Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
Showing 3 appraisals
Journal of speech, language, and hearing research : JSLHR
Augmentative and Alternative Communication Generative Language Intervention: A Randomized Controlled Trial
PURPOSE: Children with a wide range of impairments such as cerebral palsy and childhood apraxia of speech can benefit from augmentative and alternative communication (AAC). When AAC is provided, it frequently focuses on improving basic pragmatic skills such as requesting or on early semantic skills such as vocabulary acquisition. To address this issue, the primary goal of this study was to evaluate the effects of implementing the AAC Generative Language Intervention (AAC-GLI) program on the aided expressive grammar of preschoolers with relatively intact receptive language skills who could benefit from AAC. METHOD: A randomized controlled trial was used to evaluate the results. A total of 40 children who required AAC participated in the control group, intervention group, or both groups. The families of both the control and intervention group participants received a half-day AAC workshop. The intervention group also received 28 play-based AAC-GLI sessions. Weighted mean length of utterance in symbols (W-MLUSym), which was developed specifically for aided communicators, was used to measure progress. RESULTS: The intervention group demonstrated superior effects on W-MLUSym compared with the control group. Additionally, growth modeling demonstrated that the intervention condition was a significant moderator of change over time, with children in the intervention condition having statistically significantly greater increases in W-MLUSym, while W-MLUSym for children in the control condition remained similar to baseline. DISCUSSION: AAC-GLI can be used to teach preschoolers with a range of impairments to improve their expressive grammar skills. Providing AAC intervention that focuses on grammatical growth is an important part of expressive language development for these young children.
13 June 2026
Read appraisal →European journal of pediatrics
Evaluation of the quality, reliability, and readability of ChatGPT-4 responses related to the treatment and rehabilitation of children with cerebral palsy
UNLABELLED: This study aims to evaluate the reliability, quality, and readability of ChatGPT-4's responses to questions about cerebral palsy (CP) and rehabilitation strategies. The 56 most frequently asked questions by families about CP, its treatment, and rehabilitation strategies were divided into five categories (A1-5) and asked in ChatGPT-4. The reliability, quality, and readability of the responses were assessed by two researchers, respectively, using the modified DISCERN (mDISCERN) tool, the Global Quality Scale (GQS), and the Flesch Reading Ease Scale (FRE). Median (IQR) values for mDISCERN ranged from 3 (3-3) in A5 to 4 (3-4) in A1, while GQS values ranged from 3 (3-3.5) in A2 to 3.5 (3-4) in A1. The mean readability values assessed with FRE ranged from 31.47 ± 12.92 to 44.84 ± 17.39. No statistically significant differences were observed between the categories. The ICC values suggested very good agreement for both scales, with 0.851 for the mDISCERN total score and 0.824 for the GQS total score. CONCLUSION: This study suggests that ChatGPT-4 provides moderate reliability and generally acceptable quality of responses regarding CP treatment and rehabilitation. FRE scores indicated that many responses were difficult for families to understand. While ChatGPT-4 may serve as a supportive source of general information, its outputs should be interpreted with caution, particularly in clinical contexts, and supervision and oversight by healthcare professionals remain essential for safe and effective use. WHAT'S KNOWN: • Children with cerebral palsy (CP) receive lifelong rehabilitation. Exercise plays a fundamental role in maintaining functional independence and quality of life, as well as physical development. The use of AI-based tools such as ChatGPT-4 for health information is increasingly widespread; however, uncertainties regarding the reliability, quality,and readability of these tools remain. WHAT IS NEW: • Our study shows that ChatGPT-4''s responses to questions about treatment and rehabilitation strategies for children with CP have moderate to good reliability and quality, but low readability.
27 Apr 2026
Read appraisal →Journal of speech, language, and hearing research : JSLHR
Rhotic Generalization Is More Rapid in Biofeedback Than Motor-Based Treatment for Residual Speech Sound Disorder: Secondary Outcomes of a Randomized Controlled Trial
PURPOSE: This study examined the effects of visual biofeedback approaches and nonbiofeedback motor-based treatment on generalization outcomes following speech therapy for children with residual speech sound disorders (RSSDs). METHOD: A total of 108 children aged 9-15 years with RSSD affecting American English /ɹ/ were randomly assigned to receive 19 motor-based speech treatment sessions, with or without visual biofeedback (divided into ultrasound or visual-acoustic biofeedback). The treatment included practice designed to implement several motor learning principles, with task difficulty systematically adjusted based on the child's performance. Children's /ɹ/ accuracy on untreated words before and after treatment was rated as correct or incorrect by lay listeners who were blinded to participant characteristics, treatment conditions, and time points. RESULTS: The mixed-effects regression model revealed a statistically significant interaction between treatment type and time point. Specifically, both the biofeedback and nonbiofeedback motor-based treatment groups made progress over time, but the amount of generalization to untreated words was significantly greater in the biofeedback condition than in the motor-based treatment. In a subanalysis comparing biofeedback types, greater generalization was observed following ultrasound biofeedback than visual-acoustic biofeedback, although this effect was strongest at one treatment site. DISCUSSION: This randomized controlled trial found that adding biofeedback to motor-based treatment can increase the rate of accurate production of the American English /ɹ/ in untreated words.
12 Apr 2026
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