Word-finding intervention for children with specific language impairment: a multiple single-case study

Word-finding behaviours in narration for typically developing French speakers of school age

BACKGROUND

Research in word-finding difficulties is sparse, especially in languages other than English. As a result, the factors associated with the frequency of word-finding behaviours are poorly understood, particularly in discourse.

AIMS

This exploratory study is the first to collect data relative to the expected frequency of word-finding behaviours in narration for French speakers aged 7-12 years old with typical development; and (2) to identify the factors associated with the frequency of word-finding behaviours in narration. We hypothesized that sociodemographic characteristics, language abilities and characteristics of the spoken productions could be linked to word-finding behaviours.

METHODS & PROCEDURES

The participants consisted of 61 French-speaking children aged 7-12 years old (M = 9;09 years, SD = 1;06 years) with typical development. Children were asked to complete a receptive vocabulary task, a non-word-repetition task and two narrative tasks. The children's narrative samples were coded using a discourse analysis of word-finding behaviours, as described by Diane J. German.

OUTCOMES & RESULTS

Participants produced 39% of T-units with least one word-finding behaviour, which included relatively frequent use of repetitions and word reformulations. Regression analyses revealed that the participants' gender was the only significant variable associated with the frequency of word-finding behaviours in narration. Boys produced a higher percentage of T-units with at least one word-finding behaviour. Post-hoc analyses suggested that gender differences reflected differences in repetitions and word reformulations. Boys and girls did not differ on any other language measures collected.

CONCLUSIONS & IMPLICATIONS

Speech-language pathologists may want to take into account a child's gender when assessing word-finding difficulties in narration. Additional studies are needed to understand whether this finding extends to other word-finding tasks and to children with word-finding difficulties.

WHAT THIS PAPER ADDS

What is already known on the subject Studies in English have identified that analyses of word-finding behaviours in discourse can be used to correctly identify children with word-finding difficulties. Studies are needed in other languages to determine if this observation holds true across languages. Moreover, the factors associated with the frequency of word-finding behaviours in discourse are poorly understood. What this paper adds to existing knowledge The frequency of word-finding difficulties in narration was higher in our study of French-speaking children than in previous studies of English. Gender was the only factor associated with the frequency of word-finding difficulties. What are the potential or actual clinical implications of this work? The language and task used to assess word-finding skills as well as the child's gender may be important to take into account when assessing word-finding difficulties based on word-finding behaviours.

Intervención en Trastorno del Desarrollo del Lenguaje (TDL). Una revisión sistemática (2000-2020)

Este trabajo presenta los resultados de una revisión sistemática de la producción científica sobre de la intervención en TDL (antiguamente denominado como Trastorno Específico del Lenguaje, TEL) durante el periodo 2000-2020. Se accede a 31 publicaciones localizadas en las Bases de datos DIALNET y EBSCO, que cumplen los siguientes criterios de selección: año de publicación, idioma (inglés y español), revisión por pares e intervenciones en población con TDL o TEL. Se analizan entre otras, las siguientes dimensiones: objetivos de la intervención, estrategias, colaboración, resultados y limitaciones declaradas. Los principales hallazgos se refieren a la irrupción del concepto Trastorno del Desarrollo del Lenguaje (TDL) en los últimos años, a la preferencia por diseños experimentales y cuasi experimentales, y a los resultados positivos que coexisten con ganancias modestas en la mayoría de los estudios analizados. Las principales limitaciones encontradas son la ausencia de grupo control y la diferenciación de efectos. Las conclusiones señalan la necesidad de contar con mayor número de intervenciones basadas en un enfoque interactivo-colaborativo, ampliar la cobertura de objetivos hacia las necesidades de aprendizaje y cognitivas derivadas del TDL, así como considerar los diseños intra-sujetos, con observación de efectos a mediano y largo plazo que incluya a jóvenes y adultos.

Understanding differing outcomes from semantic and phonological interventions with children with word-finding difficulties: A group and case series study

Developmental Language Disorder occurs in up to 10% of children and many of these children have difficulty retrieving words in their receptive vocabulary. Such word-finding difficulties (WFD) can impact social development and educational outcomes. This research aims to develop the evidence-base for supporting children with WFD and inform the design and analysis of intervention studies. We included 20 children (age 6 to 8) with WFD each of whom participated in two interventions one targeting semantic attributes and the other phonological attributes of target words. The interventions, employing word-webs, were carefully constructed to facilitate direct comparison of outcome which was analysed at both group and case-series level. The study used a robust crossover design with pre-intervention baseline, between-intervention wash-out and post-intervention follow-up testing. We incorporated: matching of item sets on individual performance at baseline, independent randomisation of order of intervention and items to condition, blinding of assessor, evaluation of fidelity and control items. The interventions were clinically feasible, with weekly sessions over six weeks. Intervention improved children's word-finding abilities with statistically significant change only during treatment phases of the study and not over baseline, wash-out or follow-up phases. For the group the semantic intervention resulted in a gain of almost twice as many items as the phonological intervention, a significant difference. However, children differed in their response to intervention. Importantly, case-series analysis revealed outcomes predictable on the basis of children's theoretically driven language profiles. Taking account of individual profiles in determining choice of intervention would enable more children to benefit. The study provides new evidence to inform and refine clinical practice with this population. Future studies should be designed such that results can be analysed at both group and case series levels to extend theoretical understanding and optimise use of appropriate interventions.

Intervention for children with word-finding difficulties: a parallel group randomised control trial

PURPOSE

The study investigated the outcome of a word-web intervention for children diagnosed with word-finding difficulties (WFDs).

METHOD

Twenty children age 6-8 years with WFDs confirmed by a discrepancy between comprehension and production on the Test of Word Finding-2, were randomly assigned to intervention (n = 11) and waiting control (n = 9) groups. The intervention group had six sessions of intervention which used word-webs and targeted children's meta-cognitive awareness and word-retrieval.

RESULT

On the treated experimental set (n = 25 items) the intervention group gained on average four times as many items as the waiting control group (d = 2.30). There were also gains on personally chosen items for the intervention group. There was little change on untreated items for either group.

CONCLUSION

The study is the first randomised control trial to demonstrate an effect of word-finding therapy with children with language difficulties in mainstream school. The improvement in word-finding for treated items was obtained following a clinically realistic intervention in terms of approach, intensity and duration.

Vocabulary intervention for adolescents with language disorder: a systematic review

BACKGROUND

Language disorder and associated vocabulary difficulties can persist into adolescence, and can impact on long-term life outcomes. Previous reviews have shown that a variety of intervention techniques can successfully enhance students' vocabulary skills; however, none has investigated vocabulary intervention specifically for adolescents with language disorder.

AIMS

To carry out a systematic review of the literature on vocabulary interventions for adolescents with language disorder.

METHODS & PROCEDURES

A systematic search of 14 databases and other sources yielded 1320 studies, of which 13 met inclusion criteria. Inclusion criteria were: intervention effectiveness studies with a focus on enhancing oral receptive and/or expressive vocabulary skills in the study's aims; participants in the age range 11;0-16;11 with receptive and/or expressive language difficulties of any aetiology.

MAIN CONTRIBUTION

There was a high degree of diversity between studies. Types of intervention included: semantic intervention (four studies); comparison of phonological versus semantic intervention (two); and combined phonological-semantic intervention (seven). The strongest evidence for effectiveness was found with a combined phonological-semantic approach. The evidence suggested a potential for all models of delivery to be helpful (individual, small group and whole class).

CONCLUSIONS & IMPLICATIONS

Tentative evidence is emerging for the effectiveness of a phonological-semantic approach in enhancing the vocabulary skills of adolescents who have language disorder. Future research needs to refine and develop the methodologies used in this diverse group of studies in order to replicate their findings and to build consensus.

Effectiveness of 1:1 speech and language therapy for older children with (developmental) language disorder

BACKGROUND

Evidence of the effectiveness of therapy for older children with (developmental) language disorder (DLD), and particularly those with receptive language impairments, is very limited. The few existing studies have focused on particular target areas, but none has looked at a whole area of a service.

AIMS

To establish whether for students with (developmental) language disorder attending a specialist school, 1:1 intervention with an SLT during one school term improves performance on targeted areas, compared with untreated control areas. Also, to investigate whether gender, receptive language status, autism spectrum disorder (ASD) status, or educational Key Stage affected their response to this intervention.

METHODS & PROCEDURES

Seventy-two students (aged 9-17 years, 88% of whom had receptive language impairments) and all speech and language therapists (SLTs) in our specialist school for children with Language Disorder, most of whom have DLD participated in this study over one school term. During this term, the SLTs devised pre- and post-therapy measures for every student for each target they planned to treat 1:1. In addition, for each target area, a control measure was devised. The targets covered a wide range of speech, language and communication areas, both receptive and expressive. Post-therapy tests were administered 'blind'.

OUTCOMES & RESULTS

During the term, SLTs and students worked 1:1 on 120 targets, the majority in the areas of expressive and receptive language. Targets and controls did not differ pre-therapy. Significant progress was seen both on targets (d = 1.33) and controls (d = 0.36), but the targeted areas improved significantly more than the controls with a large and clinically significant effect size (d = 1.06). There was no effect of language area targeted (targets improved more than their controls for all areas). Participants with versus those without receptive language difficulties, co-occurring ASD diagnosis or participants in different educational Key Stages did not differ significantly in terms of the progress they made on target areas.

CONCLUSIONS & IMPLICATIONS

Direct 1:1 intervention with an SLT can be effective for all areas of language for older children with (D)LD, regardless of their gender, receptive language or ASD status, or age. This adds to the relatively limited evidence base regarding the effectiveness of direct SLT intervention for school-aged children with (D)LD and for children with receptive language impairments. If direct 1:1 intervention can be effective with this hard-to-treat group, it may well also be effective with younger children with (D)LD. Thus, direct SLT services should be available for school-aged children with (D)LD, including older children and adolescents with pervasive difficulties.

Cross-linguistic transfer effects after phonologically based cognate therapy in a case of multilingual specific language impairment (SLI)

BACKGROUND

Clinicians globally recognize as exceptionally challenging the development of effective intervention practices for bi- or multilingual children with specific language impairment (SLI). Therapy in both or all of an impaired child's languages is rarely possible. An alternative is to develop treatment protocols that facilitate the transfer of therapy effects from a treated language to an untreated language.

AIMS

To explore whether cognates, words that share meaning and phonological features across languages, could be used to boost lexical retrieval in the context of multilingual SLI. This is dependent on exploiting the phonological information in the one, trained language as a mechanism for (phonological) language transfer to the other, untrained languages.

METHODS & PROCEDURES

The participant is an 8.5-year-old girl diagnosed with SLI who showed a severe naming deficit in her three spoken languages (Bulgarian, English and Greek). She received training on cognates (n = 20) using a picture-based naming task in English only, three times a week, over a 4-week period for 20 min each time. Phonological-based naming therapy was carried out using form-based strategies.

OUTCOMES & RESULTS

There was a significant improvement during therapy and immediately after intervention on cognate performance in English which was maintained 1 month after intervention. Cognate production in Bulgarian and Greek also improved during all stages of the intervention. Improvement in the non-treated languages was slightly more than half of the improvement recorded in English. The findings reflected some degree of cross-linguistic transfer effects.

CONCLUSIONS & IMPLICATIONS

Cross-linguistic transfer effects were evident during therapy and after therapy had finished and the effects were maintained 1 month post-treatment. Both the native language (Bulgarian) and the dominant language (Greek) benefitted equally from the treatment of cognates in English. Generalization to non-treatment words was evident, predominantly for English. The results suggest that cognates can indeed be used successfully as a WFD intervention strategy for multilingual children with SLI with lasting effects.

Enhancing the Therapy Experience Using Principles of Video Game Design

PURPOSE

This article considers the potential benefits that applying design principles from contemporary video games may have on enhancing therapy experiences.

METHOD

Six principles of video game design are presented, and their relevance for enriching clinical experiences is discussed.

RESULTS

The motivational and learning benefits of each design principle have been discussed in the education literature as having positive impacts on student motivation and learning and are related here to aspects of clinical practice. The essential experience principle suggests connecting all aspects of the experience around a central emotion or cognitive connection. The discovery principle promotes indirect learning in focused environments. The risk-taking principle addresses the uncertainties clients face when attempting newly learned skills in novel situations. The generalization principle encourages multiple opportunities for skill transfer. The reward system principle directly relates to the scaffolding of frequent and varied feedback in treatment. Last, the identity principle can assist clients in using their newly learned communication skills to redefine self-perceptions.

CONCLUSION

These principles highlight areas for research and interventions that may be used to reinforce or advance current practice.

Picture naming and verbal fluency in children with cochlear implants

PURPOSE

In the present study, the authors examined lexical naming in children with cochlear implants (CIs). The goal was to determine whether children with CIs have deficits in lexical access and organization as revealed through reaction time in picture-naming and verbal fluency (VF) experiments.

METHOD

Children with CIs (n = 20, ages 7-10) were compared with 20 children with normal hearing (NH) matched for age and nonverbal IQ. Lexical abilities were examined using two naming tasks: a timed picture-naming task and a phonological and semantic VF naming task. Picture naming taps into lexical access capabilities and the VF task elucidates lexical organization.

RESULTS

No group differences were found between children with CIs and children with NH on the timed picture-naming task. Children with CIs generated significantly fewer words than the children with NH on the VF tasks. Larger group differences were found for the phonological VF task compared with the semantic VF task.

CONCLUSIONS

Limited early linguistic and auditory experiences may affect lexical representations and organization (lexical-semantic connections) in school-age children with hearing loss who use CIs. Further analyses and studies should continue to examine these underlying linguistic deficits. The present results suggest a need to emphasize not only increasing the size of children's vocabularies during therapy, but also expanding and increasing the semantic and phonological richness of their lexical representations.

What do verbal fluency tasks measure? Predictors of verbal fluency performance in older adults

This study examined the contributions of verbal ability and executive control to verbal fluency performance in older adults (n = 82). Verbal fluency was assessed in letter and category fluency tasks, and performance on these tasks was related to indicators of vocabulary size, lexical access speed, updating, and inhibition ability. In regression analyses the number of words produced in both fluency tasks was predicted by updating ability, and the speed of the first response was predicted by vocabulary size and, for category fluency only, lexical access speed. These results highlight the hybrid character of both fluency tasks, which may limit their usefulness for research and clinical purposes.