Speech Pathology

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Randomised controlled trial of community based legal transfer
and language therapy in preschool children
Margaret Glogowska, Sue Roulstone, Pam Enderby, Tim J Peters

Abstract
Objective To compare routine words and language
therapy in preschool children with delayed talking to
and language against 12 months of awake(p) waiting.
design Pragmatic randomised controlled trial.
Setting 16 community clinics in Bristol.
Participants 159 preschool children with appreciable
speech or language difficulties who fulfilled criteria for
admission to speech and language therapy.
Main outcome measures Four quantitative measures
of speech and language, assessed at 6 and 12 months;
a binary changeable indicating amelioration, by 12
months, on the trial entry criterion.
Results Improvement in auditory comprehension was
significant in favour of therapy (adjusted contravention in
means 4.1, 95% confidence interval 0.5 to 7.6;
P = 0.025). No significant differences were observed
for expressive language (1.4, ? 2.1 to 4.8; P = 0.44);
phonology misconduct rate ( ? 4.4, ? 12.0 to 3.3; P = 0.26);
language development (0.1, ? 0.4 to 0.6; P = 0.73); or
improvement on entry criterion (odds ratio 1.3, 0.67
to 2.4; P = 0.46).



At the end of the trial, 70% of all
children still had substantial speech and language
deficits.
Conclusions This claim provides little evidence for
the effectiveness of speech and language therapy
compared with watchful waiting over 12 months.
Providers of speech and language therapy should
see the appropriateness, timing, nature, and
intensity of such therapy in preschool children.
Continued research into much specific provision to
subgroups of children is also necessary to identify better
discourse methods. The lack of resolution of
difficulties for most of the children suggests that
further research is needed to identify effective ways of
helping this population of children.

Introduction
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