Interventions that improve narrative language (Pico et al., 2021)

Purpose: The purpose of this systematic review with meta-analyses was to examine interventions that aimed to improve narrative language outcomes for preschool and elementary school–age children in the United States. Our goal was to examine peer-reviewed publications to describe the characteristics of these interventions and synthesize their overall effectiveness on narrative comprehension and production via meta-analysis.Method: We searched electronic databases, examined previously published reviews, and consulted experts in the field to identify published studies that employed robust experimental and quasi-experimental designs. We included randomized controlled trials, studies with nonrandomized comparison groups, and single-case design (SCD) studies. We completed a qualitative synthesis of study factors for all identified studies and calculated meta-analyses for the studies that had sufficient data. All included studies were analyzed for risk of bias.Results: Our systematic search yielded 40 studies that included one or more narrative language outcomes as part of their assessment battery. Twenty-four of the included studies were group design studies, including randomized controlled trials and quasi-experimental designs, and the other 16 were SCD studies. Effect sizes were analyzed based on narrative production and comprehension outcomes. The meta-analyses of 26 studies indicated overall positive effects of the interventions, with effect sizes of d = 0.51 and 0.54 in the group design studies and d = 1.24 in the SCD studies.Conclusions: A variety of effective interventions were found that improve narrative production and comprehension outcomes in children with diverse learner characteristics. Some common characteristics across these interventions include manualized curricula, opportunities to produce narrative language, verbal and visual supports, direct instruction of story grammar, and use of authentic children’s literature.Supplemental Material S1. Social validity and fidelity of implementation.Supplemental TablesTable S1. PICOS inclusion criteria.Table S2. Search terms and results.Table S3. Data extraction categories.Table S4. Types of narrative language solicited in interventions and in outcome measures.Table S5. Group design studies – production outcomes.Table S6. Group design studies – comprehension outcomes.Supplemental FiguresFigure S1. Risk of bias for group design studies.Figure S2. Risk of bias for single case design studies.Figure S3. Summary risk of bias across all group design studies.Figure S4. Summary risk of bias across all single case design studies.Figure S5. Funnel plots for narrative production group design study effect sizes.Figure S6. Funnel plots for narrative comprehension group design study effect sizes.Pico, D. L., Prahl, A. H., Biel, C. H., Peterson, A. K., Biel, E. J., Woods, C., & Contesse, V. A. (2021). Interventions designed to improve narrative language in school-age children: A systematic review with meta-analyses. Language, Speech, and Hearing Services in Schools. Advance online publication. https://doi.org/10.1044/2021_LSHSS-20-00160