Competing views on interventions for pragmatic language skills in persons with pragmatic language impairment: An umbrella review

This umbrella review aimed to evaluate the effectiveness of pragmatic language interventions and existing competing views in improving pragmatic language skills in persons with pragmatic language impairment (PLI). A comprehensive search was conducted to identify qualitative and quantitative systematic reviews that included diagnostic criteria, features, development and course, risk and prognostic factors, differential diagnosis of PLI, and existing interventions, views, and arguments to improve the pragmatic language abilities/skills of persons with PLI. Syntheses were critically appraised by two independent reviewers using the JBI Critical Appraisal Checklist for Systematic Reviews and Research Syntheses. This umbrella review was registered with PROSPERO on 9th December 2022 under the registration number CRD42022378690. Out of 3,609 studies, 42 reviews were included in this umbrella review. The extracted findings were categorized based on theoretical intervention perspectives, which included behavioral, social-pragmatic, and cognitive-linguistic approaches. The studies revealed that pragmatic language interventions had a positive impact on improving pragmatic language skills in persons with PLI. However, competing views on pragmatic language interventions were also identified, suggesting the need for a more comprehensive approach that includes both behavioral and cognitive-linguistic components. In conclusion, cognitive-linguistic approach was the most documented intervention method, and suiting intervention methods to the complex nature of PLI is crucial. The documented intervention methods reflected competing views on the nature of PLI, highlighting the need for tailored interventions.