Randomised controlled trial of community based speech and language therapy in preschool children
Editorial: Treating children with speech and language impairments
The effectiveness of speech and language therapy compared with "watchful waiting" for preschool children is called into question in this week's BMJ. The study suggests that providers of speech and language therapy services should reconsider the therapy offered to preschool children.
Glogowska and colleagues identified 159 preschool children with speech or language difficulties. The children were randomised to receive one-to-one therapy or to "watchful waiting" over a period of 12 months. The authors found that therapy was not effective compared with watchful waiting and, after one year, 70% of all the children in the study still had substantial speech and language deficits.
Despite some limitations, this trial is by far the largest to date investigating the effectiveness of speech and language therapy in preschool children. Such a low rate of resolution of difficulties for most of the children suggests that further research is needed to identify effective ways of helping these children, conclude the authors.
In an accompanying editorial, Gina Conti-Ramsden and James Law argue that there are some features of this study that should be interpreted with caution. For instance, the authors point out that the children spent on average just six hours with their therapist in 12 months. Offering limited amounts of speech and language therapy is not a tenable solution to the problem, they say. A reorganisation of speech and language therapy services is required to enable therapists to offer a more flexible package of interventions to children in the UK, they conclude.
Contacts:
[Paper] Sue Roulstone, Clinical Research Director, Speech and Language Therapy Research Unit, Frenchay Hospital, Bristol, UK
Email: sue@speech-therapy.org.uk
[Editorial] Gina Conti-Ramsden, Professor of Child Language and Learning, University of Manchester, UK
Email: gina.conti-ramsden@man.ac.uk
James Law, Reader in Language and Communication Science, City University, London, UK
Email: j.c.law@city.ac.uk