Efficacy, model of delivery, intensity and targets of pragmatic interventions for children with developmental language disorder: A systematic review.
Kristine M Jensen de López, Jelena Kuvač Kraljević, Emilie L Bang Struntze
PMID 35445482WHAT IT FOUND
Five of eleven studies found significant gains in pragmatic language after intervention, but the targets, measures, and doses varied so much that no single approach can be recommended.
The evidence is too thin to change how you treat a child's conversational or narrative skills.
Key findings
01Five of the eleven included studies reported significant improvement in pragmatic language outcomes, with the authors describing effect sizes from 0.04 to 1.50.
02A prior systematic search found significantly fewer intervention studies targeting pragmatics than those targeting grammar, vocabulary, or phonology in children with DLD.
03Seven of the eleven interventions were delivered indirectly by parents, teaching assistants, or other trained professionals, and four were delivered directly by a specialist.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The 11 included studies used different targets, different outcome measures, and different doses, so they cannot be compared directly or pooled. Several individual studies had small samples (as few as 3 children in one study) and high or unclear risk of bias in selection, performance, and detection domains. Half of the studies had no follow-up period, so there is no evidence that any gains were maintained. Only one study was conducted in a non-English-speaking country (Italy), and all participants were monolingual, so the findings do not extend to multilingual children. The review is a narrative synthesis, not a meta-analysis, so no overall effect size can be calculated.
Declared interests
The authors declare no known conflict of interest. The review was conducted as part of European COST Action 1406, a publicly funded research network.
The easy way to misread this
Do not read the five positive studies as proof that pragmatic intervention works for all children with DLD. The six studies that found no effect used different targets and measures, and the positive studies had high or unclear risk of bias in several domains. The authors themselves state that the results did not show a clear picture of which aspects of pragmatics lead to improvement.
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