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document
The Social Communication Intervention Project : a randomized controlled trial of the effectiveness of speech and language therapy for school-age children who have pragmatic and social communication problems with or without autism spectrum disorder . BACKGROUND Children who show disproportionate difficulty with the pragmatic as compared with the structural aspects of language are described as having pragmatic language impairment ( PLI ) or social communication disorder ( SCD ) . Some children who have PLI also show mild social impairments associated with high-functioning autism or autism spectrum disorder ( ASD ) . There is little robust evidence of effectiveness of speech-language interventions which target the language , pragmatic or social communication needs of these children . AIMS To evaluate the effectiveness of an intensive manualized social communication intervention ( SCIP ) for children who have PLI with or without features of ASD . METHODS & PROCEDURES In a single-blind RCT design , 88 children with pragmatic and social communication needs aged 5 ; 11-10 ; 8 , recruited from UK speech and language therapy services , were randomly assigned in a 2:1 ratio to SCIP or to treatment-as-usual . Children in the SCIP condition received up to 20 sessions of direct intervention from a specialist research speech and language therapist working with supervised assistants . All therapy content and methodology was derived from an intervention manual . A primary outcome measure of structural language and secondary outcome measures of narrative , parent-reported pragmatic functioning and social communication , blind-rated perceptions of conversational competence and teacher-reported ratings of classroom learning skills were taken pre-intervention , immediately post-intervention and at 6-month follow-up . Analysis was by intention to treat . OUTCOMES & RESULTS No significant treatment effect was found for the primary outcome measure of structural language ability or for a measure of narrative ability . Significant treatment effects were found for blind-rated perceptions of conversational competence , for parent-reported measures of pragmatic functioning and social communication , and for teacher-reported ratings of classroom learning skills . CONCLUSIONS & IMPLICATIONS There is some evidence of an intervention effect on blind and parent/teacher-reported communication outcomes , but not standardized language assessment outcomes , for 6-11-year-old children who have pragmatic and social communication needs . These findings are discussed in the context of the increasingly central role of service user outcomes in providing evidence for an intervention . The substantial overlap between the presence of PLI and ASD ( 75 % ) across the whole cohort suggests that the intervention may also be applicable to some verbally able children with ASD who have pragmatic communication needs .
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Intervention_Educational
intensive manualized social communication intervention ( SCIP )
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Intervention_Educational
SCIP
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Intervention_Other
treatment-as-usual
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Intervention_Educational
SCIP
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Intervention_Other
20 sessions of direct intervention from a specialist research speech and language therapist working with supervised assistants
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Outcome_Mental
structural language
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Outcome_Mental
narrative
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Outcome_Mental
parent-reported pragmatic functioning and social communication
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Outcome_Mental
blind-rated perceptions of conversational competence
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Outcome_Mental
teacher-reported ratings of classroom learning skills
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Outcome_Mental
structural language ability
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Outcome_Mental
a measure of narrative ability
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Outcome_Mental
blind-rated perceptions of conversational competence
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Outcome_Mental
for parent-reported measures of pragmatic functioning and social communication
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Outcome_Mental
for teacher-reported ratings of classroom learning skills
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Participant_Age
school-age children who have pragmatic and social communication problems with or without
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Participant_Condition
autism spectrum disorder
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Participant_Condition
disproportionate difficulty with the pragmatic as compared with the structural aspects of language
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Participant_Condition
pragmatic language impairment ( PLI )
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Participant_Condition
PLI with or without features of ASD
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Participant_Sample-size
88
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Participant_Age
aged 5 ; 11-10 ; 8
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Participant_Condition
Children in the SCIP condition
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Participant_Age
6-11-year-old children
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Participant_Condition
pragmatic and social communication needs