The Efficacy of Fast ForWord Language Intervention in School-Age Children With Language Impairment: A Randomized Controlled Trial PurposeA randomized controlled trial was conducted to compare the language and auditory processing outcomes of children assigned to receive the Fast ForWord Language intervention (FFW-L) with the outcomes of children assigned to nonspecific or specific language intervention comparison treatments that did not contain modified speech.MethodTwo hundred sixteen children between the ... Article/Report
Article/Report  |   February 2008
The Efficacy of Fast ForWord Language Intervention in School-Age Children With Language Impairment: A Randomized Controlled Trial
 
Author Affiliations & Notes
  • Ronald B. Gillam
    Utah State University, Logan
  • Diane Frome Loeb
    The University of Kansas, Lawrence
  • LaVae M. Hoffman
    University of Oklahoma Health Sciences Center, Oklahoma City
  • Thomas Bohman
    The University of Texas at Austin
  • Craig A. Champlin
    The University of Texas at Austin
  • Linda Thibodeau
    The University of Texas at Dallas
  • Judith Widen
    The University of Kansas, Lawrence
  • Jayne Brandel
    The University of Kansas, Lawrence
  • Sandy Friel-Patti
    The University of Texas at Dallas
  • Contact author: Ronald B. Gillam, Department of Communicative Disorders and Deaf Education, 1000 Old Main Hill, Logan, UT 84322. E-mail: ron.gillam@usu.edu.
  • © 2008 American Speech-Language-Hearing Association
Article Information
Language Disorders / Language
Article/Report   |   February 2008
The Efficacy of Fast ForWord Language Intervention in School-Age Children With Language Impairment: A Randomized Controlled Trial
Journal of Speech, Language, and Hearing Research, February 2008, Vol. 51, 97-119. doi:10.1044/1092-4388(2008/007)
History: Received November 9, 2006 , Revised April 24, 2007 , Accepted July 2, 2007
 
Journal of Speech, Language, and Hearing Research, February 2008, Vol. 51, 97-119. doi:10.1044/1092-4388(2008/007)
History: Received November 9, 2006; Revised April 24, 2007; Accepted July 2, 2007
Web of Science® Times Cited: 83

PurposeA randomized controlled trial was conducted to compare the language and auditory processing outcomes of children assigned to receive the Fast ForWord Language intervention (FFW-L) with the outcomes of children assigned to nonspecific or specific language intervention comparison treatments that did not contain modified speech.

MethodTwo hundred sixteen children between the ages of 6 and 9 years with language impairments were randomly assigned to 1 of 4 conditions: (a) Fast ForWord Language (FFW-L), (b) academic enrichment (AE), (c) computer-assisted language intervention (CALI), or (d) individualized language intervention (ILI) provided by a speech-language pathologist. All children received 1 hr and 40 min of treatment, 5 days per week, for 6 weeks. Language and auditory processing measures were administered to the children by blinded examiners before treatment, immediately after treatment, 3 months after treatment, and 6 months after treatment.

ResultsThe children in all 4 conditions improved significantly on a global language test and a test of backward masking. Children with poor backward masking scores who were randomized to the FFW-L condition did not present greater improvement on the language measures than children with poor backward masking scores who were randomized to the other 3 conditions. Effect sizes, analyses of standard error of measurement, and normalization percentages supported the clinical significance of the improvements on the Comprehensive Assessment of Spoken Language (E. Carrow-Woolfolk, 1999). There was a treatment effect for the Blending Words subtest of the Comprehensive Test of Phonological Processing (R. K. Wagner, J. K. Torgesen, & C. A. Rashotte, 1999). Participants in the FFW-L and CALI conditions earned higher phonological awareness scores than children in the ILI and AE conditions at the 6-month follow-up testing.

ConclusionFast ForWord Language, the intervention that provided modified speech to address a hypothesized underlying auditory processing deficit, was not more effective at improving general language skills or temporal processing skills than a nonspecific comparison treatment (AE) or specific language intervention comparison treatments (CALI and ILI) that did not contain modified speech stimuli. These findings call into question the temporal processing hypothesis of language impairment and the hypothesized benefits of using acoustically modified speech to improve language skills. The finding that children in the 3 treatment conditions and the active comparison condition made clinically relevant gains on measures of language and temporal auditory processing informs our understanding of the variety of intervention activities that can facilitate development.

Acknowledgments
This research was funded by National Institutes of Health (NIH) Grant U01 DC04560, awarded to the first two authors. It also was supported by resources from NIH Grant P30 HD02528, Grant BNCD P30 DC005803 from The Kansas Mental Retardation and Developmental Disabilities Research Center at the University of Kansas, and the Lillywhite endowment at Utah State University.
We acknowledge the dedication and assistance of Emily Tobey, Lori Betourne, and Alicia Wanek. We also acknowledge the guidance of our Project Officer, Julia Gulya. We thank Steven Camarata, Chris Dollaghan, Judith Gravel, Fred Gruber, and Mark Espland, who served on our Data Safety Monitoring Board. Jack Fletcher, Judith Johnston, and Karen Rascati, who served on our Advisory Committee, provided important suggestions throughout the course of the project. Diane Anderson and William Clarke, at the University of Iowa, oversaw the data management with great diligence. This study could not have been conducted without the very able assistance of numerous speech-language pathologists, graduate students, and undergraduate students. We are grateful to the school districts that participated: Blue Valley Schools, Dallas Independent School District, Kansas City (Kansas) Public Schools, Lawrence Public Schools, Leander Independent School District, Pflugerville Independent School District, and Plano Independent School District. Last, but not least, we thank the children and their families for their long-term commitment to this study.
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