Effective collaborative practice is expected of newly qualified speech and language therapists (SLTs) in order to achieve the best outcomes for clients. Research into collaborative practice has identified a number of barriers to and facilitators of collaborative practice, but there has been limited research into how well prepared newly qualified SLTs are to carry out collaborative practice or their beliefs about its value. There is emerging research into the teaching of collaborative practice in higher education institutions; however, studies have typically focused on medical professions, with limited research into the teaching of collaborative practice for allied health professionals. This study set out to explore newly qualified SLTs’ beliefs about the value of collaborative practice; barriers to and facilitators of collaborative practice in paediatric work settings; the effectiveness of the teaching of collaborative practice on their pre-registration higher education course; and how the teaching of collaborative practice on SLT university courses could be improved. Semi-structured telephone interviews were carried out with 10 newly qualified speech and language therapists. Responses were analysed qualitatively using thematic analysis. Results indicated that participants in this study regard collaborative practice as important for effective practice, particularly for the purpose of delivering intervention. The participants typically described their role as a provider and receiver of information about a child, but only as a provider of skills. This lack of reciprocity may be an additional barrier to effective working relationships with school staff. Participants emphasized the need for better links between theory and practice in the teaching of collaborative practice at university, and were disappointed by the variability of opportunities to experience collaboration on placement. Increasing the value of collaborative practice could be addressed by assessing it in line with more traditional clinical skills. Additionally, engagement with other professionals at university through case-based workshops could ensure that all students have equitable opportunities to experience and develop skills in collaborative practice. This study adds to the literature on barriers to and facilitators of collaborative practice. It also serves as a preliminary study to enrich understanding of the beliefs of newly qualified SLTs regarding the current teaching of collaborative practice and indicate how learning opportunities could be improved.
Speech and language therapists’ (SLTs) roles include enabling parents to provide intervention. We know little about how parents understand their role during speech and language intervention or whether these change during involvement with SLTs. The theory of conceptual change, applied to parents as adult learners, is used as a framework for understanding changes in parents’ conception of roles during intervention. The aims of the study were (1) to investigate parents’ conception of their own and SLT roles during speech and language therapy intervention and (2) to explore changes in parents’ conception of their role as they work with SLTs. A qualitative study was conducted using semi-structured interviews with 14 parents of pre-school children with speech and language needs referred to speech and language therapy in the UK. A subset of 8 parents participated in a longitudinal study over nine months to track any changes in conception of roles during intervention. Interviews were analysed using Thematic Network Analysis to identify basic, organizing and global themes. Framework Analysis was used to compare participants over time and identify any changes reported by parents. Parents had a firm conception of their role as advocates but did not express a clear notion of their role as intervener before involvement with the SLT. During intervention, some described changing their conception of role including adopting roles as ‘implementer’ and ‘adaptor’ of intervention. In some cases, parents described changes in their approach to parenting which they associated with adopting more active roles as interveners. Policy statements about parental choice and co-working typically present parents’ conception of roles as fixed. This research shows that parents may change their conception of role as they work with SLTs and become increasingly involved as interveners. Implications for practice include negotiating roles in the partnership before intervention begins and enabling parents to adopt an intervener role.
Early intervention is widely recommended for children at risk of difficulties with speech, language and communication. Evidence for effective practice remains limited due in part to inherent difficulties in defining complex interventions and measuring change. The innovative Language Environment Analysis (LENA) system has exciting potential for early intervention and for evaluating outcomes. LENA is used widely in the USA; however, there is little to guide the introduction of this new technology in the UK. Successful implementation of new technology is predicted by its perceived acceptability and usefulness. This qualitative pilot study aimed to explore the acceptability of LENA for UK families with a young deaf child. Four families used LENA to record for one day. They received and discussed LENA feedback reports with a specialist speech and language therapist. Using qualitative methodology with a pragmatic epistemology, semi-structured interviews were conducted and the data explored using thematic analysis. Three families were positive about using LENA; they identified benefits of the feedback, suggested important factors for future use and would recommend it to other families. One family chose not to complete the recording. Key to acceptability is parental understanding of LENA’s purpose and the need for a trusted professional to facilitate interpretation and change. LENA is acceptable for some UK families with a young deaf child suggesting there is potential for successful implementation. Further study to explore LENA’s usefulness is recommended.
Speech and language therapists (SLT) frequently operate in an integrated manner, working with other professionals in the delivery of services to children. Since the end of the 1990s within the UK SLTs have developed integrated services within the field of public health. This study reports an evaluation of an integrated model of service delivery for a family focused health promotion service for early language development, the Babytalk Home Visiting (BTHV) service in terms of reach and perceived quality of service delivery. Children’s Centres workers were trained to deliver the service alongside existing SLT assistants. Ongoing supervision was delivered by the SLT service. The effect of integrated staffing was compared with the original single agency model through comparison of contact monitoring data and parental feedback questionnaires. Availability of the BTHV service was successfully extended by a factor of 4.46 and actual contacts by a factor of 3.96 compared to a staffing increase of a factor of 2.88. There was no evidence of a significant difference between results of parental evaluation forms from the extended service and the original service, indicating that the quality of service delivery was not compromised. Limitations of evaluation methods are highlighted and research priorities recommended.
The aim of this study was to evaluate the effectiveness of a computer-based executive function (EF) training in children with specific language impairment (SLI). Ten children with SLI, ages 8 to 12 years, completed a 25-session training of visuospatial working memory, inhibition and cognitive flexibility over a 6-week period. Treatment outcome was examined directly after training and at 6 months follow-up by tasks of the three trained EF, tasks of untrained neurocognitive functions (verbal working memory, attention, planning and fluency), and ratings of EF and behavioral problems by parents and teachers. Directly after training, results showed significant improvement on cognitive flexibility and a positive trend for visuospatial storage and inhibition. At 6 months follow-up, the children performed significantly better on tasks of all three trained EFs. Furthermore, the results showed significant improvement on sustained attention, attention control, parent- and teacher-rated attention behavior and parent-rated EF and externalizing behavior with medium effect sizes. The results of this pilot study highlight the importance of a large-scale, randomized controlled trial examining the possible effects of EF training in children with SLI.
Young people from areas of socioeconomic disadvantage (SED) are more likely to present with language difficulties, particularly vocabulary difficulties. Studies have shown the effectiveness of vocabulary interventions for children with language impairment but not for adolescents from areas of SED. This article aims to establish the effectiveness of a whole class vocabulary intervention provided by teachers, with speech and language therapy support for adolescents in secondary schools in areas of SED. Two hundred and three adolescents (aged 11;11–13;11) from four secondary schools were assessed at pre-intervention and post-intervention on measures of receptive and expressive language; word definitions; receptive vocabulary (standardized assessments/subtests) and word associations (criterion referenced subtest). The intervention group (n = 128) received the intervention delivered by their English teacher twice a week for 12 weeks in the first school term and were compared with a group of waiting controls (n = 75). Waiting controls were given the intervention in the second school term and were assessed a third time in a repeated measures design. At pre-intervention stage 37%–60% of all students scored in the vocabulary difficulties range on all assessments. Following intervention, the treated group showed significant, but small, time by group interactions for raw score measures of expressive language and receptive vocabulary. The intervention group improved significantly on all four standardized measures; waiting controls improved on two: receptive language and word definitions. There were no significant time by group interactions. Following receiving intervention waiting controls showed significant interactions for all raw score and expressive language, word definitions and receptive vocabulary standard/scaled score measures. The findings suggest that adolescents in schools in areas of SED present with significant vocabulary difficulties, but whole class teacher-directed intervention supported by speech and language therapists has the potential to improve receptive and expressive oral vocabulary skills.
While little is known about why children make speech errors, it has been hypothesized that cognitive-linguistic factors may underlie phonological speech sound disorders. This study compared the phonological short-term and phonological working memory abilities (using immediate memory tasks) and receptive vocabulary size of 14 monolingual preschool children with phonological delay with individually matched peers with typical speech development. The immediate memory tasks examined forward recall of familiar words (pointing response), reverse recall of familiar words (pointing response), and reverse recall of digits (spoken response). The results indicated that children with typical speech development had larger receptive vocabularies and performed significantly better than children with phonological delay on all immediate memory tasks. Qualitative error analyses revealed that while the two groups made similar errors on the forward memory task, children with phonological delayed performed differently on reverse recall of spoken digits. These findings suggest a link between immediate memory and delayed phonological development.
Substantial evidence exists that social circumstances can affect children’s language development. As a result many children in socially deprived areas start school with delayed language, which may persist and adversely affect their attainment. We assessed the language of children in seven reception classes in a London (UK) borough and followed the progress of children with English as their first language (E1L) and with English as an additional language (EAL) during their first 2 years at school. Significant differences were found between schools. The effect of social factors on performance was reflected in a high correlation between the mean language score for each school and the percentage of children in the school receiving the pupil premium. Many of the children with EAL had very low scores reflecting their limited exposure to English prior to starting school. Most of these children attended schools where children with E1L also had low scores increasing the demands on the schools and their teachers. Children who had low initial scores made modest but significant progress during their reception year but failed to improve further during year 1 despite having non-verbal ability appropriate for their age. These results support previous findings that social deprivation can seriously delay language development, and that many children start school with weak communication skills. They add to previous findings by showing that the level of delay may differ substantially across schools in the same borough, by reporting data on children with EAL and by showing that children struggle to improve their abilities in the first 2 years of school.
Children with developmental language impairments (DLI) are often reported to show difficulties with working memory. This review describes the four components of the well-established working memory model, and considers whether there is convincing evidence for difficulties within each component in children with DLI. The emphasis is on the most demanding form of working memory that draws on central executive (CE) resources, requiring concurrent processing and storage of information. An evaluation of recent research evidence suggests that, not only are children with DLI impaired on verbal CE measures, but they also show difficulties on non-verbal CE tasks that cannot be assumed to tap language. Therefore, it seems increasingly likely that children with DLI show domain-general CE impairments, along with their more established impairments in verbal short-term memory. Implications for potential working memory interventions and classroom learning are discussed.
Foetal growth restriction is associated with problems in neurocognitive development. In the present study, prospectively collected cohorts of foetal growth restricted (FGR) and appropriate for gestational age grown (AGA) children were examined at early school-age by using the Children’s Communication Checklist-2 (CCC-2) to test the hypothesis that FGR children demonstrate poorer communication skills than AGA children. Furthermore, potential differences between FGR children born prematurely and at term were evaluated, as well as the effect of assessment age on CCC-2 performance. The FGR-children demonstrated poorer language structure and language use than the AGA group. Nineteen percent of the FGR children scored below the 15th percentile threshold value in General Communication Composite, compared to 7% of the AGA children, indicating clinically significant problems in communication skills. Furthermore, impaired communication skills became more evident as the FGR children reached >= 9 years of age. Prematurity was associated with low CCC-2 scores. We conclude that FGR, especially in combination with prematurity, is associated with reduced communication skills. With advancing age and increased academic demands the problems become more evident, indicating a need for early recognition, timely interventions and continuous linguistic evaluations of FGR children in order to optimize their long-term outcome in academic and communication skills.
Children with speech, language, and communication needs (SLCN) form a highly heterogeneous group, including those with an unexplained delay in language development known as specific language impairment (SLI). There is growing recognition that multiple mechanisms underlie the range of profiles observed in these children. Broadly speaking, both the domain-general executive attentional system known as working memory and domain-specific linguistic processing have been implicated in children with SLI. It has been challenging to tease apart these influences, however, due to the symbiotic relationship between working memory and language learning. For example, working memory limits might constrain the linguistic detail encoded, whereas poor language knowledge would place greater demands on working memory for retaining unfamiliar phonological information. There is growing evidence for separable impairments in these processing resources leading to relative deficits in linguistic or working memory processes in different children. Such findings have important clinical implications for both the assessment and treatment of children with SLCN.
This study investigates whether extension of a caregiver-led interactive language program may enhance its effectiveness in supporting communication. Caregiver-led language programs, which focus on establishing responsive interaction patterns to support opportunities for communication between caregivers and young children within natural settings, are frequently used in early childhood intervention services. One example is the Hanen Program It Takes Two to Talk® (ITTT), which involves working in groups with caregivers, with some concurrent individualized support for families. Given the importance of communication, potential strategies to enhance the effectiveness of such programs warrant investigation. Based on a transactional theory of interaction, it can be hypothesized that by directly supporting communication partners to continuously adapt to each others’ behaviours, individualized interventions may further enhance the outcomes of ITTT and, potentially, similar programs. In phase one of this study, 10 caregivers of young children with a range of disability labels completed the ITTT program. Participants were then randomly assigned to a control or experimental group for phase two. In the experimental group, the caregivers were provided with additional individual sessions with a Speech Language Therapist over the subsequent four months. Assessments of caregiver–child interactions were conducted prior to commencing the ITTT program, following the completion of phase one, and again at the completion of phase two. Significant positive changes were found at the completion of phase one for all participants. These findings support the effectiveness of the ITTT program. At the completion of phase two further significant positive changes were found for the experimental group. For the control group there was no further notable change. Although this is a small study, the findings have implications for practice in demonstrating that extending the individualized support provided within such programs may facilitate increased communication, with benefits for caregiver–child interactions and relationships and for child participation more broadly.
A growing number of research projects show that graphic symbols with linguistic characteristics are one of the tools that professionals use in order to support pupils in inclusive school settings. However, there is scant literature investigating the collaboration between professionals who use these symbols in these settings and, hence, this research article is aimed at exploring the factors that promote or hinder collaboration between speech and language therapists and school staff who use graphic symbols. The phenomenology of pedagogy was the methodological framework used in the research and for this reason, semi-structured interviews, close observations and the researcher keeping a reflective journal were the main instruments that were used during data collection. Based on a survey conducted in 100 schools in two different geographical areas in England and in Cyprus, four schools were selected in which nine professionals in total participated in the research. The findings show that collaboration among school staff was influenced by the shared understanding the participants had about their own and others’ professional roles and goals, the availability of time for meeting as well as the support they received from school staff in positions of authority.
Language comprehension delays in pre-schoolers are predictive of difficulties in a range of developmental domains. In England, early years practitioners are required to assess the language comprehension of 2-year-olds in their care. Many use a format based on the Early Years Foundation Stage Unique Child Communication Sheet (EYFS:UCCS) in which the child’s language comprehension is assigned to an age band based on written guidance. Seventy 21/2–3-year-olds were assessed on the comprehension component of the Preschool Language Scale (PLS) by psychology graduates. Early years practitioners assessed language comprehension in the same children using the EYFS:UCCS and the WellComm, which involves some direct testing. The EYFS:UCCS had poor sensitivity and specificity, and the understanding section did not correlate with the PLS. The WellComm had good to acceptable levels of sensitivity and specificity and significantly correlated with the PLS. Early years setting staff can accurately assess the language comprehension of 2-year-olds if provided with a tool which gives specific instructions on administration, but current frequently used procedures (EYFS:UCCS) are not fit for this purpose.
While participatory research approaches are being developed and applied within speech and language therapy practice it is not clear that all children are afforded the opportunity to participate in such activities. This study aimed to explore the involvement of young children, aged between two and four years, with developmental disabilities in the research process, focusing on early intervention disability services. Eight young children took part in this qualitative research. Clark and Moss’s (2011) framework for listening was used to structure the multi-method data collection process. The design was iterative; the collection of data from each participant was followed by a review of theoretical ideas to support the emerging data. Findings suggest that the use of an asset based approach to participation in research, focusing on participants strengths through a variety of data collection tools, used by a skilled facilitator, supported by parental expertise enabled the children to be part of the data collection process. The research highlights that speech and language therapists can facilitate the inclusion of children with disabilities in research activities about their early intervention service they receive. As members of early intervention teams speech and language therapists need to promote their skills in facilitating the active engagement of children with developmental disabilities in research. Thus making their participation in early intervention research, a reality with potential to promote holistic practice.
A common early intervention approach for preschool children with language problems is parent–child interaction therapy (PCIT). PCIT has positive effects for children with expressive language problems. It appears that speech and language therapists (SLTs) conduct this therapy in many different ways. This might be because of the variety of approaches available, the diverse set of families SLTs work with or the different organizational structures. Understanding the critical components of PCIT would enable SLTs to map the variations that are implemented and researchers to evaluate the effects of such variation. This study aimed to identify the potentially critical components of PCIT based on the practical experience of SLTs and to identify SLTs’ rationales for the way they structure PCIT. Both parameters are important for the long term goal, that is, to develop a framework that can be used to support practice. Semi-structured interviews were conducted with 10 SLTs who had at least one year experience in delivering PCIT with preschool children with language impairment. The interviews were transcribed and analysed, using thematic analysis. Analysis of the SLT interview data identified four potentially critical components that underpin the teaching of strategies to parents: parents’ engagement, parents’ understanding, parents’ reflection and therapists’ skills. SLTs suggested that all four components are needed for the successful delivery of PCIT. The reasons that SLTs give for the way in which they structure PCIT are mainly based on organizational constraints, family needs and practicalities. SLTs consider PCIT to be valuable but challenging to implement. A framework that makes explicit these components may be beneficial to support practice.
The Intelligibility in Context Scale (ICS) is a screening questionnaire that focuses on parents’ perceptions of children’s speech in different contexts. Originally developed in English, it has been translated into 60 languages and the validity and clinical utility of the scale has been documented in a range of countries. In South Africa, there are 11 official languages, yet few assessment materials are available in languages other than English. In this article we describe the cross-cultural adaptation of the ICS into a screening tool encompassing all South Africa’s official languages in addition to English. Objectives were: (1) to describe the linguistic and conceptual equivalence of the 10 translated versions compared to the original ICS; and (2) to evaluate speech-language therapists’ (SLT) perceptions of the usability and value of the ICS translations in the languages of South Africa. Twenty-five participants translated the ICS into 10 official languages of South Africa using forward and back translation and community checking. Next, a survey of 23 SLTs practicing in South Africa, and semi-structured interviews with five SLTs working in Cape Town, took place. The conceptual and linguistic equivalence of the adapted materials for each language was considered. Concepts that were challenging to translate from English into many of the Bantu languages included those relating to immediate/extended family, acquaintances, strangers and hearing/understanding. Linguistic challenges in translation related to dialectal differences and the use of pronouns. The SLTs in the sample found the ICS easy to use and saw it as a useful component of assessment especially when working with families who do not share a language with the SLT. Overall the study contributes to the development agenda of SLTs working in South Africa by creating and trialing the ICS in all the countries’ official languages to improve access and quality of services offered to all the families they serve.
Enhancing communication performance skills may help children with Down Syndrome (DS) to expand their opportunities for participation in daily life. It is a clinical challenge for speech-language pathologists (SLP) to disentangle various mechanisms that contribute to the language and communication problems that children with DS encounter. Without clarity of different levels of functioning, appropriate interventions may be poorly conceived or improperly implemented. In the present study, the International Classification of Functioning, Disability and Health – Children and Youth Version (ICF-CY) framework was used to classify contributing factors to communication performance in a multiple case study of six young children with DS. Within a comprehensive assessment, we identified individual and environmental facilitators and barriers, leading to an integrative profile of communication performance (IPCP) for each child. Whereas these six children shared a developmental, and/or expressive vocabulary age and/or level of communicative intent, the children faced similar but also unique personal and environmental factors that play an important role in their communication performance. Our data reveal that a combination of different factors may lead to the same language outcomes and vice versa, based on a unique pattern of interdependency of ICF-CY domains. Planning SLP interventions for enhancing communication performance in children with DS should therefore be based on a comprehensive view on the competences and limitations of every individual child and its significant communication partners. This evaluation should address facilitators and barriers in body functions, structures, activities, participation and environment, with a specific focus on individual strengths. The ICF-CY provides a useful framework for constructing an IPCP that serves this purpose.
Young children need rich learning experiences to maximize their potential. Early childhood educators (ECEs) working in childcare have knowledge of individual children as well as skills and professional knowledge that afford opportunities to provide language-rich environments for learning. To successfully work in partnership with ECEs, speech-language pathologists need to understand what they know about early communication development and how they apply it in their work. This study explored ECEs’ understanding of early communication development in childcare contexts, and how they related this to the education and care they provided. In this exploratory study we conducted three focus groups with 19 ECEs who were employed in eight different childcare centres in low socio-economic areas in metropolitan Adelaide, South Australia. Data were analysed thematically revealing three core themes: ‘Knowing and doing in context’; ‘ECEs’ role’; and ‘ECEs’ challenges’. Participants articulated understanding of early communication development and the importance of strong relationships between ECEs, children and their families. These ECEs’ skills and knowledge of children in their care was the basis from which they provided language-rich learning environments with individually tailored educational programmes to support all children, including those experiencing communication difficulties. They highlighted challenges in delivering this care, including the need for more explicit support from speech-language pathologists. There is potential to further develop interdisciplinary partnerships between ECEs in childcare and other professionals, such as speech-language pathologists, to maximize early developmental opportunities for children attending childcare.
Research into intervention strategies for developmental verbal dyspraxia (DVD) clearly demonstrates the need to identify effective interventions. The goals of this study were to examine changes in articulation skills following the use of phonetic, multimodal intervention and to consider the relationship between these improved articulation skills and perceptions of resilience behaviors. These changes were related to components of the World Health Organization (WHO) International Classification of Functioning, Disability, and Health, Children and Youth version (ICF-CY). The intervention was implemented daily for 12 children diagnosed with DVD, ages 3 to 10 years, enrolled in a school for children with speech, language, and hearing impairments on a university campus in the southeast of the USA. Eleven children presented with significant comorbid conditions. Changes in articulation, along with changes in parents’ and speech-language therapists’ (SLTs’) perceptions of resilience behaviors were measured. At the end of a 2-year period, statistically significant gains in articulation and parents’ and SLTs’ perceptions of resilience behaviors were noted. The relationship between improved articulation skills and increased resilience behaviors is discussed.
Two 6-year-old male fraternal twins each received 8 weeks of morphosyntactic and phonological intervention in counterbalanced order. Progress occurred for most targets and measures, with each child making greater progress for either phonology or morphosyntax during the corresponding unitary-domain block. Gains were maintained during the subsequent alternate treatment block. Possible indirect changes in the non-treated domain were also observed in global measures. The data suggest that at least some school-aged children with concomitant difficulties in morphosyntax and phonology, perhaps those with significant constraints in each domain, can benefit from sequences of unitary-domain intervention. This study invites further research concerning many unresolved clinical issues for school-aged children with protracted development in both phonology and morphosyntax.
Models of speech and language intervention for communicative disabilities vary from structured programmes to more interactive and ecological methods (Fey, 1986). Ideally, a model for intervention should fit the interests and personality of the patient, focus on crucial aspects of speech and language, and be suited to the patient’s everyday communication needs (Johnston, 2006). The present article addresses how features of everyday interaction and speech and language intervention may be captured and used for children with language impairment (LI), their caretakers, and speech and language therapists (SLTs), within and outside of clinical practice. Specifically, the aim of the study is to explore the use of retrospection (Erickson and Schultz, 1982), based on Conversation Analytical (CA) methodology (e.g. Schegloff, 2007), and to establish if and how CA-based retrospection may contribute to raising participants’ awareness of their own and others’ interactional behaviours. Retrospection here refers to sessions where participants watch and comment on sequences of video-recordings from intervention, as well as from situations captured in a variety of everyday settings. Four children with LI and three speech and language therapists participated, as well as parents of the children. The procedure comprised analysis and transcription of video-recordings of everyday interaction and intervention involving the children, retrospections with the children, the parents of the children with LI, and the SLTs, and analysis and transcription of the recordings made of the retrospections. The analysis of the retrospections generated four categories of phenomena relevant for intervention and everyday interaction: (1) Observations of well-functioning interaction strategies; (2) Observations of less well-functioning interaction strategies; (3) Assessment of positive performance; and (4) Comments relating to intervention. The results show that CA-based retrospection may be used to raise the participants’ awareness of their own interactional behaviours, and provide the opportunity to discuss strategies relevant for both intervention and everyday interaction for children with LI.
This study analyses the case of a gifted child (9;6 year) with autism spectrum disorder (ASD) who had a particularly high verbal IQ (146) and a specific cognitive, linguistic, and metalinguistic profile. A description of some salient behavioral characteristics of the child is provided. A metalinguistic ability test assessing metagrammatical, metasemantic, and metaphonological abilities and a metaphor comprehension test were administered. Both tests place high value on justifications of responses, which permits investigators to grasp different levels of metalinguistic awareness. The child gave poor metalinguistic responses in subtests assessing metasemantic abilities, contrary to subtests assessing metagrammatical and metaphonological abilities. These discrepant results are interpreted in terms of this child’s specific difficulty with ‘open’ linguistic systems, such as semantics, in spite of his high ‘closed’ language capabilities. The discussion highlights the importance of assessing the meta-level of the verbal competencies of gifted children with ASD.
This pilot study compared the phonological awareness skills and vocabulary performance of English monolingual and Spanish–English bilingual children with and without hearing loss. Preschool children with varying degrees of hearing loss (n = 18) and preschool children without hearing loss (n = 19) completed measures of phonological awareness and receptive and expressive vocabulary knowledge. On phonological awareness tasks, the performance of bilingual children with hearing loss was significantly higher than bilingual children with normal hearing, but not higher than either monolingual group of children. On norm-referenced vocabulary knowledge measures, the performance of monolingual and bilingual children with hearing loss was significantly lower than monolingual and bilingual children with normal hearing. Correlations for phonological awareness and vocabulary knowledge were found for both groups of children with normal hearing, but not children with hearing loss. This study represents preliminary evidence that children with hearing loss may develop phonological awareness differently than children with normal hearing and that language and educational experience are critical to understanding the phonological awareness performance in children with hearing loss.
Word finding difficulties are often seen in children with language difficulties. Their problem is readily observed and has led to investigations of its nature and encouraged attempts at intervention. Semantic errors in their naming suggest that their knowledge of items is poorly developed and that therapies to strengthen it may be effective. Twelve children between 7 and 11 years of age were offered 3 hours of semantic therapy in two 15-minute sessions per week for 6 weeks. The children had severe and complex speech, language and communication needs and all were in the bottom 5% for their age on a test of word finding. Two categories of items were treated. Each category was divided into sets of items that were directly treated, and items which appeared during therapy but were not specifically targeted. Categories and sets of items were counterbalanced across children. The children were blind assessed on naming the items before and after therapy and at a maintenance assessment 6 weeks after the treatment ceased. The children improved significantly on the treated items and on untreated items from the same category but not on items from the untreated category. Improvement was maintained at the maintenance assessment. Although results were significant, only medium effect sizes were obtained. These results add to the evidence that semantic therapy can help children with word finding difficulties. In assessing their clinical significance, the severity of the children’s communication problems should be taken into account.
Dynamic assessments (DA) of language have been shown to be a useful addition to the battery of tests used to diagnose language impairments in children, and to evaluate their skills. The current article explores the value of the information gained from a DA in planning intervention for a child with language impairment. A single case study was used to demonstrate the detailed qualitative information that can be derived from a DA procedure, and how that information may be used to elicit greater gains from intervention. The participant was a boy, aged 9, with a previously diagnosed language impairment. He was receiving language therapy regularly in a language resource base attached to his school. The CELF-3(UK) was used to monitor changes in his language, before and after two periods of intervention. The initial baseline phase consisted of regular ongoing language therapy. The second phase of therapy was modified by the speech and language therapist after receiving a report of the child’s performance on the Dynamic Assessment of Sentence Structure (DASS; Hasson et al., 2012), and observations of the child’s metalinguistic and metacognitive awareness. Greater gains observed in the second phase of therapy reflected the good modifiability shown by the child’s performance on the DASS.
The ultimate aim of intervention for children with language impairment is an improvement in their functional language skills. Baseline and outcome measurement of this is often problematic however and practitioners commonly resort to using formal assessments that may not adequately reflect the child’s competence. Language sampling, transcription and analysis provide a more thorough and realistic picture of a child’s abilities but are time consuming and usually considered unfeasible in the typical clinic setting. This article reports on a pilot study in which a speech and language therapy assistant (SLTA) carried out language transcription using language analysis software. Following a brief initial training period, the SLTA carried out transcriptions on 17 language samples at two time periods. Reliability between a speech and language therapist and the assistant’s transcriptions were calculated and were found to be acceptable for the majority of measures taken. The use of software by assistants is proposed as a viable alternative for outcome measurement of naturalistic language skills.
Young people are using digital technology and online social media within their everyday lives to enrich their social relationships. The UK government believes that using digital technology can improve social inclusion. One well-recognized outcome measure for establishing social inclusion is to examine opportunities for self-determination. Individuals with physical disabilities and complex communication needs who use forms of augmentative and alternative communication (AAC) have lower social participation opportunities. The integration of mainstream digital technology into high-tech forms of AAC (voice output communication aids), and the recent appearance of voice output applications, or ‘apps’, on Apple and Android products, has provided increased opportunities for people who use AAC to engage with digital technology. Research exploring this area, especially in regard to online social media, with people who use AAC is extremely limited, and a specific gap for self-reported experiences exists within the UK. This article describes qualitative, interview-based, grounded theory research with 25 adolescents and young adults who use AAC about their use of digital technology and online social media. The data presented here are part of a larger study, and the findings within this article suggest that participants have a desire to use the internet and online social media as it is perceived to increase opportunities for self-determination and self-representation whilst enriching friendships. The wide diversity of literacy and language skills amongst participants, as well as accessibility challenges, mean collaborating with others and receiving technical support from educational settings, families and friends are vital.
There is a rapidly increasing range of augmentative and alternative communication (AAC) systems available for children who cannot communicate orally. Finding the best system for any one user is a challenge for the professionals and carers involved. As yet the use of portable, tablet forms of communication aid has been little researched, despite the rapid growth in their popularity. This article seeks to establish how a tablet form of AAC is exploited in day-to-day domestic interactions between a parent and a child where the child has a severe physical disability and complex communication needs. The study utilises conversation analysis (CA) as the methodology and looks in detail at sequential components of the interaction and the salience of certain interactional moves to both adult and child participants. The mother chose when and where the iPad or other forms of AAC were utilised within the day. Extracts were selected from the available data to exemplify the types of typical exchange that occurred and some key features of the iPad enhanced interaction. The analysis describes how turns are designed incorporating the iPad and discusses what is added to the communication toolkit. Asymmetries in this mother–child interaction are observed and discussed. The child typically remains a respondent to initiations by the caregiver, who in this scenario necessarily remains in control of the iPad symbol display. However, the child uses eye-gaze strategies to indicate interests that lie both within and external to those on offer on the iPad. The article reflects on the child’s agency in initiating a possible novel topic in this way.
Research indicates that a significant number of children enter primary school with insufficient vocabulary knowledge. This study investigates whether a small group daily word learning programme delivered by the class teacher can improve word learning in young children.
Eighteen children, aged five to six years, with English as an additional language or poor language development, attending three schools in an area of social deprivation, participated in the study. Class teachers implemented a principled approach for teaching and learning vocabulary that included the development of word-learning strategies. Vocabulary knowledge was assessed pre- and post-intervention using a non-standardized, study-specific measure that compared taught and untaught vocabulary. Receptive vocabulary was also measured using standardized assessment. Pupil and teacher questionnaires were presented before and after the intervention. There were significant changes in children’s knowledge of both taught and untaught words, with more change in knowledge of taught words. Some children also showed significant change on standardized measurement of vocabulary. Class teachers reported changes in their practice and some children reported using a wider range of strategies to learn words.
Video modeling involves the learner viewing videos of a model demonstrating a target skill. According to the National Professional Development Center on Autism Spectrum Disorders (2011), video modeling is an evidenced-based intervention for individuals with Autism Spectrum Disorder (ASD) in elementary through middle school. Little research exists evaluating video modeling for individuals with ASD in high school. This study examined the effectiveness of video modeling to facilitate the development of word recognition and pronunciation in three male high school students with ASD. A single-case multiple baseline experimental design across participants (i.e. video modeling sequentially implemented across three students) was used to evaluate the effectiveness of video modeling. Results indicate that video modeling was effective in facilitating word recognition and pronunciation. Findings suggest that video modeling may be a viable intervention to foster the reading development of adolescents with ASD.
Youth with complex communication needs (CCN) face increased barriers to their social participation due to limited communication abilities and opportunities. Youth today use the internet as a social tool and youth with CCN may also benefit from internet use to increase their social participation. Five youth between the ages of 10–18 with CCN who are unable to use speech for everyday communication and require augmentative and alternative communication were provided with assistive technology and a tailored 1:1 intervention at home to learn to use the internet for connecting with others. Pre and post assessments measured changes in performance on internet use goals, social networks, loneliness and self-concept. Multiple measures were used to examine the impact of internet use for social networking on a range of outcomes and to gather emerging evidence in this area. Results showed that the intervention was effective in increasing performance and satisfaction with goals for increasing internet use to connect with others and for increasing the number of online communication partners. There was no significant change in loneliness or self-concept. This study shows that the internet may be a viable tool in increasing the social participation of youth with CCN. However, some youth and their families required intensive support and technical assistance to gain confidence in internet use and in use for social purposes.
Speech and language delay occurs in approximately 6% of the child population, and interventions to support this group of children focus on the child and/or the communicative environment. Evidence about the effectiveness of interventions that focus on the environment as well as the (reported) practices of speech and language therapists (SLTs) and other Early Years Practitioners (EYPs) in this regard are limited. One-to-one, semi-structured interviews were carried out with 12 EYPs from one city in North England in order to reveal their beliefs about the impact of the child’s environment on language development and how they report assessing and intervening where they have concerns about child language development, in children aged from birth to 5;11 (5 years, 11 months). Interviews were analysed thematically. Results are presented as three themes: (1) environmental influences on language development (people, physical objects, experiences and opportunities, the auditory environment); (2) assessment of the child’s environment, including how and what assessment is carried out; and (3) the interventions provided, including what interventions (interaction with children, the physical environment and play) and how they are carried out (strategies, individualization of intervention, sensitivity and modelling). Implications for services are discussed, including increasing parental awareness of the importance of early language input, the perceived value of home-based assessment, sensitivity in referral and individualized interventions. There remains a need to test out practitioners’ expressed beliefs and practices and their impact on child language outcomes.
Accurate production of polysyllables (words of three or more syllables) can be challenging for children with phonological impairment. Research with typically developing children has suggested that children can improve their polysyllable productions in response to requests for clarification containing an incorrect model of a target word (Gozzard et al., 2008). This study extends the work of Gozzard et al. (2008) by determining whether accuracy can improve in response to requests for clarification containing a correct (e.g. ‘did you say elephant?’) versus an incorrect (e.g. ‘did you say eresemp?’) model. Four children with phonological impairment (aged 3;10, 3;11, 4;3 and 5;4) had segmental and structural difficulties with polysyllables, in both single word and connected speech contexts. All participants revised their productions following requests for clarification containing the incorrect production, with 75.8% of suprasegmental and phonological revisions demonstrating increased accuracy. No phonological or suprasegmental revisions occurred following requests for clarification containing the correct model. The findings suggest that role of communication breakdown and repair in intervention targeting children’s polysyllable difficulties needs to be better understood.
It has been suggested that difficulties with tense and agreement marking are a core feature of language impairment. Hence, studies are required that analyse the effectiveness of intervention in this area, including consideration of whether changes seen in therapy sessions generalize to spontaneous speech. This study assessed the effectiveness of therapy based around Shape Coding in developing the use of the regular past tense morpheme -ed in two school-aged children with language impairments. It also considered whether participants benefited from additional generalization therapy in order to start using target forms in their spontaneous speech. The former was assessed using a sentence completion task and the latter by a conversational task with blind assessors. One participant improved markedly in sentence completion but did not gain in the conversation task until after the generalization therapy. The other made more modest gains on the sentence completion task and seemed to generalize to the conversation task without recourse to the generalization therapy. Larger studies are required to confirm these interpretations and to determine whether they are applicable to the wider population of children with language impairments.
New media are commonplace in children’s lives. Speech and language therapists (SLTs), educational psychologists and teachers are sometimes called upon by caregivers to provide advice on whether or how children and young people with language impairments should be encouraged to use these media. This article aims to illuminate some of the key issues and to review the implications of different types of advice that practitioners might provide. Four broad strategies are considered: Prohibition, Laissez-faire, Restriction, and Constructive use. Possible consequences of each strategy are outlined and it is proposed that Constructive use should be the strategy of choice. Reasons in favour of a constructive orientation include the benefits of joint engagement, enjoyment, cognitive and perceptual challenges and social motivation; effective uses can support educational attainment in young people with language impairments. Some areas where children and young people with language impairments need support with new media are noted. Decisions that we make about whether to constrain or support uses of new media have direct implications for the quality of young people’s lives and futures. SLTs, educational psychologists and teachers have important roles to play in the development of better-informed policies and strategies concerning language impaired youngsters and digital media.
This study uses a nationally representative sample of 9-month-old infants and their families from the Growing Up in Ireland (GUI) study to investigate if reading to infants is associated with higher scores on contemporaneous indicators of cognitive development independently of other language-based interactions between parent and infant, such as showing them pictures or talking to them. Reading to infants had an independent positive effect on scores for both the problem-solving and communication subscales of the Ages and Stages Questionnaire (ASQ), while the positive effect of showing pictures was independent only for communication scores. The effects of both of these activities were, however, less substantial than the positive effect observed for the more informal activity of frequently talking to the infant while doing other things; and this was observed for both communication and problem-solving. The analyses were robust to adjustment for several other factors including maternal education, gestational age, non-parental care, breastfeeding, attachment and presence of siblings. The findings highlight the potential of reading and talking to infants, not just for language and literacy development but also for other aspects of cognitive development.
This study addressed two aims: First, to examine the quality of adult shared book-reading behaviors for teachers and caregivers of children with communication impairments (CI) and, second, to compare the level of child literacy engagement during the teacher-led (group) and caregiver-led (one-on-one) shared book-reading sessions. Sixteen children with communication impairments were observed in both teacher-led and caregiver-led book-reading sessions using four matched manipulative storybooks. Children were observed during the fall and the spring of their preschool year. The quality of book-reading was evaluated using the ‘systematic assessment of book reading’ (SABR). Children’s level of literacy engagement was documented using the Children’s Orientation to Book Reading Rating Scale. Results indicated that teachers’ shared book-reading quality was significantly higher than caregivers’. Children’s level of engagement was high across both adult-led contexts.
This pilot study examined the feasibility of a home–school partnership for improving emergent literacy skills in Spanish-speaking pre-school children of migrant farmworkers. Parents were requested to send labeled drawings of family activities to their children’s classroom for supplementing bilingual language and literacy instruction. Participants were 19 children (between 2;6 and 5;2) assigned randomly to experimental (n = 11) or control (n = 8) classrooms. Pretest–posttest measures in Spanish and English were obtained using the Early Literacy Skills Assessment (ELSA). Results indicated significant increases in pre- to posttest English and Spanish scores for the experimental group, but not for the control group in alphabetic and print knowledge. Parental participation rates (as measured by weekly drawing submissions) exceeded 90%. These results suggest that integrating parent-generated content into classroom language intervention activities may be feasible both in terms of parental involvement as well as children’s emergent literacy skills development.
A common literacy practice in early childhood classrooms is reading aloud to children. Little is known, however, about the quality of engagement in shared reading activities for young children with Autism Spectrum Disorders (ASD). Dialogic reading is one method of shared reading in which adults encourage children to actively participate in the reading process by asking them a variety of questions while reading a book. The current study used a multiple baseline design across participants to examine the effect of a dialogic reading intervention on book reading participation for three preschool boys with ASD. Compared to baseline book readings, dialogic book reading resulted in increased rates of child verbal participation and longer duration spent engaged with printed materials. Based on these preliminary findings we suggest that this reading strategy may be a promising practice for early childhood educators that warrants further exploration.
This exploratory study was conducted to describe how children and young adults with autism spectrum disorder (ASD) are currently using iPads® and applications, to explore the role of education professionals on iPad® and application use, and to determine potential research needs regarding iPad® use in children with ASD. Naturalistic observations were conducted on six individuals (ages 6;6 to 20;8) with ASD while they were using iPads® in their school environment. The data suggest that (1) the participants used iPads® and applications for a variety of purposes, (2) there was considerable variability regarding whether or not the application was used consistent with its intended function, and (3) the presence of an education professional and the type of application impacted the variability in functional use of the application. Pertinent lines of research that are needed to expand the base of evidence regarding effective iPad® use in children with ASD are discussed.
This pilot study explored the potential for Project ASPIRE to effect behavior change in a sample of 11 parents of children with hearing loss who were from typically underserved populations, such as families from backgrounds of low socioeconomic status or families who speak English as a second language. The study consisted of one education session, five 16-hour home audio environment recordings, and four linguistic feedback reviews. The educational session focused on child language development and early language environment enrichment strategies. Parents received ‘quantitative linguistic feedback’ on the home audio recordings to further support behavior change through increased awareness of linguistic behaviors. The audio recordings were completed with the Language ENvironment Analysis system. This system measured parental linguistic behavior (adult word count or AWC), child linguistic behavior (child vocalization count or CVC), and child–parent interactive linguistic behavior (conversational turn count or CTC). Post-intervention both CTC and CVC had increased significantly compared to pre-intervention recording counts (p < 0.01; p < 0.05). Increase in AWC trended towards significance between pre- and post-intervention recordings (p < 0.1). These preliminary findings support ‘quantitative linguistic feedback’ as a viable behavior change strategy for enriching children’s early language environments through parental linguistic behaviors.
This article describes the development of new scales for assessing the status of a young child’s language comprehension and production. Items and sections on the scales were included to reflect advances in research on language acquisition and impairment. The New Reynell Developmental Language Scales (NRDLS) were trialled on 301 children and then standardized on a sample of 1,266 participants across the age range 2;00–7;06 years. Evaluations of reliability (internal and test–retest) and concurrent validity were carried out and also discriminant validity was evaluated with a further small sample of children with primary language impairment. Results are reported and discussed. An illustrative example of how the NRDLS could be used is given, in which the performance of a typically developing child and that of a matched child with primary language impairment are compared.
This article reports on the development and preliminary implementation trials of a modular small-group intervention targeting syntax and vocabulary for children at high risk for reading comprehension difficulties in grades prekindergarten through first. The intervention, delivered by trained paraprofessionals, included 12 weeks of 20-minute lessons that included hands-on activities promoting receptive and expressive acquisition of grade-specific targeted syntax and semantic features such as prepositions, passive sentence structure, and adverbial clauses. Children (n = 354) ranging in age from 40–101 months were screened for inclusion on several standardized language measures and those included in the intervention (64–68 per grade, scoring below the 30th percentile on several measures) were assessed on two proximal measures of intervention-linked syntax and listening-comprehension. Results from the repeated implementation trials in each grade indicate that the intervention shows substantial promise as a method of supporting syntax growth and ultimately improving comprehension skills in young children.
This study examined the influence of phonotactic probability on word recognition in English-speaking toddlers. Typically developing toddlers completed a preferential looking paradigm using familiar words, which consisted of either high or low phonotactic probability sound sequences. The participants’ looking behavior was recorded in response to correctly-produced and incorrectly-produced forms of familiar words. Results indicate that toddlers were more sensitive to mispronunciations of high probability words as compared to low probability words. Toddlers’ word recognition skills were more closely related to the frequency with which they have heard and produced phonological sequences, rather than word familiarity. These findings are discussed in terms of toddlers with expressive language delay.
This article reports the evaluation of a 6-week programme of teaching designed to support the development of phoneme blending skills in children with Down syndrome (DS). Teaching assistants (TAs) were trained to deliver the intervention to individual children in daily 10 –15-minute sessions, within a broader context of reading and language instruction. Ten children with Down syndrome (aged 6 years 11 months to 10 years 6 months) took part in the study; assessments of reading and phonological skills were completed at baseline, after an 8-week control period, and after 6-weeks of intervention. Children made significantly greater gains in phoneme blending skills and single word reading during the intervention period than in the control period. Thus, children with Down syndrome can make gains in blending skills, which may generalize to wider literacy skills, following targeted training over relatively short periods.
This study aimed to consider collaborative practice in contributing to joint assessment and producing appropriate referral of children to speech and language therapy (SLT). Results of formal testing of selected comprehension skills are compared with functional/classroom performance as rated by class teachers. Thirty children aged 6.5–8.4 years, from three mainstream schools, were assessed using Clinical Evaluation of Language Fundamentals (CELF-4; Semel et al., 2006) subtests: ‘Understanding Spoken Paragraphs’ and ‘Concepts and Directions’. The children’s teachers completed the ‘listening’ component of the Observational Rating Scale. Combined scores for Understanding Spoken Paragraphs and Concepts and Directions subtests are significantly correlated with Observational Rating Scale scores, which reflect teachers’ ratings of comprehension in the classroom. The Concepts and Directions subtest scores alone correlated significantly with the teachers’ Observational Rating Scale ratings, but the Understanding Spoken Paragraphs scores did not. The findings suggest that teachers can fairly accurately identify the level of children’s functioning from informal observations, and these were corroborated through standardized speech and language therapy assessment. It is argued that holistic assessment and collaboration between health and education professionals can provide the basis for appropriate referral and effective assessment, contributing to accurate profiling and monitoring of intervention.
The purpose of this research was to ascertain the views of staff and managers within a youth offending team on their experiences of working with a speech and language therapist (SLT). The model of therapy provision was similar to the whole-systems approach used in schools. The impact of the service on language outcomes is reported elsewhere (Gregory and Bryan, 2011). A questionnaire was sent to all staff asking about their experiences related to working with a speech and language therapist. Eight telephone interviews were then conducted to explore the questionnaire findings further and to gain a management perspective on speech and language therapy within a youth offending service (YOS) team. Staff were largely positive about their experience of working with a SLT. Understanding the nature of the presenting communication difficulties and having strategies to manage these were linked to improvements in wider working practices, which managers linked to culture change. The whole-systems model of service delivery appeared to have potential application to youth justice contexts. Direct access to the SLT to support communication aspects of their work was particularly important to the YOS staff. Further research is needed to examine the optimum model of speech and language therapy in youth justice settings, and the potential contribution to criminal justice outcomes such as prevention of re-offending.
Communication and play skills are important aspects of development yet are largely uncharted in children with attention deficit hyperactivity disorder (ADHD). This exploratory study examined whether changes in pragmatic skills and problem-solving skills were observed in children with ADHD pre- and post-participation in a play-based intervention conducted by occupational therapists and speech-language pathologists. The study also investigated whether the presence of language difficulties affected the children’s play outcomes. Fourteen children with ADHD (5;0–10;7 years) participated in a 7-week, pilot intervention to address play and social skill deficits. Pre- and post-intervention testing included: (a) the assessment of play and problem-solving skills via standardized testing, and (b) pragmatic skills via parent report. The children’s language skills were also screened and compared with their play scores. Play skills significantly improved post-intervention. No significant differences were observed for pragmatic skills while prediction skills, an aspect of problem-solving, significantly improved pre- and post-play-based intervention. Fifty percent of children failed the language screener, yet separate paired t-tests identified significant play improvements irrespective of the presence or absence of language difficulty. Two independent t-tests revealed significant differences in play scores between these groups at pre- but not post-intervention.
While play and predicting skills significantly improved post-play-based intervention, other aspects of problem-solving and pragmatics did not. Reasons for the lack of change in these areas are discussed. The presence of language difficulties did not appear to affect the play outcomes of children with ADHD following a play-based intervention. A larger scale experimental trial investigating the play and language skills of children with ADHD is warranted, as is future collaborative research between occupational therapists and speech-language pathologists in the assessment and management of children with ADHD.
The reading skills of many deaf children lag several years behind those of hearing children, and there is a need for identifying reading difficulties and implementing effective reading support strategies in this population. This study embraces a balanced reading approach, and investigates the efficacy of applying multi-sensory coding strategies and reading scaffolding to facilitate elementary phase deaf readers’ reading development. Sign language – in combination with multiple visual, tactile and kinaesthetic coding strategies and reading scaffolding techniques – was used to facilitate literacy and vocabulary development. Participants were 64 children, diagnosed with severe to profound bilateral hearing loss and aged from 6;03 to 11;08 years (mean age 9.37 years). Participants were randomly assigned to an experimental and a control group. There were no significant differences between the groups pre-intervention on measures of sight word fluency, word recognition, receptive and expressive vocabulary knowledge and reading comprehension. Results demonstrated a significant increase in reading and vocabulary skills of deaf readers who received the balanced reading approach intervention, as compared to the control group who received usual classroom instruction. The article concludes with a discussion of the theoretical and pedagogical implications these findings have for deaf children’s reading and literacy development.
The primary objectives of this research were to establish whether dynamic assessment could be implemented in children with hearing loss with a range of language abilities and to obtain pilot data to support the use of dynamic assessment for determining narrative language learning difficulties in children with hearing loss. Participants were three children aged seven to 12 years with moderate to profound hearing loss. The Test of Narrative Language (TNL) was used to measure narrative skills before and after two Mediated Learning Experience (MLE) sessions. Responsiveness to mediation in MLE sessions was compared to ability to learn based on a comparison of pre- versus post-test TNL scores. Two participants showed substantial improvements in their Oral Narrative subtest scores, and showed good responsiveness and modifiability in MLE sessions. One participant showed no change in TNL results, and low responsiveness and low modifiability in MLE sessions. Children with greater response to mediation had more improved TNL scores. Differential diagnosis of language learning difficulties in children with hearing loss may be possible using ‘dynamic assessment’ (DA).