わが国における言語聴覚療法のエビデンス—システマティックレビューによる検討—言語発達障害に対する言語聴覚療法（言語・コミュニケーション指導）のエビデンス

A systematic review of evidence on the effectiveness of speech-language therapy for language developmental disorders in Japan

【目的】わが国における言語発達障害児への言語・コミュニケーション指導がどのようなアウトカムをもたらすかを検討する．

【検索方法】PRISMA 2020声明に基づきシステマティックレビューを行った．医中誌Web，医書.jp，PubMedを検索し，さらに『聴能言語学研究』と『言語聴覚療法』をハンドサーチした．採択条件を設け1次スクリーニングはタイトルと要旨から，また，2次スクリーニングでは全文を読み評価した．

【結果】自閉スペクトラム症ではランダム化比較試験1編，単一事例研究15編，発達性読み書き障害では単一事例研究1編，症例研究7編，言語発達の遅れでは症例研究5編が採択された．すべての論文で指導効果を確認していた．他方サンプルサイズが小さく，品質にばらつきがみられた．

【結論】一定の肯定的効果が見込まれるが，現時点でエビデンスは限られたものであった．研究デザインの洗練，効果量の算定および対象，介入法，評価法の明示が推奨された．

　Objectives：To assess the effects of speech-language and communication interventions for children with language developmental disorders in Japan.

　Search methods：We performed a systematic review according to the PRISMA 2020 statement. We searched Ichushi-Web, Isho.jp and PubMed and hand searched the Japanese Journal of Communication Disorders and Japanese Journal of Speech, Language, and Hearing Researh. Titles and abstracts were assessed for relevance in the primary screening, while in the secondary screening, the full texts were assessed based on PICO (Patient, Intervention, Comparison, Outcome) .

　Results：Included in this review were 16 articles (1 randomized controlled trial and 15 single-case studies) in autism spectrum disorders, 8 articles (1 single-case study and 7 case reports) in developmental dyslexia, and 5 articles (all case reports) in developmental language delay. All of the studies reported that their interventions were effective, but the sample sizes were small and the study qualities varied substantially.

　Conclusion：Evidence for the subject in question is currently limited. Refinement of study design, calculation of effect size, and clear description of patients, intervention and comparison are needed to improve the evidence level in the future.