Fast ForWord is a suite of computer-based intervention programs designed to improve oral language and literacy skills in children with language learning weaknesses. The programs developed from a theory that claims language and literacy learning difficulties in children may arise from impairments in rapid auditory temporal processing skills (Tallal & Piercy, 1973; Tallal, 1980; Reed, 1989; Tallal, Miller, & Fitch, 1993; Tallal et al., 1996; Tallal, 2000). A corollary of this theory is that, given neuroplasticity, appropriate training can lead to lasting improvements in underlying neural systems and concomitant improvements in children’s language and reading skills (Merzenich & Jenkins, 1998).
Early studies used a precursor to Fast ForWord on small groups of children with specific language impairment (SLI). Two linked papers by Tallal et al. (1996) and Merzenich et al. (1996) reported data from two small-scale studies. In the first study, which lacked a control group, it was reported that 7 children with language impairments showed improvements on measures of language skills after just 4 weeks’ training with a computer-based program using acoustically modified speech. A second, small-scale non-randomised study of 22 children, described in the same articles, compared the effectiveness of an equivalent training program either with, or without, the acoustically modified speech component. It was claimed that the children in the acoustically modified speech group made greater gains on measures of language ability, although these gains would not be reliable based on a conventional (2-tailed) statistical test. We believe that the design limitations (very small sample sizes, and only the second study included a control group but did not use random assignment) and the absence of statistically reliable effects (the effects were reliable on a 1-tailed test only in the second study) preclude any strong claims for the effectiveness of Fast ForWord from these studies.
Based on these early studies, Fast ForWord was launched as a commercial product by the Scientific Learning Corporation, and it is claimed that the program results in a ‘wide range of improved critical language and reading skills’ (see http://www.scilearnglobal.com/the-fast-forword-program/). Fast ForWord is a suite of computer programs that contain language-based audiovisual games designed around themes intended to engage children aged between 4 and 14 years with language difficulties (Scientific Learning Corporation, 1999; http://www.scilearnglobal.com/; http://en.wikipedia.org/wiki/Fast_Forword). The games are adaptive and contain speech that is acoustically modified by a two-stage processing algorithm (Nagarajan et al., 1998) and adapt with the child’s progress, gradually decreasing modification. The program also incorporates other language training elements, akin to those used by speech and language therapists, in order to ‘cross-train’ many different skills at the same time (Tallal, 2000).
Fast ForWord was launched commercially in 1997, and is now used in many schools and clinics in the USA, Canada and Australia as well as in the UK and other countries. In a scope of use study by the What Works Clearinghouse (2007) it was estimated that Fast ForWord has been used by over 570,000 children in more than 3,700 schools in the US, with the Scientific Learning Corporation (1999) claiming language gains of 1½ to 2 years in a training period of only 4 to 8 weeks. However, there is much controversy over the effectiveness of Fast ForWord (Cirrin & Gillam, 2008). Many of the claims which the Scientific Learning Corporation make appear to be based on findings from their privately conducted and non-peer-reviewed studies (Scientific Learning Corporation, 1999, 2003) rather than independent studies published in peer-reviewed journals. Moreover, it is still unclear as to whether the improvements observed in these studies are directly related to the acoustically modified speech component of the program.
A scoping review, carried out as background to the present review, revealed four existing systematic reviews dealing with the effectiveness of the Fast ForWord program. The first review was a meta-analysis of the effectiveness of Fast ForWord on academic performance in general (Sisson, 2009). The second reviewed general language interventions for children with spoken language disorders (Cirrin & Gillam, 2008); two reviews, conducted by the What Works Clearinghouse, were intervention effectiveness reports looking at the effects of Fast ForWord on beginner readers and Fast ForWord-Language on English language learners (What Works Clearinghouse, 2007, 2006).
Sisson (2009) carried out a systematic review of studies measuring the efficacy of Fast ForWord and located 31 studies which met inclusion criteria. Effect sizes were computed across many areas of academic skill; however, Fast ForWord was found to have no particular effect on any of the skills analysed. The computed mean effect size was found to be small and pooled effect sizes for each skill were also subject to much variability, suggesting that there are no significant effects of Fast ForWord on academic performance.
Cirrin and Gillam (2008) reviewed studies of language intervention practices published since 1985 which involved school-aged children who were diagnosed with spoken language disorders. A search of electronic databases and a hand search of other sources located 21 studies that the authors judged to have used suitably stringent procedures for evaluating general language interventions; of these, five studies involved Fast ForWord. The conclusion drawn from this review is that programs such as Fast ForWord are ‘neither necessary nor sufficient to induce significant changes in processing or expressive and receptive language skills’ (Cirrin & Gillam, 2008, p. S129).
In a report on the effects of Fast ForWord on beginner readers (kindergarten to third grade) published by the What Works Clearinghouse (2007), five studies were located which met their standards and an additional study was included with reservations. Effectiveness was assessed by outcome measures of phonic reading skills (phonological awareness, phonics and letter knowledge) and comprehension. This report concludes that there are positive effects of Fast ForWord on phonic reading skills but mixed effects on comprehension outcomes. However, the procedures used and the conclusions drawn from this review have been roundly criticised by McArthur (2008); in particular, McArthur argued that this review was largely based on unpublished studies conducted by the Scientific Learning Corporation and failed to include a key study that was published in a peer-reviewed journal.
The What Works Clearinghouse (2006) intervention report for Fast ForWord Language on English language learners reviewed one paper which met evidence standards and one which met them with reservations. These studies focused on phonological awareness, reading achievement and English language development outcome measures in children between kindergarten and sixth grade. The conclusions of this review are that Fast ForWord Language could have a positive effect on English language development but no apparent influence on reading achievement.
The evidence from existing reviews of the effectiveness of the Fast ForWord program appears unpromising. Given the fact that this program is in such widespread use it seems a matter of some importance and urgency to establish whether the program can be deemed to be effective, and if so, for which skills. With this aim in mind, this paper reports a systematic meta-analytic review of evidence for the effectiveness of the Fast ForWord program.
In this paper, we report a meta-analysis of all the studies of Fast ForWord that we could identify that have used an appropriate design (see below for details). We assess the effects of the program on the four critical areas that have been most studied and that are of clear practical and clinical relevance (standardised measures of Single Word Reading, Passage Reading Comprehension, Receptive Vocabulary and Expressive Vocabulary).