Table 1.

Study design, participants, intervention features, outcome measures, and evidence of treatment effectiveness.

Article	Research Design and Participant Description	Intervention	Outcome Measures	Effectiveness of Intervention
Children with Language Impairments
Fazio (1997a)	Quasi-experimental pre- and post-test design; no random assignment to treatment. Matched pairs on gender, classroom, nonverbal mental age, and IQ. Two groups: SwLI (n = 8; M age = 4.6 years) Mental-age Matched Typically Developing Peers (n = 8; M age = 4.6 years)	Research staff taught children 5 nursery rhymes in a whole-class preschool setting. 4 days/week × 6 weeks. Total time cannot be estimated as session time not reported.	RM tasks: rhyme oddity, percentage of nursery rhyme repeated correctly, and partial rhyme (cloze)	Mental-age Matched Typically Developing Peers learned significantly more than SwLI on all tasks. SwLI increased from 2% to 18% in ability to recite nursery rhymes. SwLI able to complete rhyme cloze procedure. M = 55% No reliability or validity of measures. No fidelity reported.
Fazio (1997b)	Quasi-experimental pre- and post-test design; no random assignment to treatment. Matched pairs from classroom on chronological age or language age. Three groups: SwLI (n = 16; M age = 5.7 years) Chronological-age Matched Typically Developing Peers (n = 16; M age = 5.4 years) Matched on gender, classroom, age, and race. Language-age Matched Peers (n =16; M age = 4.3 years) Matched on gender, classroom, and language.	Research staff trained children individually to repeat a poem under 4 conditions: with or without hand motions, with or without singing the poem. Setting unspecified. 1 day/week × 15 min × 4 weeks. Total time = 1 hr.	RM tasks: rhyme oddity, percentage of poem repeated correctly, and tests of initial sound oddity	Chronological-age Matched Typically Developing peers and Language-age Matched peers performed significantly higher in all 4 conditions than SwLI on all 3 measures. SwLI in “with hand motion” condition performed significantly higher than the SwLI in the “no hands” condition. No reliability or validity of measures. No fidelity reported.
Warrick, Rubin, & Rowe-Walsh (1993)	Quasi-experimental pre- and post-test design. Twenty-eight SwLI (4–5 year olds) randomly assigned to Treatment vs. No-Treatment condition and compared to Typically Developing Controls (n = 14).	Research staff trained children in small groups (n = 7) in PA (syllable awareness, initial phoneme segmentation, rhyming, and phonemic segmentation) in a classroom setting. 2 days/week × 20 min × 8 weeks. Total time = approximately 5.5 hr.	RM Phoneme Awareness tasks not specified or described: error, repair, manipulation, rhyme, and segmentation WRMT-R Word Identification and Word Attack	Treatment SwLI made significant gains on repairs, manipulations, rhymes, and final segmentation. No significant differences between Typically Developing Controls and Treatment SwLI on any phoneme awareness tasks. Significant differences between Typically Developing Controls and No-Treatment SwLI on manipulation and rhyme. One-year follow-up: Treatment SwLI and Typically Developing Controls were equivalent and both scored significantly higher than No-Treatment SwLI on all phoneme tasks (except Repairs subtest) and on both reading measures. No fidelity of treatment reported.
Segers & Verhoeven (2004)	Quasi-experimental pre- and post-test design with random assignment to one of three conditions. All students (n = 36; M age = 5.9 years) had LI and were matched on chronological age, nonverbal IQ, and PA tasks and then assigned to one of three conditions.	Treatment 1: Computer- supported PA program—word, syllable, phoneme analysis, rhyme, syllable and phoneme synthesis. Treatment 2: Same as Treatment 1 but, speech slowed down as in FFW. Control: Computer vocabulary games. 2–3 days/week × 15 min × 5 weeks in a computer lab. Total time = 3.5 hr.	RM PA tasks: rhyme, word awareness, phoneme analysis, syllabic awareness, phonemic synthesis	No significant pre-test differences between groups. Positive effects of intervention for Treatment 1 (Computer- supported PA program). Treatment 1 made more progress than Control on combined PA tasks. No statistically significant differences between Treatment1 and Treatment 2 (Computer- supported PA program with speech slowed down). No statistically significant differences between Treatment 2 and Control. No fidelity reported.
Pokorni, Worthington, & Jamison (2004)	Quasi-experimental pre- and post-test design with random assignment to one of three conditions. SwLI (n = 60; age range = 7.5–9 years) had current IEPs, were enrolled in S/L therapy, and were reading 1 year below grade level.	Trained professional from school district administered the intervention under the supervision of 3 SLPs in a computer lab. Compared 3 PA interventions: FFW: phoneme discrimination, listening comprehension, word meaning, syntax, and processing speed. Earobics Step 2: following directions, sound recognition, auditory memory, segmentation, blending, and sound discrimination. LiPS: discovering oral-motor features of sounds, tracking, reading, and spelling. Students using FFW and Earobics assigned to a computer station with stereo headphones in a computer lab. 3 days/week × 1 hr during 20 day summer program. Total time = 60 hr.	Pre-test measures administered 4–6 weeks before intervention Post-test measures administered 6–8 weeks after intervention CELF-3 Concepts & Directions, Recalling Sentences, and Listening to Paragraphs PAT Phoneme Blending and Phoneme Segmentation WLPB-R Letter-Word Identification, Passage Comprehension, Word Attack, and Spelling	Repeated measures MANOVA combining scores into 3 clusters: Phonemic Awareness: LiPS—significantly better blending scores Earobics —significantly better phoneme segmentation scores Language-Related skills—no significant differences across interventions Reading-Related skills—no significant differences across interventions Percent of students with standard scores < 90 remained high after intervention. No treatment fidelity reported.
Children with Speech Impairments
Constantine (2001)	Descriptive case-study. Pre-school children with articulation/phonological disorders (n = 4; age range not reported)	Group of 4 students. 2 days/week × 1.5 hrs. × 10 weeks. Total time = 30 hr. 5 SLP graduate clinicians provided the intervention integrating thematic-fantasy play and PA instruction. Intervention consisted of highlighting story events, modeling, supporting turn-taking, and eliciting target responses using popular preschool stories.	RM tasks: rhyme discrimination and rhyme production	All four children showed improvements in rhyme discrimination and rhyme production. No treatment fidelity reported.
Hesketh, Adams, Nightingale, & Hall (2000)	“Semi-random” assignment. Three groups: SwSI in ART therapy (n = 30) SwSI in MET therapy (n = 31) Typically Developing Controls (n = 59) age range = 3.6–5.0 years	ART therapy: Focused on production of phonemes and phoneme classes. MET therapy: Focused on rhyming, syllable clasping, alliteration, blending, and segmenting SLPs conducted individual MET and ART therapy. 10 weekly sessions (no time given).	RM Metaphonological Abilities Battery: rhyme matching, word initial matching, blending phonemes, word initial segmentation/matching, and consonant deletion	Composite scores on the Metaphonological battery revealed MET and ART students had statistically greater growth than controls, and that growth for MET students was similar to growth for ART students. How composite derived not reported. No fidelity reported. No reliability or validity of measures.
Gillon (2000)	Pre- and post-test design; no random assignment. Matched pairs on age, severity of problem, and clinician judgment. 61 Total students with or without SI in four groups: Group 1: Experimental intervention (n = 23; M age = 6years) Group 2: Traditional intervention (n = 23; M age = 6.2 years) Group 3: Minimal intervention (n = 15; M age = 6.2 years) Group 4: Cognitive-age Matched Typically Developing Peers (n =30; M age = 6.1 years)	Research staff or SLPs individually trained Group 1 students using a PA program (rhyme, phoneme manipulation of sounds, phoneme identity, segmentation and blending, linking speech to print). 2 days/week × 1 hr × 10 weeks. Total time = 20 hr. SLPs individually trained Group 2 using a traditional program for articulation and language skills. 1 hr/week × 10 weeks. Total time = 20 hrs. SLPs consulted with teachers or parents for Group 3. Consultations took place no more than once a month. All children were exposed to a Whole Language approach to reading in their classrooms.	Burt Word Reading Test—New Zealand Revision LAC Letter Identification task Neale Analysis of Reading Ablilty—Revised Nonword reading task from the Reading Freedom Diagnostic Test Ready-to-Read Word Test QUIL	The 3 SwSI groups performed comparably to each other but significantly below their Typically Developing peers at pre-test. Group 1 made significantly greater growth than the other 3 groups on PA skills as measured by LAC and QUIL and Reading Measures. At post-test, Group 1 not statistically different than Group 4 on LAC. Group 1 made significantly greater growth than Groups 2 and 3 on all reading measures. No fidelity reported.
Gillon (2002)	Four Groups: Group 1: n = 20 (of the 23 participants in Gillon 2000) Groups 2 and 3: n = 20 (38) Group 4: n = 20 (30)	Follow up 11 months post- intervention (Gillon, 2000).	Burt Word Reading Test—New Zealand Revision QUIL	Follow-up only: Group 1 significantly different from Groups 2 and 3. Groups 2 and 3 significantly different from Group 4 on PA tasks of QUIL. Group 1 = Group 4 on QUIL. Group 1 and Groups 2 and 3 improved on word-recognition, but Group 1 made more progress over time. Group 1 > Groups 3 and 4 non- word reading test of QUIL.
Gillon (2005)	Quasi-experimental/3-year longitudinal design with random selection of controls. Phase 1 Group 1: Students with moderate or severe speech impairment (n = 12; M age = 3.5 years) Group 2: Typically Developing peers (n = 19; M = 3.5 years) Phase 2-Longitudinal Group 1: Subset of students with moderate or severe speech impairments students from phase 1 (n = 10; M age = 6.0 years) Group 3: Controls with speech impairments who were chosen retrospectively and received no treatment (n = 19; M age = 6.4 years)	Group 1 received an average of 25.5 intervention sessions delivered by therapists at a university clinic. Treatment divided into 3 blocks; each block 45 min × 2 days/week × 4–6 weeks. Total time = 6–9 hr. One group and one individual session. Focus of intervention: improving speech intelligibility, facilitation of PA, and letter-name and letter- sound knowledge. At 6 years of age (Time 2), performance of Group 1 was compared to Group 3 on PA, reading and spelling measures.	Modified Bradley and Bryant’s tasks: rhyme, phoneme matching, and letter recognition Burt Word Reading Test—New Zealand Revision Nonword reading task from the Reading Freedom Diagnostic Test Phonological Variability Test PIPA (to obtain a score of PA and a score of letter knowledge) Spelling task	No statistically significant differences between Groups 1 and 2 on PPVT-3. Group 1 comparable to Group 2 on phoneme awareness tasks at Time 1 and Time 2. Improvements also noted in speech intelligibility. At 6 years of age (Time 2), statistically significant differences were noted between Group 1 and Group 3 on Burt Word Reading Test—New Zealand Revision, nonword reading, combined raw score of the PIPA, and spelling. Results suggest 1) children with speech impairments are at risk and can benefit from PA training starting as early as 3 years 2) integrating PA and speech production therapy can result in the two skills improving concurrently. Treatment fidelity: 12% of total session randomly selected for video analysis.
Moriarty & Gillon (2006)	Single subject with repeated measures; subjects as own controls. Timeline for measurement: baseline, pre- and post. 3 children with childhood apraxia of speech aged 7.3, 6.3, and 6.10 years who were in S/L therapy.	3 days/week × 45min × 3 weeks. Total time = 6.75 hr. Intervention focus: develop phoneme awareness, increase knowledge of phoneme grapheme correspondence, and improve speech.	Burt Word Reading Test—New Zealand Revision PIPA Letter-Sound Knowledge	Two (out of 3) subjects showed improved speech, PA skills, and non-word reading. Four sessions were randomly chosen for evaluation of treatment fidelity. Reliability: point-by-point analyses on 20% of baseline and intervention probes.
Denne, Langdown, Pring, & Roy (2005)	Pre- and post-test design with random assignment to treated and untreated groups. Children with expressive phonological problems (n = 20; age range = 5–7 years)	Groups of 3 students each. SLPs provided Gillon’s PA training program in a clinical setting. 1 day/week × 1.5 hrs. × 8 weeks. Total time = 12 hr. Pre- and post-test assessments conducted by different clinicians.	Non-Word Decoding Test PAT WORD	Treated group made significantly greater gains in PA.
Major & Bernhardt (1998)	Alternating treatment design with cycles approach. Children with moderate or severe speech impairments (n = 19; M age = 3.11 years)	3 days/week × 45 min × 16 weeks. Total time = 36 hr. Individual sessions provided by SLPs. Focus of intervention: syllable structure, phonemes, rhyming, alliteration and/or segmentation.	IPSyn RM tasks: metaphonology and articulation	Significant gains in consonant and vowel production, language production, and metaphonological awareness. No fidelity reported.
Bernhardt & Major (2005)	Descriptive case-study without control group. Three years after preschool intervention. n =12 from Major and Bernhardt (1998) M age = 7.2 years	No intervention	APP-R CELF-3. GFTA-R PIAT-R (reading recognition, reading comprehension, spelling, math) PPVT-R Rhyming, alliteration, deletion task TONI-2	7/12 students scored average or above average scores on GFTA- R. 9/12 students scored within 1 standard deviation on metaphonology. 12/12 students scored average to low average on PPVT-R/CELF-3. 10/12 students scored average or above average on RR and RC of PIAT-R. 9/12 students scored average or above average on math. 7/12 students scored average or above average on spelling.
Children with Speech and/or Language Impairments
Fuchs et al. (2002)	Three groups: Students (100%) with SLD who received PA and PALS training (n = 8; M age= 5.96 years) Students with SLD (83%) who received PA training (n = 6; M = 5.93 years) Controls with SLD (100%) who received no training (n = 10; M = 5.76 years)	Classroom teachers in the PA and PA and plus PALS conditions taught whole class PA activities (word and syllable awareness, rhyming, first-sound isolation, onset-rime-level blending, segmenting sounds, blending or segmenting of sounds, manipulation of printed letters) selected from Ladders to Literacy (O’Connor et al., (1998). Teachers in the PA plus PALS teachers conducted PALS. Whole-class instruction 15 min/day (45 min per week) for 20 weeks. Total time = 15 hr.	RM tasks: rapid letter naming, rapid letter sound, segmentation, and blending WRMT-R Word Attack WRMT-R Word Identification WIAT Spelling	Larger effect sizes were reported for the PA and PALS vs. the PA group on all measures. Small to moderate differences favoring PA and PALS over controls. The controls vs. PA comparison favored the controls on 6/8 measures. Adequate fidelity was reported.
van Kleeck, Gillam, & McFadden (1998)	Quasi-experimental. Three groups: Preschool students with speech and/or language impairments (n = 8; M age = 4.1 years) 2. Pre-K students with speech and/or language impairments (n = 8; M age = 5 years) Controls with speech and/or language impairment who received no treatment (n = 8; M age = 6 years)	Research staff and classroom teachers (certified SLPs) conducted small group (n = 3 or 4) sound centers. Fall: Rhyme Spring: Phoneme Awareness 2 days/week × 15 min across nine months. Total time = 12 hr.	RM task: Rhyme (composite score derived from 4 tasks, including oddity, identification, production, and fluency) RM task: Phoneme Awareness (composite score derived from 4 tasks, including phoneme judgment and correction, identification and production of initial sounds, identification of final sounds)	No post-test conducted for control group. No statistical comparison at pre-test reported between treatment and control. Both treatment groups made significant growth in rhyme and phonemic awareness. Only later can be attributed to intervention. No statistically significant differences in growth between treated groups. No reliability or validity of measures. No fidelity reported.
Laing & Espeland (2005)	Quasi-experimental pre- and post-test design. Two groups: Students with SI and/or LI (n = 6; M age = 4.3 years) Typically Developing Controls (n = 5; M age = 4.7 years)	Fall 3 days/week × 30 min of individual S/L therapy. Total time = 1.5 hr. Spring Low intensity, short-term, whole- class, PA program focused on rhyme identification, rhyme production, sound categorization, letter identification, and letter- sound correspondence. 2 days/week × 15 min. Total time = 4 hr. Control students did not receive any specific PA training. Undergraduate SLP students supervised by 2 certified SLPs.	Categorization GFTA Sounds-in-Words Rhyme Identification Rhyme Production	PA training contributed to statistically significant gains in PA (rhyme identification, rhyme production, and categorization) for LI and/or SI students. No fidelity reported.
Roth, Troia, Worthington, & Handy (2006)	Single-subject multiple baseline design. Students with speech and/or language impairments (n = 11; M age = 4.3 years)	Preschool program for children with communication disorders. In addition to regular curriculum, Orton-Gillingham-Stillman- multisensory approach to alphabetic principles. PASS blending intervention program delivered individually by either graduate student clinicians or advanced undergraduates. 3 days/week × 30 min. × 6–8 weeks. Total time = 9–12 hr.	Students with speech and/or language impairments given a battery of speech tests, language tests, IQ test, and blending task. RM tasks: rhyming, segmentation, and blending	Treatment fidelity reported. Blending: Average gain was statistically significant with large effect size pre-to post-test. Rhyming: Average gain was statistically significant with a moderate effect size. Segmenting: Average gain was not statistically significant.

Note. SwLI = Students with Language Impairments; RM = Researcher Made. PA= Phonological Awareness.

WRMT-R = Woodcock Reading Mastery Tests-Revised. LI = Language Impairment. FFW = Fast ForWord. IEPs = Individualized Education Programs. SLPs = Speech-language Pathologists. LiPS = Lindamood Phonemic Sequencing Program. S/L = Speech/Language. CELF-3 = Clinical Evaluation of Language Fundamentals-3. PAT = Phonological Awareness Test. WLPB-R = Woodcock Language Proficiency Battery-Revised. SwSI = Students with Speech Impairments. ART = Articulation. MET = Metaphonological Articulation. LAC = Lindamood Auditory Conceptualization Test. SI = Speech Impairment. QUIL = Queensland University Inventory of Literacy. PIPA = Preschool and Primary Inventory of Phonological Awareness. WORD = Wechsler Objective Reading Dimension. IPSyn = Index of Productive Syntax. APP-R = Assessment of Phonological Processes-Revised. GFTA-R = Goldman Fristoe Test of Articulation-Revised. PIAT-R = Peabody Individual Achievement Test-Revised. PPVT-R = Peabody Picture Vocabulary Test-Revised. TONI-2 = Test of Nonverbal Intelligence-2. SLD = Specific Learning Disability. PALS = Peer Assisted Learning Strategies. WIAT = Wechsler Individual Achievement Test. GFTA = Goldman Fristoe Test of Articulation. PASS = Promoting Awareness of Sounds in Speech.