性语言障碍的学龄前儿童进行干预的证据,包括此类干预措施的内容/交付,有针对性的语言和语言领域,以及研究质量的广泛概述。
根据JoannaBriggs研究所的指导使用了范围审查方法。在对OvidMedline进行系统搜索之后,OvidEmcare,OVIDEmbase,CINAHL,Psychinfo和ERIC,11项研究纳入审查。使用研究人员开发的数据提取表来提取有关每个干预措施的特定信息,使用JBI评估工具对每项研究的质量进行了广泛的概述。
纳入的论文包括六个随机对照试验(RCT),两项队列研究,两个案例研究和一个案例系列。干预分为两大类:(1)综合干预措施,将语音和语言目标的内容结合起来,和/或明确使用相同类型的技术来改善这两个领域;(2)单域干预措施,明确包含仅针对语音或语言的内容,但也旨在间接改善其他领域。学习质量各不相同,详细的内容,干预措施的背景和交付往往被低估,阻碍研究结果的复制和临床适用性。
早期出现的证据被确定为支持综合言语和语言干预以及单领域干预。然而,由于干预措施报告的质量和详细程度存在差异,因此应谨慎行事。未来的干预研究可能会通过根据干预描述和复制模板(TIDieR)报告指南进行报告来解决此问题。这种方法将使临床医生能够考虑干预对不同环境下的个别儿童的适用性。
关于该主题的已知知识,患有语音SSD和表达性语言障碍的学龄前儿童经常在言语和语言治疗服务中出现。与孤立地具有这些需求的儿童相比,这些儿童面临长期交流和识字困难的风险更高。一些新出现的证据表明,对具有这种共同发生特征的儿童的干预措施可能存在于文献中;然而,临床医生在日常实践中可能不知道这些证据.本文是对现有知识的补充。这篇综述是第一个系统地研究针对同时发生语音SSD和表达语言困难的学龄前儿童的干预措施的证据。审查确定了少量干预研究,这些研究在研究质量和干预措施的内容和实施方面提供的详细程度各不相同。这项工作的潜在或实际临床意义是什么?这项研究的结果突出了针对同时发生语音SSD和表达性语言困难的学龄前儿童的干预措施的已发表证据。这些可以采取将语音/语言技术集成到单个干预中的形式,或明确瞄准一个域,目的是也影响另一个域。然而,需要在这一领域进一步进行高质量的研究。此类研究应提供足够的细节以实现复制。这将使临床医生能够理解这些干预结果对他们在临床实践中看到的个体儿童的相关性和适用性。
Recent evidence suggests that pre-school children with co-occurring phonological speech sound disorder (SSD) and expressive language difficulties are at a higher risk of ongoing communication and literacy needs in comparison with children with these difficulties in isolation. However, to date there has been no systematic or scoping
review of the literature specific to interventions for children with this dual profile.
To explore the evidence regarding interventions for pre-school children with co-occurring phonological SSD and expressive language difficulties, including the content/delivery of such interventions, areas of speech and language targeted, and a broad overview of study quality.
A scoping
review methodology was used in accordance with the guidance from the Joanna Briggs Institute. Following a systematic search of Ovid Medline, Ovid Emcare, OVID Embase, CINAHL, Psychinfo and ERIC, 11 studies were included in the
review. A researcher-developed data extraction form was used to extract specific information about each intervention, with the JBI appraisal tools used to provide a broad overview of the quality of each study.
Included papers consisted of six randomized controlled trials (RCTs), two cohort studies, two case studies and one case series. Interventions fell into two main categories: (1) integrated interventions that combined content for both speech and language targets and/or explicitly used the same type of technique to improve both domains; and (2) single-domain interventions that explicitly included content to target speech or language only, but also aimed to improve the other domain indirectly. Study quality varied, with detail on the content, context and delivery of interventions often underspecified, hampering the replication and clinical applicability of findings.
Early emerging evidence was identified to support both integrated speech and language interventions as well as single-domain interventions. However, caution should be exercised due to the variation in the quality and level of detail reported for the interventions. Future intervention studies may seek to address this by reporting in accordance with Template for Intervention Description and Replication (TIDieR) reporting guidelines. This approach would enable clinicians to consider the applicability of the intervention to individual children within differing settings.
What is already known on the subject Pre-school children with co-occurring phonological SSD and expressive language difficulties frequently present within speech and language therapy services. These children are at a higher risk of long-term communication and literacy difficulties compared with children with these needs in isolation. Some emerging evidence suggests that interventions for children with this co-occurring profile may exist within the literature; however, this evidence may not be known to clinicians in everyday practice. What this paper adds to existing knowledge This
review is the first to systematically examine evidence of interventions for pre-school children with co-occurring phonological SSD and expressive language difficulties. The
review identified a small number of intervention studies that varied in research quality and level of detail provided regarding the content and delivery of interventions. What are the potential or actual clinical implications of this work? The findings of this study highlight published evidence for interventions for pre-school children with co-occurring phonological SSD and expressive language difficulties. These may take the form of integrating techniques for speech/language into a single intervention, or the explicit targeting of one domain with the aim of also influencing the other. However, there is a need for further high-quality research in this area. Such studies should provide sufficient detail to enable replication. This would enable clinicians to understand the relevance and applicability of such intervention findings to the individual children they see within their clinical practice.