Factors accounting for the ability of children with SLI to learn agreement morphemes in intervention

Individual Predictors of Language Treatment Response in Children With Developmental Language Disorder: A Systematic Review

PURPOSE

Treatment response is the degree to which an individual benefits from a treatment. This systematic review sought to identify and synthesize research evidence regarding individual characteristics that predict language treatment response among children with developmental language disorder (DLD).

METHOD

To be eligible for inclusion, articles needed to report results of an oral language treatment program in a group of children aged 4-10 years with identified DLD and also include a quantitative analysis of the relation between one or more pretreatment child characteristics and the outcome of language treatment. Seven databases (Cumulated Index to Nursing and Allied Health Literature, Dissertations and Theses Global, Education Resources Information Center, Linguistics and Language Behavior Abstracts, PsycINFO, Medline, and Web of Science) were searched for articles in June and July 2021, with search updates conducted in May 2023. Studies were categorized by the type of treatment provided, and results were synthesized qualitatively.

RESULTS

The review included 31 studies, 1,551 participants with DLD, and over 300 statistical tests of a predictor's effect on language treatment response. Most studies (n = 21) included only monolingual speakers of English, with five studies including bilinguals and five including monolingual speakers of non-English languages. Language treatments targeted word learning in controlled or clinical conditions, grammatical learning in controlled or clinical conditions, or multiple language targets in clinical conditions. Predictors of treatment response are summarized across four categories: cognitive, demographic, pretreatment language levels, and other.

CONCLUSIONS

There were relatively few significant tests of the predictors of language treatment response. A central limitation of the evidence is that most included studies were designed to consider language treatment efficacy, not predictors of treatment response. Increasing research attention to the question of predictors of language treatment response in children with DLD is needed to enhance treatment and optimize outcomes for individual children.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.26170006.

We Have to Talk About Something: Why NOT Talk About the Curriculum? A Guide to Embedding Language Interventions in Curricular Content

PURPOSE

Children with developmental language disorder frequently have difficulty with both academic success and language learning and use. This clinical focus article describes core principles derived from a larger program of research (National Science Foundation 1748298) on language intervention combined with science instruction for preschoolers. It serves as an illustration of a model for integrating language intervention with curricular content delivery.

METHOD

We present a five-step model for a speech-language pathologist and other school professionals to follow to (a) understand the grade-level core curriculum objectives; (b) align intervention targets with the curriculum; (c) select a therapy approach that aligns with both goals and curricular content, and (d) methods for implementing the intervention; and (e) verify that both the intervention and the curriculum have been provided in accordance with best practices. We apply this model to the Next Generation Science Standards, a science curriculum popular in the United States, and to grammar and vocabulary interventions, two areas of difficulty for children with developmental language disorders, though it would be possible to extend the steps to other curricular areas and intervention targets.

CONCLUSIONS

We conclude by discussing the barriers and benefits to adopting this model. We recognize that both speech-language pathologists and teachers may have limited time to implement language intervention within a general education curriculum, but we suggest that the long-term benefits outweigh the barriers.

What predicts individual response to language treatment in bilingual children with developmental language disorder?

Purpose

For bilingual children with developmental language disorder (DLD), language treatment response is the degree to which an individual child progresses in both of their languages. Understanding what predicts language treatment response for an individual child can help clinicians plan treatment more effectively.

Methods

This study is a retrospective analysis of data from Ebert et al. (2014). Participants included 32 school-age Spanish-English bilingual children with DLD who completed an intensive language treatment program. Gains in Spanish and English were measured using raw test scores in each language. Predictors of language gains include language, cognitive, and demographic variables. To examine which predictors were significant, we calculated partial correlations between the potential predictors and the posttreatment language test scores, controlling for the effects of pretreatment test scores.

Results

In Spanish, several predictors correlated with the outcome measures. After controlling for pretreatment scores, English grammaticality, female sex, processing speed, age, and fluid reasoning were related to Spanish posttreatment scores. In English, correlations with individual predictors were minimal. After controlling for pretreatment scores, only one variable was associated with one English posttreatment score: English grammaticality.

Conclusions

The original study reported limited gains in Spanish compared to robust gains in English (Ebert et al., 2014). Treatment response in Spanish is more variable given the lack of environmental support for Spanish in the US. As a result, individual factors (including nonverbal cognition, pretreatment language levels, and demographic variables) influence treatment gains in Spanish. In contrast, strong environmental support for English supports a more consistent treatment response, with a smaller role for individual factors.

Predictors of Treatment Response for Preschool Children With Developmental Language Disorder

Purpose Enhanced Conversational Recast treatment is an effective intervention for remediating expressive grammatical deficits in preschool-age children with developmental language disorder, but not all children respond equally well. In this study, we sought to identify which child-level variables predict response to treatment of morphological deficits. Method Predictor variables of interest, including pre-intervention test scores and target morpheme production, age, and mother's level of education (proxy for socio-economic status) were included in analyses. The sample included 105 children (M = 5;1 [years;months]) with developmental language disorder who participated in 5 weeks of daily Enhanced Conversational Recast treatment. Classification and regression tree analysis was used to identify covariates that predicted children's generalization of their trained grammatical morpheme, as measured by treatment effect size d. Results Our analysis indicates that the Structured Photographic Expressive Language Test-Preschool 2 (SPELT-P 2) scores and the Peabody Picture Vocabulary Test-Fourth Edition scores significantly predicted the degree of benefit a child derived from Enhanced Conversational Recast treatment. Specifically, a SPELT-P 2 score above 75 (but still in the impaired range, < 87) combined with a high Peabody Picture Vocabulary Test-Fourth Edition score (> 100) yielded the largest treatment effect size, whereas a SPELT-P 2 score below 75 predicted the smallest treatment effect size. Other variables included in the model did not significantly predict treatment outcomes. Conclusions Understanding individual differences in response to treatment will allow service providers to make evidence-based decisions regarding how likely a child is to benefit from Enhanced Conversational Recast treatment and the expected magnitude of the response based on the child's background characteristics.

Forum on Morphosyntax Assessment and Intervention for Children

Purpose

This forum consists of articles that address the need for and approaches to assessment and treatment of morphology and syntax in children. Drawing on papers submitted by diverse laboratories working with multiple populations, this forum includes several articles describing different approaches to treatment, guidelines for goal setting, and assessment methods. Populations described include monolingual and bilingual children who speak English, Dutch, and Spanish, who use oral language and/or augmentative and alternative communication to communicate.

Conclusion

The current tools available to support traditional grammar therapy are changing and increasing. An emphasis on manualized treatments, treatments that include drill and explicit instruction, and assessment and treatment tools for a variety of populations across a wide age span are included here. Further work is needed to fully develop these promising tools and approaches for the most effective use.

Input Subject Diversity Accelerates the Growth of Tense and Agreement: Indirect Benefits From a Parent-Implemented Intervention

PURPOSE

This follow-up study examined whether a parent intervention that increased the diversity of lexical noun phrase subjects in parent input and accelerated children's sentence diversity (Hadley et al., 2017) had indirect benefits on tense/agreement (T/A) morphemes in parent input and children's spontaneous speech.

METHOD

Differences in input variables related to T/A marking were compared for parents who received toy talk instruction and a quasi-control group: input informativeness and full is declaratives. Language growth on tense agreement productivity (TAP) was modeled for 38 children from language samples obtained at 21, 24, 27, and 30 months. Parent input properties following instruction and children's growth in lexical diversity and sentence diversity were examined as predictors of TAP growth.

RESULTS

Instruction increased parent use of full is declaratives (ηp2 ≥ .25) but not input informativeness. Children's sentence diversity was also a significant time-varying predictor of TAP growth. Two input variables, lexical noun phrase subject diversity and full is declaratives, were also significant predictors, even after controlling for children's sentence diversity.

CONCLUSIONS

These findings establish a link between children's sentence diversity and the development of T/A morphemes and provide evidence about characteristics of input that facilitate growth in this grammatical system.

Do the Hard Things First: A Randomized Controlled Trial Testing the Effects of Exemplar Selection on Generalization Following Therapy for Grammatical Morphology

PURPOSE

Complexity-based approaches to treatment have been gaining popularity in domains such as phonology and aphasia but have not yet been tested in child morphological acquisition. In this study, we examined whether beginning treatment with easier-to-inflect (easy first) or harder-to-inflect (hard first) verbs led to greater progress in the production of regular past-tense -ed by children with developmental language disorder.

METHOD

Eighteen children with developmental language disorder (ages 4-10) participated in a randomized controlled trial (easy first, N = 10, hard first, N = 8). Verbs were selected on the basis of frequency, phonological complexity, and telicity (i.e., the completedness of the event). Progress was measured by the duration of therapy, number of verb lists trained to criterion, and pre/post gains in accuracy for trained and untrained verbs on structured probes.

RESULTS

The hard-first group made greater gains in accuracy on both trained and untrained verbs but did not have fewer therapy visits or train to criterion on more verb lists than the easy-first group. Treatment fidelity, average recasts per session, and verbs learned did not differ across conditions.

CONCLUSION

When targeting grammatical morphemes, it may be most efficient for clinicians to select harder rather than easier exemplars of the target.

Palavras-estímulo favorecedoras para o tratamento do desvio fonológico em onset simples

RESUMO Objetivos: propor e analisar listas com palavras-estímulo em contextos linguísticos favorecedores para segmentos-alvo na posição de onset simples, utilizando um padrão de programação para pontuar o nível de favorecimento dessas palavras. Métodos: foi desenvolvido um padrão de programação, em linguagem Java, para determinar a pontuação das palavras-estímulo, que considerou o somatório dos pesos atribuídos às variáveis linguísticas: posição na palavra, tonicidade, número de sílabas, contexto precedente e contexto seguinte, para cada segmento-alvo. Foram utilizadas 748 palavras para elaboração de listas de palavras-estímulo para cada segmento-alvo. Todas as palavras-estímulo tiveram sua pontuação de favorecimento calculada a partir do padrão de programação e classificadas quanto ao nível de favorecimento. Resultados: verificou-se que as palavras-estímulo classificadas como favorecedoras (PEF) foram as que alcançaram maior pontuação, uma vez que contemplaram os contextos mais favorecedores para produção do segmento-alvo. Contudo não foi necessário que todos os contextos favorecedores fossem privilegiados para as palavras serem classificadas como PEF. Conclusão: o padrão de programação desenvolvido foi eficiente para pontuar o nível de favorecimento das palavras-estímulo. Além disso, deve haver uma preferência por palavras-estímulo favorecedoras, ou que alcançam maior pontuação, porém nem sempre essas palavras são as mais adequadas para o tratamento de qualquer sistema fonológico desviante.

Implicações do discurso parental no desvio fonológico

Resumo O desvio fonológico é uma alteração da fala sem fatores orgânicos identificáveis, que implica o uso inadequado de fonemas após os quatro anos de idade, aparecendo com maior frequência até os oito anos. Dessa forma, constitui-se objetivo deste trabalho relacionar o desvio fonológico e o discurso parental. Empregou-se uma metodologia qualitativa, a partir da análise de conteúdo. Participaram da pesquisa 15 responsáveis por crianças diagnosticadas com desvio fonológico e encaminhadas ao serviço de atendimento fonoaudiológico de uma instituição de ensino superior. Para a coleta de dados o instrumento utilizado foi uma entrevista semiestruturada. Os dados foram generalizados e compararam os participantes quanto à significação parental destinada tanto à criança quanto à patologia. Os resultados apontaram que existe uma relação entre o discurso parental e o desvio fonológico. Além disso, as funções parentais parecem determinar o quanto o funcionamento linguístico da criança é afetado por ele ou não.

The efficacy of recasts in language intervention: a systematic review and meta-analysis

PURPOSE

This systematic review and meta-analysis critically evaluated the research evidence on the effectiveness of conversational recasts in grammatical development for children with language impairments.

METHOD

Two different but complementary reviews were conducted and then integrated. Systematic searches of the literature resulted in 35 articles for the systematic review. Studies that employed a wide variety of study designs were involved, but all examined interventions where recasts were the key component. The meta-analysis only included studies that allowed the calculation of effect sizes, but it did include package interventions in which recasts were a major part. Fourteen studies were included, 7 of which were also in the systematic review. Studies were grouped according to research phase and were rated for quality.

RESULTS

Study quality and thus strength of evidence varied substantially. Nevertheless, across all phases, the vast majority of studies provided support for the use of recasts. Meta-analyses found average effect sizes of .96 for proximal measures and .76 for distal measures, reflecting a positive benefit of about 0.75 to 1.00 standard deviation.

CONCLUSION

The available evidence is limited, but it is supportive of the use of recasts in grammatical intervention. Critical features of recasts in grammatical interventions are discussed.

Short-term speech-language intervention for children with disorders of the autism spectrum

PURPOSE

To assess any changes in the Functional Communicative Profile (FCP) and in the Social Cognitive Performance (SCP) of children with Autism Spectrum Disorders, based on two short periods of intervention.

METHODS

The study was conducted with 21 children with Autism Spectrum Disorder diagnoses, randomly allocated into two groups, who received the same short-term intervention types (6 weeks with the mother and 6 weeks with the support of an educational software program). The intervention process was conducted by speech-language pathologists who were part of a graduate program in this area.

RESULTS

Samples of 15-minute interaction sessions between the child and speech-language pathologist were used to assess the changes in the FCP and the SCP. The statistic analysis pointed out differences only in Group 1 for the variables "percentage of communicative space used" and "use of the mediating object".

CONCLUSION

With the intervention sessions structured over 12 weeks, it was possible to observe a few changes in the children's FCP and in the SCP. Therefore, we point out the need for new research studies of longer duration.

Number dissimilarities facilitate the comprehension of relative clauses in children with (Grammatical) Specific Language Impairment

This study investigates whether number dissimilarities on subject and object DPs facilitate the comprehension of subject- and object-extracted centre-embedded relative clauses in children with Grammatical Specific Language Impairment (G-SLI). We compared the performance of a group of English-speaking children with G-SLI (mean age: 12;11) with that of two groups of younger typically developing (TD) children, matched on grammar and receptive vocabulary, respectively. All groups were more accurate on subject-extracted relative clauses than object-extracted ones and, crucially, they all showed greater accuracy for sentences with dissimilar number features (i.e., one singular, one plural) on the head noun and the embedded DP. These findings are interpreted in the light of current psycholinguistic models of sentence comprehension in TD children and provide further insight into the linguistic nature of G-SLI.

Agreeing to disagree: deaf and hearing children's awareness of subject-verb number agreement

This study investigated deaf adolescents' implicit and explicit awareness of subject-verb number agreement. In Experiment 1, a self-paced reading task, the reading times of deaf and hearing children (matched for reading and chronological age, mean=8;3 and 13;10 years) increased when sentences contained disagreeing subject-verb number markers. However, deaf adolescents' slowing occurred later in the sentence than it did in both groups of hearing children. The same deaf adolescents were unable to detect and correct subject-verb agreement errors in Experiment 2, whereas both groups of hearing children performed well on this task. Thus, deaf adolescents demonstrated implicit awareness of agreement in the absence of explicit knowledge. Moreover, this nascent awareness was below that expected on the basis of their (substantially delayed) reading ability. Therefore, grammatical difficulties could be a significant impediment to deaf children's literacy. Future research should examine whether this is a result of late or incomplete learning of English, bilingualism, or another factor.

Correlação entre vocabulário expressivo e extensão média do enunciado em crianças com alteração específica de linguagem

OBJETIVOS: verificar a influência da idade no desempenho lexical e gramatical, e investigar a existência de correlação entre vocabulário expressivo e as medidas de extensão média de enunciado em crianças com alteração específica de linguagem. MÉTODO: participaram do estudo trinta sujeitos com diagnóstico de alteração específica de linguagem, entre 4:0 a 6:11 anos, sendo dez de cada faixa etária. Todos realizaram de forma completa a prova de vocabulário expressivo (ABFW) e de Extensão Média do Enunciado, independente de gênero ou escolaridade. O estudo foi retrospectivo e a coleta de dados se baseou nas filmagens e gravações das provas acima mencionadas. RESULTADOS: o desempenho gramatical não apresentou diferença estatística entre as idades, mas foi observada correlação positiva entre o vocabulário expressivo e o uso de palavras de classe fechada, e entre o vocabulário expressivo e a extensão de palavras por enunciado (p-valor <0,05). CONCLUSÃO: a idade isolada não é capaz de predizer o aprimoramento do vocabulário e da gramática, porém a expansão do vocabulário de substantivos favorece o aumento do número de palavras por sentença e o uso de palavras com função exclusivamente gramatical.

Within-treatment factors as predictors of outcomes following conversational recasting

PURPOSE

Although conversational recasting has been a generally successful treatment approach, the precise factors that influence children's learning through recasts are not yet understood. In this study, we examined details of the relationship between child utterance and clinician utterance that seemed likely to influence learning.

METHOD

Three measures were calculated from transcripts of recasting sessions with 17 preschoolers with specific language impairment. In all sessions, 3rd person singular -s served as the target. The measures of interest were the frequency of recasts following child utterances that were prompted by clinicians, the frequency of clinicians' recasts of subjectless sentences, and the frequency of clinicians' noncorrective recasts. We assessed the short-term and long-term predictive value of these measures through regression analyses.

RESULTS

Noncorrective recasts proved to be a positive predictor of short- and long-term gains in the use of the target form. Recasts of subjectless sentences were associated with poorer outcomes, though their contribution was relatively small.

CONCLUSIONS

The nature of learning that takes place varies according to the relationship between child and clinician utterances during the recasting process. These variations have implications for clinical practice and for how learning through recasting is characterized.

Relapse observed in the treatment of phonological disorder

BACKGROUND

relapse in phonological performance.

AIM

to verify relapse in the phonological performance related to sound production in the treatment of phonological disorder.

METHOD

three subjects with phonological disorders, aged 6:0, 7:0, 7:0 years, were treated for phoneme /r/ using the ABAB-Withdrawal and Multiple Probes Model. After a cycle of treatment, the phonemes that presented relapse in terms of production percentage were compared.

RESULTS

the results indicate that relapse occurred in the phonological system of all subjects. The involved features were mainly related to the main category.

CONCLUSION

a relationship between the features of the treated phoneme and the ones that presented relapse was observed for all of the studied cases.