Effects of computer-based intervention through acoustically modified speech (Fast ForWord) in severe mixed receptive-expressive language impairment: outcomes from a randomized controlled trial.

Seventy-seven children between the ages of 6 and 10 years, with severe mixed receptive-expressive specific language impairment (SLI), participated in a randomized controlled trial (RCT) of Fast ForWord (FFW; Scientific Learning Corporation, 1997, 2001). FFW is a computer-based intervention for treating SLI using acoustically enhanced speech stimuli. These stimuli are modified to exaggerate their time and intensity properties as part of an adaptive training process. All children who participated in the RCT maintained their regular speech and language therapy and school regime throughout the trial. Standardized measures of receptive and expressive language were used to assess performance at baseline and to measure outcome from treatment at 9 weeks and 6 months. Children were allocated to 1 of 3 groups. Group A (n = 23) received the FFW intervention as a home-based therapy for 6 weeks. Group B (n = 27) received commercially available computer-based activities designed to promote language as a control for computer games exposure. Group C (n = 27) received no additional study intervention. Each group made significant gains in language scores, but there was no additional effect for either computer intervention. Thus, the findings from this RCT do not support the efficacy of FFW as an intervention for children with severe mixed receptive-expressive SLI.

[1]  J Bruce Tomblin,et al.  A longitudinal investigation of reading outcomes in children with language impairments. , 2002, Journal of speech, language, and hearing research : JSLHR.

[2]  V. Hill Through the Past Darkly: A Review of the British Ability Scales Second Edition. , 2005, Child and adolescent mental health.

[3]  H. Catts,et al.  The relationship between speech-language impairments and reading disabilities. , 1993, Journal of speech and hearing research.

[4]  Marc E. Fey,et al.  Language Changes Associated With Fast ForWord-Language , 2001 .

[5]  Robert Needlman,et al.  Speech and Language Impairments in Children: Causes, Characteristics, Intervention, and Outcome , 2001 .

[6]  P Tallal,et al.  Selection of children with specific language deficits. , 1981, The Journal of speech and hearing disorders.

[7]  D. Sackett Evidence-Based Medicine: How to Practice and Teach EBM , 2018 .

[8]  P Tallal,et al.  Rapid auditory processing in normal and disordered language development. , 1976, Journal of speech and hearing research.

[9]  Guinevere F. Eden,et al.  Effect of intensive training on auditory processing and reading skills , 2004, Brain and Language.

[10]  G. A. Troia,et al.  A close look at the efficacy of Fast ForWord Language for children with academic weaknesses , 2003 .

[11]  Linda J. Lombardino,et al.  Deficits in auditory temporal and spectral resolution in language-impaired children , 1997, Nature.

[12]  A. Baddeley,et al.  Phonological memory deficits in language disordered children: Is there a causal connection? ☆ , 1990 .

[13]  J. Tomblin,et al.  Explaining and controlling regression to the mean in longitudinal research designs. , 2003, Journal of speech, language, and hearing research : JSLHR.

[14]  L Atkinson,et al.  Fourteen-year follow-up of children with and without speech/language impairments: speech/language stability and outcomes. , 1999, Journal of speech, language, and hearing research : JSLHR.

[15]  J. Law,et al.  Speech and language therapy interventions for children with primary speech and language delay or disorder. , 2003, Cochrane Database of Systematic Reviews.

[16]  J. Montgomery Sentence comprehension in children with specific language impairment: the role of phonological working memory. , 1995, Journal of speech and hearing research.

[17]  Steven L. Miller,et al.  Temporal Processing Deficits of Language-Learning Impaired Children Ameliorated by Training , 1996, Science.

[18]  Jacob Cohen Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[19]  J. Raven Coloured progressive matrices : sets A, Ab, B , 1956 .

[20]  Steven L. Miller,et al.  Neural deficits in children with dyslexia ameliorated by behavioral remediation: Evidence from functional MRI , 2003, Proceedings of the National Academy of Sciences of the United States of America.

[21]  R. Gillam,et al.  Language Change Following Computer-Assisted Language Instruction with Fast ForWord or Laureate Learning Systems Software. , 2001 .

[22]  C Donlan,et al.  Nonword repetition as a behavioural marker for inherited language impairment: evidence from a twin study. , 1996, Journal of child psychology and psychiatry, and allied disciplines.

[23]  Ronald B Gillam,et al.  Computer-Assisted Language Intervention Using Fast ForWord®: Theoretical and Empirical Considerations for Clinical Decision-Making. , 1999, Language, speech, and hearing services in schools.

[24]  Mark C. Wilson Evidence-Based Medicine: How to Practice and Teach EBM , 2001, ACP Journal Club.

[25]  R. Carlyon,et al.  Auditory temporal processing impairment: neither necessary nor sufficient for causing language impairment in children. , 1999, Journal of speech, language, and hearing research : JSLHR.

[26]  P. Lachenbruch Statistical Power Analysis for the Behavioral Sciences (2nd ed.) , 1989 .

[27]  J. Démonet,et al.  Phonological training in children with dyslexia using temporally modified speech: a three-step pilot investigation. , 2002, International journal of language & communication disorders.

[28]  S. Friel-Patti,et al.  Case Studies of Children Using Fast ForWord , 2001 .

[29]  S. Bradley-Johnson,et al.  Test of Language Development‐Primary: Third edition , 1998 .

[30]  James Law,et al.  Speech and language therapy interventions for children with primary speech and language delay or disorder (Cochrane Review) , 2003 .

[31]  P. Tallal,et al.  Relation between speech perception and speech production impairment in children with developmental dysphasia , 1976, Brain and Language.

[32]  Susan E. Stothard,et al.  Educational attainments of school leavers with a preschool history of speech-language impairments. , 2001, International journal of language & communication disorders.

[33]  Steven G Zecker,et al.  Nonlinguistic perceptual deficits associated with reading and language disorders , 2000, Current Opinion in Neurobiology.

[34]  I. Chalmers Unbiased, relevant, and reliable assessments in health care , 1998, BMJ.

[35]  D. Sackett Evidence-based medicine: how to practice and teach EBM: 2nd ed , 2000 .

[36]  M. Studdert-Kennedy,et al.  Speech perception deficits in poor readers: auditory processing or phonological coding? , 1997, Journal of experimental child psychology.

[37]  E. Plante,et al.  Criteria for SLI: the Stark and Tallal legacy and beyond. , 1998, Journal of speech, language, and hearing research : JSLHR.

[38]  P. Hook,et al.  Efficacy of Fast ForWord training on facilitating acquisition of reading skills by children with reading difficulties—A longitudinal study , 2001 .

[39]  H. V. D. Lely,et al.  Binding theory and grammatical specific language impairment in children , 1997, Cognition.

[40]  K. Beattie The effects of intensive computer-based language intervention on language functioning and reading achievement in language-impaired adolescents , 2000 .

[41]  R. Olson,et al.  Individual differences in gains from computer-assisted remedial reading. , 2000, Journal of experimental child psychology.

[42]  Stuart Rosen,et al.  Auditory processing in dyslexia and specific language impairment: is there a deficit? What is its nature? Does it explain anything? , 2003, J. Phonetics.

[43]  Heather K. J. van der Lely,et al.  Specifically language impaired and normally developing children : Verbal passive vs. adjectival passive sentence interpretation , 1996 .

[44]  D. Cantwell,et al.  A prospective psychiatric follow-up of children with speech/language disorders. , 1987, Journal of the American Academy of Child and Adolescent Psychiatry.

[45]  A. O'Connor The Cochrane Database of Systematic Reviews , 2004 .

[46]  D. Bishop,et al.  A prospective study of the relationship between specific language impairment, phonological disorders and reading retardation. , 1990, Journal of child psychology and psychiatry, and allied disciplines.

[47]  P Tallal,et al.  Developmental aphasia: impaired rate of non-verbal processing as a function of sensory modality. , 1973, Neuropsychologia.

[48]  J. Law,et al.  Prevalence and natural history of primary speech and language delay: findings from a systematic review of the literature. , 2000, International journal of language & communication disorders.

[49]  Charles Hulme,et al.  Words, nonwords, and phonological processes: Some comments on Gathercole, Willis, Emslie, and Baddeley , 1991, Applied Psycholinguistics.

[50]  P. Tallal Experimental Studies of Language Learning Impairment: From Research to Remediation , 1999 .

[51]  G. Conti-Ramsden,et al.  Educational transitions of 7-year-old children with SLI in language units: a longitudinal study. , 1998, International journal of language & communication disorders.

[52]  Susan E. Stothard,et al.  Language-impaired preschoolers: a follow-up into adolescence. , 1998, Journal of speech, language, and hearing research : JSLHR.

[53]  D. Loeb,et al.  Looking Back: A Summary of Five Exploratory Studies of Fast ForWord. , 2001 .

[54]  W M Jenkins,et al.  Speech modifications algorithms used for training language learning-impaired children. , 1998, IEEE transactions on rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society.

[55]  L B Leonard,et al.  Grammatical morphology and speech perception in children with specific language impairment. , 1992, Journal of speech and hearing research.

[56]  G. Conti-Ramsden,et al.  Follow-up of children attending infant language units: outcomes at 11 years of age. , 2001, International journal of language & communication disorders.

[57]  P. Tallal,et al.  Defects of Non-Verbal Auditory Perception in Children with Developmental Aphasia , 1973, Nature.

[58]  Maria Mody,et al.  Rapid auditory processing deficits in dyslexia: a commentary on two differing views , 2003, J. Phonetics.

[59]  D. Loeb,et al.  Looking Ahead: An introduction to Five Exploratory Studies of Fast ForWord. , 2001 .

[60]  M. Studdert-Kennedy,et al.  Auditory temporal perception deficits in the reading-impaired: A critical review of the evidence , 1995, Psychonomic bulletin & review.

[61]  Steven L. Miller,et al.  Language Comprehension in Language-Learning Impaired Children Improved with Acoustically Modified Speech , 1996, Science.