Quality of Treatment Research Designs: Lessons from a Systematic Review on CILT for Aphasia

The importance of evidence-based clinical practice has led to an effort by ASHA to develop a series of systematic reviews of treatment research to serve as a resource for its members. The first review has centered on constraint-induced language therapy for aphasia. The procedures implemented in the systematic review pertaining to the quality of treatment research investigations have the potential to incite controversy and discussion in the community of aphasia treatment researchers. This presentation is designed to engage the audience in a discussion that will influence the format of study appraisal guidelines for ongoing systematic reviews

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 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