Evidence-based systematic review: effects of different service delivery models on communication outcomes for elementary school-age children.
OBJECTIVE
The purpose of this investigation was to conduct an evidence-based systematic review (EBSR) of peer-reviewed articles from the last 30 years about the effect of different service delivery models on speech-language intervention outcomes for elementary school-age students.


METHODS
A computer search of electronic databases was conducted to identify studies that addressed any of 16 research questions. Structured review procedures were used to select and evaluate data-based studies that used experimental designs of the following types: randomized clinical trial, nonrandomized comparison study, and single-subject design study.


RESULTS
The EBSR revealed a total of 5 studies that met the review criteria and addressed questions of the effectiveness of pullout, classroom-based, and indirect-consultative service delivery models with elementary school-age children. Some evidence suggests that classroom-based direct services are at least as effective as pullout intervention for some intervention goals, and that highly trained speech-language pathology assistants, using manuals prepared by speech-language pathologists to guide intervention, can provide effective services for some children with language problems.


CONCLUSIONS
Lacking adequate research-based evidence, clinicians must rely on reason-based practice and their own data until more data become available concerning which service delivery models are most effective. Recommendations are made for an expanded research agenda.
Cirrin
Frank M
FM
Minneapolis Public Schools/Special Education, 425 5 Street, NE, Minneapolis, MN 55413, USA. fcirrin@mpls.k12.mn.us
Schooling
Tracy L
TL
Nelson
Nickola W
NW
Diehl
Sylvia F
SF
Flynn
Perry F
PF
Staskowski
Maureen
M
Torrey
T Zoann
TZ
Adamczyk
Deborah F
DF
D002648:Child; D003142:Communication; D003147:Communication Disorders / Q000628:therapy*; D055317:Evidence-Based Practice; D006801:Humans; D007808:Language Therapy / Q000379:methods*; D013070:Speech Therapy / Q000379:methods*; D016896:Treatment Outcome