Background & aims

Difficulties understanding spoken language are associated with several social and academic risks in school-age children and adolescents with developmental language disorder (DLD). Still, interventions for this group have received little attention, and there are no reviews focusing on oral language comprehension interventions in school-age children and adolescents. The objective of this systematic scoping review was to identify interventions targeting oral language comprehension in school-age children and adolescents with DLD. Further, the aim was to examine the focus of intervention, efficacy, and level of evidence of the identified interventions. The present review is the second part of a larger search on oral language comprehension interventions. The first review examined the same factors in children 8 years and younger.

Methods

A systematic scoping review of eight databases was conducted. Of the 2399 sourced articles, 12 met the inclusion criteria. Another 8 articles were identified through reference lists of sourced articles. In these 20 articles, containing 21 studies, 1661 children aged 5–16 years participated. The data were extracted and analysed, and the intervention focus, efficacy, and level of evidence were examined.

Main contribution: In the interventions intended for school-age children and adolescents with DLD, three intervention foci were identified that targeted aspects of language and language processing, as well as modifying the communicative environment. Of the included studies, 57% reported positive results, 14% reported mixed results, and 29% reported no effects on oral language comprehension. The level of evidence varied. One can have high confidence in the results of 19%, moderate in 38%, and indicative confidence in 43% of the included studies.

Conclusions

Results of the present review suggest that there are a few interventions providing high confidence on the efficacy of improving oral language comprehension difficulties in school-age children and adolescents with DLD. Most interventions indicating efficacy provide moderate or indicative confidence in the results. More research with a high level of evidence is urgently needed. Most of the interventions indicating efficacy focused directly on language skills or modified the communicative environment. The results suggest that the therapy techniques focusing on improving language processing skills indicate efficacy only when they aim at compensating current language processing skills, not trying to improve them.

Implications: The findings on different therapy techniques, their focus of intervention, efficacy, and level of evidence provide information for clinical practice and direct future investigations in this sparsely researched topic.

中文翻译：

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患有发展性语言障碍的学龄儿童和青少年的口语理解干预措施：系统范围界定审查

 背景和目标

对于患有发育性语言障碍 (DLD) 的学龄儿童和青少年来说，理解口语的困难与多种社会和学业风险有关。尽管如此，针对这一群体的干预措施却很少受到关注，也没有针对学龄儿童和青少年口语理解干预措施的评论。本次系统范围审查的目的是确定针对患有 DLD 的学龄儿童和青少年口语理解的干预措施。此外，目的是检查干预的重点、功效和已确定干预措施的证据水平。本综述是口语理解干预大规模研究的第二部分。第一项审查在 8 岁及以下儿童中检查了相同的因素。

 方法

对八个数据库进行了系统范围审查。在 2399 篇来源文章中，有 12 篇符合纳入标准。另外 8 篇文章是通过来源文章的参考列表确定的。这 20 篇文章包含 21 项研究，共有 1661 名 5-16 岁儿童参与。提取和分析数据，并检查干预重点、有效性和证据水平。

主要贡献：在针对患有 DLD 的学龄儿童和青少年的干预措施中，确定了三个干预重点，分别针对语言和语言处理方面以及改变交际环境。在纳入的研究中，57% 报告了积极结果，14% 报告了混合结果，29% 报告对口语理解没有影响。证据水平各不相同。在纳入的研究中，19% 的人对结果有高度信心，38% 的人对结果有中等信心，43% 的人对结果有指示性信心。

 结论

本综述的结果表明，一些干预措施对改善患有 DLD 的学龄儿童和青少年口语理解困难的功效提供了很高的信心。大多数表明功效的干预措施对结果提供了中等或指示性的信心。迫切需要更多具有高水平证据的研究。大多数表明有效的干预措施直接关注语言技能或改变交流环境。结果表明，专注于提高语言处理技能的治疗技术只有在旨在补偿当前的语言处理技能而不是试图提高它们时才显示出有效性。

意义：关于不同治疗技术、干预重点、疗效和证据水平的研究结果为临床实践提供了信息，并指导了这一研究较少的主题的未来研究。