Evidence-Based Systematic Review: Effects of Different Service Delivery Models on Communication Outcomes for Elementary School–Age Children 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 ... Article
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.
  • © 2010 American Speech-Language-Hearing AssociationAmerican Speech-Language-Hearing Association
Article Information
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: Received December 9, 2008 , Revised March 3, 2009 , Accepted April 22, 2009
 
Language, Speech, and Hearing Services in Schools, July 2010, Vol. 41, 233-264. doi:10.1044/0161-1461(2009/08-0128)
History: Received December 9, 2008; Revised March 3, 2009; Accepted April 22, 2009
Web of Science® Times Cited: 16

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.

ACKNOWLEDGMENTS
The authors gratefully acknowledge the resources of the American Speech-Language-Hearing Association and the National Center for Evidence-Based Practice in Communication Disorders that made this EBSR possible, and particularly, the contributions of Rob Mullen, Tobi Frymark, and Hillary Leech.
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