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A RCT and economic evaluation of direct vs indirect and individual vs group modes of SLT

People:James Boyle, John Forbes, Elspeth McCartney, Anne O’Hare
FunderThe Health Technology Assessment Commissioning Board (National Health Service Research and Development, National Co-ordinating Centre for Health Technology Assessment – NCCHTA)
Summary

This large-scale RCT developed a manualised language intervention for primary school children with persisting language impairments, and compared its delivery by SLTs or SLT Assistants to children individually or in groups. Children in these four research intervention modes showed gains in expressive language on standardised measures compared to an on-going therapy control group, but further gains were not recorded at follow up after the research intervention ceased. Much more language intervention was delivered to children in the research intervention conditions than was received as on-going therapy by children in the control group.

The research intervention was disseminated as The Language Therapy Manual, which details the research intervention activities used. These related to creating a communication-friendly classroom, developing comprehension monitoring, and developing vocabulary, later grammar and oral narrative. The language-learning activities are suitable for use by assistants and SLTs. The manual is now disseminated as the Strathclyde Language Intervention Programme on the Communication Trust’s ‘What Works’ database, via: https://www.thecommunicationtrust.org.uk/schools/what-works/whatworkssearch.aspx and available to download from the University of Strathclyde.

References
  1. McCartney, E., Boyle, J., Bannatyne, S., Jessiman, E., Campbell, C., Kelsey, C., Smith, J. & O’Hare, A. (2004). Becoming a manual occupation? The construction of a therapy manual for use with language impaired children in mainstream primary schools. International Journal of Language and Communication Disorders, 39, 135-148.
  2. McCartney, E., Boyle, J., Bannatyne, S., Jessiman, E., Campbell, C., Kelsey, C., Smith, J. McArthur J. & O’Hare, A. (2005). ‘Thinking for Two’: a case study of speech and language therapists working through assistants. International Journal of Language and Communication Disorders, 40, 221-235.
  3. Boyle, J., McCartney, E., Forbes, J. & O’Hare, A. (2007). A randomised controlled trial and economic evaluation of direct versus indirect and individual versus group modes of speech and language therapy for children with primary language impairment. Health Technology Assessment, 11 (25), 1-158.
  4. McCartney, E. (2007). The Language Therapy Manual. University of Strathclyde, http://strathprints.strath.ac.uk/32807/
  5. Boyle, J., McCartney, E., O'Hare, A., & Forbes, J. (2009). Direct versus indirect and individual versus group modes of language therapy for children with primary language impairment: principal outcomes from a randomised controlled trial and economic evaluation. International Journal of Language and Communication Disorders, 44, 6, 826-846.
  6. Dickson, K., Marshall, M., Boyle, J., McCartney, E., O'Hare, A., & Forbes, J. (2009). Cost analysis of direct versus indirect and individual versus group modes of manual based speech and language therapy for primary school-age children with primary language impairment. International Journal of Language and Communication Disorders, 44, 3, 369-381.
  7. Boyle, J., McCartney, E., O'Hare, A., & Law, J. (2010). Intervention for receptive language disorder: a commissioned review. Developmental Medicine and Child Neurology, 52, 11, 994-999.