LSHSS Papers in Press
Published online April 26, 2010
Language, Speech, and Hearing Services in Schools 2010; doi:10.1044/0161-1461(2009/08-0128)

Language, Speech, and Hearing Services in Schools 2010;41:233.

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Article

Evidence-Based Systematic Review: Effects of Speech-Language Pathology Service Delivery Model on Communication Outcomes for Elementary School-age Children

Frank M. Cirrin
Minneapolis Pubic Schools

Tracy L. Schooling
National Center for Evidence-Based Practice in Communication Disorders

Nickola Wolf Nelson
Western Michigan University

Sylvia F. Diehl
University of South Florida

Perry F. Flynn
North Carolina Department of Public Instruction & University of North Carolina Greensboro

Maureen Staskowski
Macomb Intermediate School District

T. Zoann Torrey
Kansas State Department of Education, Retired

Deborah F. Adamczyk
American Speech-Language-Hearing Association

Corresponding author: Frank M. Cirrin, Minneapolis Public Schools/Special Education, 425 5th St. NE, Minneapolis, MN 55413. E-mail: fcirrin{at}mpls.k12.mn.us.

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 service delivery model on speech-language intervention outcomes for elementary school-age students.

Method: A computer search was conducted of electronic databases 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 trials, non-randomized comparison studies, and single-subject design studies.

Results: This EBSR revealed a total of 5 studies that met 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 SLP assistants, using SLP-prepared manuals to guide intervention, can provide effective services for some children with language problems.

Conclusions: Lacking adequate research-based evidence, clinicians must rely on reason-based practice and their own data until more data become available about 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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