Susan Ellis Weismer, Ph.D., CCCSLP

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Susan Ellis Weismer, Ph.D., CCC-SLP University of
Wisconsin-Madison Department of Communicative
Disorders Waisman Center sweismer_at_facstaff.wisc.e
du http//www.waisman.wisc.edu/lpl/
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• What are the recent research findings
• regarding treatment efficacy for child
• language disorders?

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Meta-Analysis of Group-Design Treatment Studies
Law, Boyle, Harris, Harkness, and Nye
(1998) PAreas language indicated positive and statistically
significant effects of intervention
compared to untreated controls for all
areas
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META-ANALYSIS OF TREATMENT RESEARCHLaw et al.
(1998)
Figure 1 Overall Mean Effect Sizes (with 95
Confidence Intervals)
Artic./
Phonol.
Aud.-
Discrim.
Area of Language
Expressive
Receptive
-.5
1.0
1.5
2.0
0.0
.5
Standardized Effect Size (d)
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Reviews of Treatment Studies
P Evidence supporting the use of various
treatment approaches - Single-case design
studies - Randomized group design
studies (Ellis Weismer, 2000a,b Gallagher,
1998 Leonard, 1998 Warren Yoder, in press)
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Conclusions Based on Reviews of Treatment
Research
P A variety of intervention approaches are
effective in facilitating language abilities P
Treatment effects have been demonstrated for
immediate performance on training targets as
well as for more generalized language
abilities
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Conclusions
P Most intervention studies have focused on
morphosyntactic or semantic goals P There has
been limited examination of pragmatic
goals P Some evidence suggests language
treatment can positively impact phonological
skills
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Conclusions
P There is evidence to support the use of
indirect treatment approaches
- Parent-based approaches are effective - Peers
can serve as effective models
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What are important treatment efficacy questions
that need to be addressed?
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Areas of Importance for Future Language
Treatment Research
P Focus on establishing effectiveness of early
intervention P Determine how treatments
interface with child characteristics at
specific points in development P Use
treatment efficacy research to gain insights
into the nature of disorders P Examine
functional outcomes and impact on related
areas such as socialization and academic
performance
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Examining Treatment Effects In Terms of Levels
of Functioning (World Health Organization, 2001)
P Impairment P Activity limitation (disability) P
Participation restriction (handicap) (see
Olswang, 1998)
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How can we predict clinical success for children
with language impairment?
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Factors that Contribute to Clinical Success
P Developmental readiness (dynamic
assessment) P Child characteristics P Matching
instructional methods with childs cultural
background, learning style, interest P Clinician
competencies, beliefs, attitudes P Rapport
between clinician and child P Support of
treatment goals by family, teachers
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Non-Specific Treatment Variables Haley,
Camarata, Nelson (1994). Social valence in
children with specific language impairment during
imitation-based and conversation-based
intervention. JSHR.
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Social Valence (Bloom, 1993)
Degree to which child emits positive, neutral,
or negative verbal or non-verbal behaviors during
treatment activities (per Haley et al., 1994)
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Haley et al. (1994)
P Both treatment types predominantly
associated with positive social valence P
However, significantly more positive behaviors
(smiling, laughing, engagement in activities)
noted for the conversation-based treatment P
Negative social valence (expressions of
boredom or dislike) more frequent for
imitation-based treatment
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Role of Non-Specific Treatment Variables in
Clinical Success
P Responsiveness to ongoing intervention P
Treatment outcomes

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References
Bloom, L. (1993). The transition from infancy
to language Acquiring the power of expression.
Cambridge Cambridge University Press. Ellis
Weismer, S. (2000a). Language intervention for
children with developmental language delay. In D.
Bishop L. Leonard (Eds). Speech and language
impairmentsFrom theory to practice, 157-176.
Psychology Press. Ellis Weismer, S. (2000b).
Language intervention for young children with
language impairments. In L. Watson, E. Crais,
T. Layton (Eds.), Handbook of early language
impairment in children Assessment and treatment,
173-198. Albany, NYDelmar/Thomson
Learning. Gallagher, T. (1998). Treatment
research in speech, language and swallowing
Lessons from child language disorders. Folia
Phoniatrica et Logopaedica, 50, 165-182.

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References, cont. Haley, K., Camarata, S.,
Nelson, K. (1994). Social valence in children
with specific language impairment during
imitation-based and conversation-based language
intervention. Journal of Speech and Hearing
Research, 37, 378-388. Law, J., Boyle, J.,
Harris, F., Harkness, A., Nye, C. (1998).
Screening for speech and language delay A
systematic review of the literature. Health
Technology Assessment, 2(9). Leonard, L.
(1998). Children with specific language
impairment. Cambridge, MA The MIT
Press. Olswang, L. (1998). Treatment efficacy
research. In C. Frattali (Ed.), Measuring
outcomes in speech-language pathology (pp.
134-150). New York Thieme New York.
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References, cont. Warren, S., Yoder, P. (in
press). Early intervention for young children
with language impairments. In L. Verhoeven H.
van Balkom (Eds.), Developmental language
disorders Etiology, classification, and
treatment. Amsterdam Lawrence Erlbaum
Associates. World Health Organization, 2001.
http//www.who.int/icidh/brochure/concepts.htm