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 Vol.41 233-264 July 2010. doi:10.1044/0161-1461(2009/08-0128)
© American Speech-Language-Hearing Association
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
The University of North Carolina at Greensboro
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: email@example.com .
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.
KEY WORDS: service delivery models, pullout, classroom based, indirect–consultative, evidence-based practice
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