Intervention Goals for Preschoolers With Language Difficulties and Disorders: A Scoping Review Using the International Classification of Functioning, Disability and Health Framework

Abstract

Purpose: The primary aim of this scoping review was to categorize language therapy goals reported in intervention studies for preschoolers (i.e., children from birth to 5;0 [years;months]) with language difficulties and disorders within the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework. A secondary aim was to determine whether different therapy goals were reported for two language difficulty/disorder subtypes (i.e., comparing language difficulty/disorder associated with a biomedical condition to those without an associated biomedical condition). Method: The scoping review followed Arksey and O'Malley (2005) guidelines. Articles were retrieved from speechBITE, with age (under 5 years), intervention area (language), and study design (all but systematic reviews and clinical practice guidelines) specified as inclusion criteria. Language goals were extracted and categorized into the ICF components, and the distribution of goals across ICF components was compared for studies involving children with the two language difficulty/disorder subtypes. Results: A total of 287 articles were identified; 140 met inclusion criteria. Of the 293 goals extracted, 48% aligned with the activities component of the ICF framework, followed by participation (26%), environmental factors (20%), body functions and structures (3%), and personal factors (3%). Most participation-focused goals were reported from intervention studies involving preschoolers with a language difficulty/disorder associated with a biomedical condition. Conclusions: Few participation-focused goals were reported in intervention studies for preschoolers with language difficulty/disorder without an associated condition. Future work is needed to support integrating the ICF framework in goal setting for both research and practice.

“We were the best people to do the job”: Caregivers’ reported outcomes of a virtual caregiver-delivered program for autistic preschoolers

“…While clinicians are encouraged to use the ICF framework to target functional outcomes that are valued by caregivers ( McNeilly, 2018 ), the literature suggests SLPs may not be adopting that model in practice. A recent scoping review of intervention goals reported in the literature suggested most goals for preschoolers with language difficulties and disorders were categorized in the Activities component of the ICF framework and fewer goals specific to Participation were identified ( Kwok et al, 2022 ). While SLPs focus on outcomes specific to children's impairments, caregivers report prioritizing those related to Participation ( Roulstone et al, 2013 ; Thomas-Stonell et al, 2009 ).…”

“…Functioning and Disability has three components: (a) Body functions and structures : physiological functions and anatomical parts of the body (e.g., production of speech sounds); (b) Activity : completing a task or action (e.g., following two-step directions); (c) Participation : involvement in various life situations (e.g., communicating with others). There are two Contextual Factors: (a) Personal Factors : an individual trait that may impact a person's disability (e.g., age, behavioral disposition, attention); (b) Environmental Factors : factors external to the individual that can influence health, well-being, and experiences (e.g., physical, social, and attitudinal environment; Kwok et al, 2022 ). Each element includes a set of codes that can be used to systematically organize reported functional outcomes in more detail ( WHO, 2001 ) and have been used for qualitative analysis in past research ( Grawburg et al, 2014 ).…”

The Role of Naturalistic Developmental Behavioral Interventions in Early Intervention for Autistic Toddlers: An Observational Study

“…Thus, EI SLPs should collaborate with caregivers to create functional, participation-based goals that target the child's communication in natural contexts of importance to the family. Research studies for young children with communication difficulties often report activity-based outcomes (Kwok et al, 2022) which target the child's overall communication skills, raising the possibility that NDBIs do not adequately address family-centered goals. Furthermore, autistic children often experience difficulties in many domains of development and functioning (e.g., sleep, emotional and sensory regulation; (Aranbarri et al, 2021), and EI providers may need to help families gain access to information to best support children in these domains.…”

Communication in Daily Life of Children With Developmental Language Disorder: Parents' and Teachers' Perspectives

“…Although the ultimate goal of intervention should be for children to communicate effectively in all situations that arise in their daily lives, until recently, speech and language therapy has focused almost exclusively on remediating deficits and impairments in language domains, such as morphosyntax, semantics, and phonology (Cunningham et al, 2017;Kwok et al, 2022). The assumption was that if children's language disorder was remediated, interactions in daily life would improve as well.…”

“…The assumption was that if children's language disorder was remediated, interactions in daily life would improve as well. Currently, there is agreement among speech-language therapists (SLTs) that the focus of intervention should shift from improvement of language skills (i.e., being able to produce and decode spoken messages) to communication in daily life (Kwok et al, 2022;Singer et al, 2020). Baylor and Darling-White (2020) elucidate this in their proposal for an adjusted version of the International Classification of Functioning, Disability and Health (ICF;World Health Organization, 2001).…”