University of Oulu

Frizelle, P., Tolonen, A.-K., Tulip, J., Murphy, C.-A., Saldana, D., & McKean, C. (2021). The influence of quantitative intervention dosage on oral language outcomes for children with developmental language disorder: A systematic review and narrative synthesis. Language, Speech, and Hearing Services in Schools, 52(2), 738–754.

The influence of quantitative intervention dosage on oral language outcomes for children with developmental language disorder : a systematic review and narrative synthesis

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Author: Frizelle, Pauline1; Tolonen, Anna-Kaisa2; Tulip, Josie3;
Organizations: 1Department of Speech and Hearing Sciences, University College Cork, Ireland
2Department of Logopedics, University of Oulu, Finland
3School of Education, Communication and Language Sciences, Newcastle University, United Kingdom
4School of Allied Health, University of Limerick, Ireland
5Departamento de Psicología Evolutiva y de la Educación, University of Seville, Spain
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 1.1 MB)
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Language: English
Published: American Speech-Language-Hearing Association, 2021
Publish Date: 2023-09-28


Purpose: The aim of this study was to examine the degree to which quantitative aspects of dosage (dose, dose frequency, and total intervention duration) have been examined in intervention studies for children with developmental language disorder (DLD). Additionally, to establish the optimal quantitative dosage characteristics for phonology, vocabulary, and morphosyntax outcomes.

Methods: This registered review (PROSPERO ID CRD42017076663) adhered to PRISMA guidelines. Search terms were included in seven electronic databases. We included peer-reviewed quasi-experimental, randomized controlled trial or cohort analytical studies, published in any language between January 2006 and May 2020. Included articles reported on participants with DLD (M = 3–18 years); oral language interventions with phonology, vocabulary, or morphosyntax outcomes; and experimental manipulation or statistical analysis of any quantitative aspect of dosage. Studies were appraised using the Cochrane risk-of-bias tool.

Results: Two hundred forty-four articles reported on oral language interventions with children with DLD in the domains of interest; 13 focused on experimentally/statistically manipulating quantitative aspects of dosage. No article reported phonological outcomes, three reported vocabulary, and eight reported morphosyntax. Dose frequency was the most common characteristic manipulated.

Conclusions: Research is in its infancy, and significant further research is required to inform speech-language pathologists in practice. Dosage characteristics are rarely adequately controlled for their individual effects to be identified. Findings to date suggest that there is a point in vocabulary and morphosyntax interventions after which there are diminishing returns from additional dosage. If dose is high (number of learning opportunities within a session), then the literature suggests that session frequency can be reduced. Frequent, short sessions (2/3 × per week, approximately 2 min) and less frequent, long sessions (1 × per week, approximately 20 min) have yielded the best outcomes when composite language measures have been used; however, replication and further research are required before clinicians can confidently integrate these findings into clinical practice.

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Series: Language speech and hearing services in schools
ISSN: 0161-1461
ISSN-E: 1558-9129
ISSN-L: 0161-1461
Volume: 52
Issue: 2
Pages: 738 - 754
DOI: 10.1044/2020_LSHSS-20-00058
Type of Publication: A2 Review article in a scientific journal
Field of Science: 6121 Languages
Copyright information: © 2021 American Speech-Language-Hearing Association.