Please use this identifier to cite or link to this item:
Appears in Collections:Faculty of Social Sciences Journal Articles
Peer Review Status: Refereed
Title: Direct versus indirect and individual versus group modes of language therapy for children with primary language impairment: principal outcomes from a randomized controlled trial and economic evaluation
Author(s): Boyle, James
McCartney, Elspeth
O'Hare, Anne E
Forbes, John F
Contact Email:
Keywords: speech and language therapy
randomized control trial (RCT)
developmental language impairment
expressive language
receptive language
Issue Date: 30-Nov-2009
Date Deposited: 6-Nov-2018
Citation: Boyle J, McCartney E, O'Hare AE & Forbes JF (2009) Direct versus indirect and individual versus group modes of language therapy for children with primary language impairment: principal outcomes from a randomized controlled trial and economic evaluation. International Journal of Language and Communication Disorders, 44 (6), pp. 826-846.
Abstract: BACKGROUND: Many school-age children with language impairments are enrolled in mainstream schools and receive indirect language therapy, but there have been, to the authors' knowledge, no previous controlled studies comparing the outcomes and costs of direct and indirect intervention delivered by qualified therapists and therapy assistants, and each delivery mode offered to children individually or in groups. AIMS: To investigate the relative effectiveness of indirect and direct intervention therapy modes delivered individually or in groups for children with primary language impairment. METHODS & PROCEDURES: A multi-centre randomized controlled trial investigated 161 children with primary language impairment aged 6-11 years randomized to a usual-therapy control group or to direct individual, indirect individual, direct group or indirect group therapy modes. Intervention was delivered three times a week for 30-40-min sessions in mainstream schools over 15 weeks. Language performance was assessed at baseline, post-therapy and at 12 months. Cost analysis was based on salary and travel costs for intervention modes and usual therapy. OUTCOMES & RESULTS: Compared with controls, children receiving project therapy made short-term improvements in expressive (p = 0.031), but not receptive, language immediately following intervention. Children with specific expressive language delay were more likely to show improvement than those with mixed receptive-expressive difficulties. The four project therapy modes did not differ on primary language outcomes (all p-values>0.392) and there were no further improvements evident at follow-up. Indirect group therapy was the least costly mode, with direct individual therapy the most costly. CONCLUSIONS & IMPLICATIONS: Intervention in this age group can be effective for expressive language and can be delivered equally effectively though speech and language therapy assistants and to children in groups.
DOI Link: 10.1080/13682820802371848
Rights: The publisher does not allow this work to be made publicly available in this Repository. Please use the Request a Copy feature at the foot of the Repository record to request a copy directly from the author. You can only request a copy if you wish to use this work for your own research or private study.
Licence URL(s):

Files in This Item:
File Description SizeFormat 
McCartney_International_Journal_of_Language_and_Communication_Disorders_v44(6)_2009.pdfFulltext - Published Version380.37 kBAdobe PDFUnder Permanent Embargo    Request a copy

Note: If any of the files in this item are currently embargoed, you can request a copy directly from the author by clicking the padlock icon above. However, this facility is dependent on the depositor still being contactable at their original email address.

This item is protected by original copyright

Items in the Repository are protected by copyright, with all rights reserved, unless otherwise indicated.

The metadata of the records in the Repository are available under the CC0 public domain dedication: No Rights Reserved

If you believe that any material held in STORRE infringes copyright, please contact providing details and we will remove the Work from public display in STORRE and investigate your claim.