The Efficacy of Fast ForWord-Language Intervention in School-Age Children with Language Impairment: A Randomized Clinical Trial.

Purpose: A randomized controlled trial was conducted to compare the languageand auditory processing outcomes of children assigned to receivethe Fast ForWord Language intervention (FFW-L) with the outcomesof children assigned to nonspecific or specific language interventioncomparison treatments that did not contain modified speech. Method: Two hundred sixteen children between the ages of 6 and 9 yearswith 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) individualizedlanguage intervention (ILI) provided by a speech-language pathologist.All children received 1 hr and 40 min of treatment, 5 days perweek, for 6 weeks. Language and auditory processing measureswere administered to the children by blinded examiners beforetreatment, immediately after treatment, 3 months after treatment,and 6 months after treatment. Results: The children in all 4 conditions improved significantly on aglobal language test and a test of backward masking. Childrenwith poor backward masking scores who were randomized to theFFW-L condition did not present greater improvement on the languagemeasures than children with poor backward masking scores whowere randomized to the other 3 conditions. Effect sizes, analysesof standard error of measurement, and normalization percentagessupported the clinical significance of the improvements on theComprehensive Assessment of Spoken Language (E. Carrow-Woolfolk, 1999).There was a treatment effect for the Blending Words subtestof 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 higherphonological awareness scores than children in the ILI and AEconditions at the 6-month follow-up testing. Conclusion: Fast ForWord Language, the intervention that provided modifiedspeech to address a hypothesized underlying auditory processingdeficit, was not more effective at improving general languageskills or temporal processing skills than a nonspecific comparisontreatment (AE) or specific language intervention comparisontreatments (CALI and ILI) that did not contain modified speechstimuli. These findings call into question the temporal processinghypothesis of language impairment and the hypothesized benefitsof using acoustically modified speech to improve language skills.The finding that children in the 3 treatment conditions andthe active comparison condition made clinically relevant gainson measures of language and temporal auditory processing informsour understanding of the variety of intervention activitiesthat can facilitate development