Efficacy, model of delivery, intensity and targets of pragmatic interventions for children with developmental language disorder: A systematic review

• Published in: International journal of language & communication disorders 2022-07, Vol.57 (4), p.764-781
• Main Authors: Jensen de López, Kristine M., Kraljević, Jelena Kuvač, Struntze, Emilie L. Bang
• Format: Article
• Language: English
• Subjects: Autism; Children; Comparative Analysis; Developmental Delays; Developmental disabilities; developmental language disorder; Grammar; intensity; Intervention; Language disorders; Language Impairments; model of delivery; Monolingualism; Narratives; Native language acquisition; Oral Language; Parent Child Relationship; Parent-child relations; pragmatic skills; Pragmatics; Pretests Posttests; Randomized Controlled Trials; Research Reports; Skill Development; Spoken language; Story Reading; Systematic review; targets; Teaching Methods; Vocabulary Skills
• ISSN: 1368-2822; 1460-6984
• DOI: 10.1111/1460-6984.12716

Background It is widely acknowledged that children with developmental language disorder (DLD) predominantly have difficulties in the areas of grammar and vocabulary, with preserved pragmatic skills. Consequently, few studies focus on the pragmatic skills of children with DLD, and there is a distinct lack of studies examining the effectiveness of pragmatic interventions. Aims To carry out a systematic review of the literature on pragmatic interventions for children with DLD. Methods & Procedures This systematic review was registered with PROSPERO (ID = CRD42017067239). A systematic search in seven databases yielded 1031 papers, of which 11 met our inclusion criteria. The included papers focused on interventions for children with DLD (mean = 3–18 years), enhancing oral language pragmatic skills, published between January 2006 and May 2020, and were based on a group‐study design such as randomized control trial or pre‐post‐testing. Study participants were monolingual speakers. The quality of papers was appraised using the Cochrane Risk of bias tool for randomized controlled trials. Outcomes & Results There was a high degree of variability between the included intervention studies, especially regarding intensity, intervention targets and outcomes. The evidence suggested that pragmatic intervention is feasible for all models of delivery (individual, small and large group) and that interventions for pragmatic language are mostly focused on encouragement of conversation and narrative skills observed through parent–child interaction or shared book‐reading activities. Conclusions & Implications This study highlights the importance of promoting and explicitly teaching pragmatic skills to children with DLD in structured interventions. A narrative synthesis of the included studies revealed that in addition to direct intervention, indirect intervention can also contribute to improving oral pragmatic skills of children with DLD. What this paper adds What is already known on the subject? An increasing number of studies have shown that difficulties in acquiring pragmatic language is not only present in children with autism. What this study adds to existing knowledge? Interventions for pragmatic language in children with DLD are mostly focused on encouragement of conversation and narrative skills, very often through parent–child interaction or shared book‐reading activities. Interventions that target language pragmatic are feasible for all models of delivery (individual, s