title: Evidence-based systematic review: effects of different service delivery models on communication outcomes for elementary school-age children.
abstract: 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.
authors.affiliation: Minneapolis Public Schools/Special Education, 425 5 Street, NE, Minneapolis, MN 55413, USA. fcirrin@mpls.k12.mn.us
authors.forename: Frank M
authors.initials: FM
authors.lastname: Cirrin
authors.forename: Tracy L
authors.initials: TL
authors.lastname: Schooling
authors.forename: Nickola W
authors.initials: NW
authors.lastname: Nelson
authors.forename: Sylvia F
authors.initials: SF
authors.lastname: Diehl
authors.forename: Perry F
authors.initials: PF
authors.lastname: Flynn
authors.forename: Maureen
authors.initials: M
authors.lastname: Staskowski
authors.forename: T Zoann
authors.initials: TZ
authors.lastname: Torrey
authors.forename: Deborah F
authors.initials: DF
authors.lastname: Adamczyk
mesh_terms: 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