The effectiveness of narrative-based intervention on language abilities in school-aged children with language impairment : a systematic review and meta-analysis

Abstract

Objective: This systematic review and meta-analysis (SR-MA) evaluated the effectiveness and maintenance effect of narrative-based intervention (NBI) on language abilities in school-aged children with language impairment. It also aimed to identify which programs or procedures of NBI lead to greater improvement. Methods: This SR-MA was designed based on the framework of Cochrane Handbook for Systematic Review of Intervention and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The study protocol was pre-registered at PROSPERO. Studies published from 1 January 1980 to 13 February 2019 were searched using 14 electronic databases. Two independent reviewers searched for and critically appraised the included studies. Meta-analysis was conducted on selected studies. Results: Eleven studies were included in systematic review and four were further included in meta-analysis. All studies demonstrated certain methodological limitations. The overall results suggested a significant medium-to-large effect on expressive narrative macrostructure, non-significant effect on receptive macrostructure, and a mixed effect on different microstructures. Conclusion: Positive effects of NBI on expressive macrostructure and certain microstructures were demonstrated. Clinicians may consider using NBI on these aspects. The limitations of the current studies urge a large-scale randomized controlled trial and further research on microstructure, treatment procedures, maintenance and generalization effects.