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The interaction between behaviour and speech and language difficulties: does intervention for one affect outcomes in the other?

What do we want to know?

We wanted to identify research which investigated the relationship between speech, language and communication difficulties (SLCD) and emotional and behavioural difficulties (EBD) in children of primary school age (5–12 years) as both are common causes of concern for parents and teachers of young children. We also wanted to identify research which investigated whether intervening within one domain had the potential to influence outcomes in the other.

Who wants to know and why?

Potential users of this review include researchers and practitioners who have regular contact with primary school aged children with SLCD or EBD. These include teachers, speech and language therapists, and those providing child and adolescent mental health services. It is also of direct relevance for policy-makers, parents and carers.

What did we find?

We identified 21 intervention studies for children with either SLCD or EBD and which included both communication and behavioural outcomes. There was considerable variability in the profile of the children described and in both the types of intervention and the outcomes adopted. We grouped the studies under three broad intervention types: didactic, hybrid and pharmacological.

Didactic interventions (8 studies) are those that use behavioural modification alone to improve communication skills on the one hand or behavioural skills on the other.

Hybrid interventions (11 studies) are those that teach communication or behavioural skills within a range of contexts and are of more generic application than didactic interventions.

Pharmacological interventions (2 studies) refer to interventions that employ drug therapy to improve communication and behaviour outcomes.

All studies included in our in-depth review reported evidence of positive effects of intervention on both communication and behavioural outcomes. However, all of the studies identified in this review were small scale and of a low weight of evidence making it difficult to generalise their results or draw firm conclusions as to how children with SLCD and EBD should be managed.

What are the implications?

The overlap between SLCD and EBD should be accounted for in the development of both clinical and educational practice. This would be facilitated by a greater awareness amongst professionals and parents of the interaction between how a child communicates and the way they behave. In terms of research, more interventions need to be developed which address both domains, and this should be reflected in the outcomes used to evaluate those interventions. Much of the research to date has been ‘clinical’ in nature. It would be of considerable value to develop and evaluate interventions which are directly applicable to the educational context.

How did we get these results?

We looked for research on the relationship between behaviour and speech and language difficulties. We did this through keyword searches of bibliographic databases, and searches of websites and key journals. We then applied inclusion and exclusion criteria to build up a map of relevant studies. Additional criteria were applied to the studies in the map, which produced the 21 studies that were used to address the research question above.

The EPPI-Centre reference number for this report is 1705.

This report should be cited as:

Law J, Plunkett C (2009) The interaction between behaviour and speech and language difficulties: does intervention for one affect outcomes in the other? Technical report. In: Research Evidence in Education Library. London: EPPI-Centre, Social Science Research Unit, Institute of Education, University of London.

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