Abstract
Background: A manualized language therapy developed via a randomized controlled trial had proved efficacious in the short-term in developing expressive language for mainstream primary school children with persistent language impairment. This therapy had been delivered to a predetermined schedule by speech and language therapists or speech and language therapy assistants to children individually or in groups. However, this model of service delivery is no longer the most common model in UK schools, where indirect consultancy approaches with intervention delivered by school staff are often used.
Aims: A cohort study was undertaken to investigate whether the therapy was equally efficacious when delivered to comparable children by school staff, rather than speech and language therapists or speech and language therapy assistants.
Methods & Procedures: Children in the cohort study were selected using the same criteria as in the randomized controlled trial, and the same manualized therapy was used, but delivered by mainstream school staff using a consultancy model common in the UK. Outcomes were compared with those of randomized controlled trial participants.
Outcomes & Results: The gains in expressive language measured in the randomized controlled trial were not replicated in the cohort study. Less language-learning activity was recorded than had been planned, and less than was delivered in the randomized controlled trial. Implications for ‘consultancy’ speech and language therapist service delivery models in mainstream schools are outlined.
Conclusions & Implications: At present, the more efficacious therapy is that delivered by speech and language therapists or speech and language therapy assistants to children individually or in groups. This may be related to more faithful adherence to the interventions schedule, and to a probably greater amount of language-learning activity undertaken. Intervention delivered via school-based 'consultancy' approaches in schools will require to be carefully monitored by schools and SLT services.
Acknowledgements
The randomised controlled trial was funded by the (then) National Co-ordinating Centre for Health Technology Assessment (NCCHTA) (project Number 99/36/04). A copy of the final report (Boyle et al. 2007) can be downloaded via http://www.hta.ac.uk/project/1232.asp. The cohort study was funded by the Chief Scientist Office (Scotland) through the West of Scotland Research and Development Partnership (Project Number FV PC 56). The views expressed in this paper are those of the authors alone and not necessarily those of the funding bodies. Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.
Notes
1. Details of how the therapy manual was constructed and audited appear in CitationMcCartney et al. (2004); for the full manual, see: http://www.strath.ac.uk/eps/centresdivisions/slt/teachingresources/.
2. Cf. their Language Support Model for Teachers at: http://www.strath.ac.uk/eps/courses/slt/lms.html; and McCartney et al. (2010).