Clinical Practice Guideline: Interventions for Developmental Language Delay and Disorders.

Abstract

It is estimated that 9.9% of children have developmental language disorders (DLD), 7.6% in the form of circumscribed DLD without any serious accompanying impairment and 2.3% with comorbidities that have a bearing on language, such as hearing disorders. Developmental language disorders are among the more commonly treated childhood disorders; if they persist, they often adversely affect educational attainment and social standing later in life. Developmental language delay during the third year of life is an important risk factor for developmental language disorders. This interdisciplinary clinical practice guideline reflects current knowledge on evidence-based interventions for developmental language delay and disorders. A systematic literature review was conducted on the efficacy of various interventions against developmental language disorders. The recommendations in this guideline include: for expressive developmental language delay, structured parental training (Hedges' g = 0.38-0.82); in case of a receptive component or other risk factors, language therapy (Cohen's d = -0.20-0.90); for phonological pronunciation disturbances, phonological or integrated treatment methods (Cohen's d = 0.89-1.04); for phonetic disturbances (in the absence of a developmental language disorder), a traditional motor approach; for lexical-semantic and morphologic-syntactical disturbances, combinations of implicit and explicit methods (input enrichment, modeling techniques, elicitation methods, creation of production opportunities, metalanguage, visualizations; Cohen's d = 0.89-1.04). Further recommendations include interventions for pragmatic-communicative developmental language disorders, as well as for developmental language disorders in bi-/multilingual children and in children with impaired hearing, intellectual disability, autism-spectrum disorders, selective mutism, and syndromes and multiple disabilities that have a bearing on language. Inpatient language rehabilitation is also recommended in certain situations. Early parent- and child-centered interventions combined with pedagogical language promotion, and the use of evidence-based treatment components, dose frequencies and forms, and settings, can help improve the efficacy of interventions for developmental language delay and disorders.