Article  |   July 2010
Evidence-Based Systematic Review: Effects of Different Service Delivery Models on Communication Outcomes for Elementary School–Age Children
Author Affiliations & Notes
  • Frank M. Cirrin
    Minneapolis Public Schools, MN
  • Tracy L. Schooling
    National Center for Evidence-Based Practice in Communication Disorders, Rockville, MD
  • Nickola W. Nelson
    Western Michigan University, Kalamazoo
  • Sylvia F. Diehl
    University of South Florida, Tampa
  • Perry F. Flynn
    North Carolina Department of Public Instruction, Raleigh
  • Maureen Staskowski
    Macomb Intermediate School District, Clinton Township, MI
  • T. Zoann Torrey
    Kansas State Department of Education (Retired), Topeka
  • Deborah F. Adamczyk
    American Speech-Language-Hearing Association, Rockville, MD
  • Contact author: Frank M. Cirrin, Minneapolis Public Schools/Special Education, 425 5th Street, NE, Minneapolis, MN 55413. E-mail: fcirrin@mpls.k12.mn.us.
School-Based Settings / Research Issues, Methods & Evidence-Based Practice
Article   |   July 2010
Evidence-Based Systematic Review: Effects of Different Service Delivery Models on Communication Outcomes for Elementary School–Age Children
Language, Speech, and Hearing Services in Schools July 2010, Vol.41, 233-264. doi:10.1044/0161-1461(2009/08-0128)
History: Accepted 22 Apr 2009 , Received 09 Dec 2008 , Revised 03 Mar 2009
Language, Speech, and Hearing Services in Schools July 2010, Vol.41, 233-264. doi:10.1044/0161-1461(2009/08-0128)
History: Accepted 22 Apr 2009 , Received 09 Dec 2008 , Revised 03 Mar 2009

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.

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