They evaluated the
outcomes of treatment in general compared with no
treatment, using a waiting list control method. They
found that the children who received treatment made
268 Karen M. Smith-Lock et al.
significantly more progress than those who were untreated
(i.e. more progress than maturation alone) even
though the study included children with significant difficulties
in all three primary categories of comprehension,
expressive language and speech.
One study has examined the effectiveness of a language
intervention programme which included expressive
grammar as one of several language goals, in place in
the community. Gallagher and Chiat (2009) compared
three groups. One group received an intensive language
treatment programme delivered by a speech pathologist;
a second group received a nursery-based programme in
which a speech pathologist consulted to nursery teachers
who provided treatment; and a third group was a
no intervention waiting list control. Participants were
4- and 5-year-old children with severe expressive and/or
receptive language impairment. Treatment was delivered
by community-based speech pathologists and nursery
teachers (not researchers) and targeted a variety of language
goals. They found that children in the intensive
treatment group improved significantly more than the
children in the nursery and the no intervention groups
on comprehension of grammar, comprehension of vocabulary,
expressive vocabulary and expressive information,
but not expressive grammar. The progress of the
nursery group did not differ from the no intervention
group on most measures. These findings suggest that
treatment provided by nursery teachers via consultation
with speech pathologists may be less effective than treatment
provided directly by speech pathologists.However,
the intervention groups in this study differed in many
ways in addition to the treatment agent. These include
dosage, the range of techniques employed and the experience
of the clinicians providing treatment. Such factors
would have been controlled in an efficacy study.
However, the significance of this study is that it examined
effectiveness of two programmes delivered in the
community, and importantly, evaluated the outcome of
a change made in the provision of community speech
pathology services.
In summary, while there is some evidence for the
efficacy of interventions targeted specifically at expressive
grammar, there is limited evidence to date for the
effectiveness of such interventions delivered in real-life
situations, such as school classrooms. Available effectiveness
research has typically examined entire community
services, rather than the effectiveness of specific,
targeted grammar intervention. While Gallagher and
Chiat (2009) provided evidence for effective language
intervention when provided directly by speech pathologists,
the results were less successful when a consultative
model was applied in a nursery.