The Impact of Dose and Dose Frequency on Word Learning by Kindergarten Children With Developmental Language Disorder During Interactive Book Reading

Learning Verbs in Sentences: Children With Developmental Language Disorder and the Role of Retrieval Practice

PURPOSE

Retrieval practice has been shown to assist the word learning of children with developmental language disorder (DLD). Although this has been true for learning new verbs as well as new nouns and adjectives, these children's overall verb learning has remained quite low. In this preregistered study, we presented novel verbs in transitive sentences with varying subjects/agents and objects/patients to determine if recall could be improved and if retrieval practice continued to be facilitative.

METHOD

Fourteen children with DLD aged 4-5 years and 13 same-age peers with typical language development (TD) learned eight novel verbs over two sessions. Half of the novel verbs were presented with spacing between study and retrieval trials, and half were presented with the same frequency in study trials without the opportunity for retrieval. All novel verbs were presented in sentences such as, "The woman is deeking the shoe." Children's ability to recall and use the novel verbs in the same sentence structure was tested after the second session and 1 week later. The children were also required to use the novel verbs in bare-stem form in a new structure, as in, "That woman likes to deek the towel."

RESULTS

Both groups of children showed increased recall relative to a previous novel verb study. The children with TD showed the expected advantages of spaced retrieval over repeated study and could use the novel verbs in the new morphological form and sentence structure. The children with DLD, however, showed an advantage for spaced retrieval only shortly after the learning period. These children had great difficulty changing the novel verbs to a bare stem and using them in a new structure.

CONCLUSION

Although spaced retrieval assists children's novel verb recall, children with DLD in particular require additional help using these verbs with morphological and syntactic flexibility.

Word Learning in Arabic Diglossia in Children With Typical Language Development and Developmental Language Disorder

PURPOSE

Word learning requires the creation of phonological and semantic representations and links in long-term memory. Phonological distance of a given word from the spoken language affects children's lexical-phonological representations and processing. The study investigates the role of the phonological distance of Modern Standard Arabic (StA) words from the child's Spoken Arabic (SpA) vernacular in word learning in Arabic diglossia. It also examines whether, given their vulnerable phonological skills, children with developmental language disorder (DLD) show a stronger impact of phonological distance on word learning than children with typical language development (TLD).

METHOD

One hundred children with TLD and DLD in kindergarten and in first grade (25 per group) were tested on comprehension and production word-learning probes manipulating phonological distance. Learning monosyllabic and disyllabic nonwords encoding only SpA phonemes was compared with the learning of parallel nonwords encoding one unique StA consonant each.

RESULTS

Repeated-measures analyses of variance showed higher word learning scores in children with TLD on both probes and for both syllable lengths. Moreover, all children fared significantly lower, in both comprehension and production probes, when the target stimulus was phonologically distant from the spoken language. Finally, an interaction effect was observed on the production probes, revealing differences in the developmental dynamics of phonological distance effects between the groups: Phonological distance hindered word learning among children with TLD in kindergarten, but among children with DLD in the first grade.

CONCLUSIONS

The results support the role of phonological distance as a phonological complexity factor in word learning in Arabic diglossia. Furthermore, they show that the effect of phonological distance is complex and it interacts with modality, language aptitude, and grade level. The theoretical and clinical implications are discussed.

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.

The Feasibility of an Online Language Program Delivered Through Music and the Impact of Dosage on Vocabulary Outcomes in Young Children With Down Syndrome

BACKGROUND

Few studies have explored the feasibility of online language interventions for young children with Down syndrome. Additionally, none have manipulated dose frequency or reported on the use of music as a medium through which language and sign can be learned.

PURPOSE

The purpose of this study was to (a) examine the feasibility and acceptability of an online language through music intervention for young children (1-3;6 years) with Down syndrome and (b) compare effectiveness at two intervention dose frequencies.

METHOD

The study was carried out in two phases using a mixed-methods design. Phase 1: Qualitative data were gathered from parents to examine feasibility when implementing a video-based language intervention. Phase 2: Seventy-six families participated in an online language intervention at home. Effectiveness was examined comparing two groups, randomly assigned to a high and low dose frequency. The Down Syndrome Education (DSE) checklists (combined) were the primary outcome measure. Process data were gathered to determine intervention acceptability in practice and to identify factors that would improve successful future implementation. Acceptability data were analyzed with reference to the theoretical framework of acceptability (Version 2).

RESULTS

Forty-three parents completed the Phase 1 scoping questionnaire, five of whom took part in focus groups. Once weekly morning sessions were indicated as the preferred scheduling choice. Phase 2 quantitative data were analyzed using beta regression adjusted for baseline scores and indicated no additional benefit to receiving the higher dose. However, exploratory interaction models suggested that the efficacy of the high-dose intervention was higher (than low-dose intervention) in participants with higher baseline DSE performance. Parents perceived the intervention to be effective and positive for the family.

CONCLUSION

The results add to our knowledge of real-world effective online interventions and suggest that a critical minimum language level is required for children with Down syndrome to benefit optimally from a higher intervention dose frequency.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.25979704.

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.

Group Size: An Active Ingredient of School-Based Language Therapy

PURPOSE

This study explored the relation between therapy group size and language outcomes for children receiving school-based language therapy through an implementation science lens.

METHOD

Data for the current study were gathered as part of the Speech-Language Therapy Experiences in Public Schools study. Participants included 273 English-speaking kindergarten through second-grade children with language impairment receiving business-as-usual therapy on the caseloads of 75 speech-language pathologists. Data were collected over an academic year, including weekly therapy logs, speech-language pathology questionnaires, and pre- and post-language measures.

RESULTS

Descriptive analysis revealed that children primarily experienced small-group therapy sessions (two to four children); however, there was considerable variability in group size. Hierarchical general linear modeling indicated that caseload size did not explain group size variability. However, the number of student cancellations was positively associated with receipt of large-group sessions. Notably, a significant negative association was found between receipt of large-group sessions (i.e., five to 10 children) and language outcomes. Children who received more than the average number of sessions in large groups (i.e., more than 5% of total sessions) experienced 0.18 SD less language gain over the academic year compared to the mean (0.54 SD). No other group size configurations (i.e., individual, small group, and extra large) yielded significant associations with language outcomes.

CONCLUSIONS

The findings suggest that young children receiving language-based therapy in large groups make substantially fewer language gains over an academic year. These results have considerable implications for educational policy and clinical practice, which are discussed through an implementation science frame.

A Word-Learning Intervention Pilot Study Utilizing Principles of Retrieval- and Criterion-Based Learning for Children With Developmental Language Disorder

PURPOSE

Vocabulary knowledge at school entry provides an essential foundation for academic and literacy learning. Thus, school entry is an important timepoint to support word learning by children with developmental language disorder (DLD). Retrieval-based training strategies support both learning and retention of words for individuals with DLD in lab-based research. Additionally, lab-based research with adults with typical development demonstrates that pairing retrieval- and criterion-based training strategies supports learning efficiency. Currently, it is unclear if retrieval- and criterion-based training in word-learning interventions is feasible and effective for children with DLD.

METHOD

In this pilot study, we taught preschool- and kindergarten-age children with DLD (N = 7) words in an intervention format. We implemented retrieval-based training in that children were asked to retrieve and produce the forms and meanings of words. We also implemented a criterion-based approach. Words were targeted until the child retrieved the form and meaning of a word at the beginning of two sessions. We assessed learning at the end of training and retention after 2- and 8-week post-training delays.

RESULTS

The retrieval- and criterion-based approach was effective to support word learning for six of the seven children. Children demonstrated better learning and retention of forms than meanings. Additionally, achieving criterion with a word during training was positively related to post-training retention.

CONCLUSIONS

A retrieval- and criterion-based approach is likely to support word learning during interventions for children with DLD. We include suggestions for future research to improve the effective and efficient implementation of these approaches.

Speech-Language Pathologists' Perceptions of Language and Literacy Instruction for Pre-K Children With Developmental Language Disorder

PURPOSE

Speech-language pathologists (SLPs) have multiple roles and responsibilities related to language and literacy instruction in schools. The purpose of this exploratory, qualitative study was to analyze school-based SLPs' perceptions related to effective language and early literacy instruction for pre-K children with developmental language disorder (DLD). The goal of this study was to inform development of a new language and early literacy professional development program for inclusive pre-K teachers.

METHOD

Eight school-based SLPs participated in a 1-hr virtual focus group conducted via Zoom recording technology. The researchers used a conventional content analysis approach to analyze the focus group data and identify themes from the discussion.

RESULTS

The researchers developed two themes: (a) SLPs identified repeated exposure to books, peer interaction, and teaching vocabulary with visual supports and props as key elements of language and literacy instruction that can be integrated into a variety of contexts, and (b) SLPs want more time with parents and teachers to support their book reading and model specific language strategies.

CONCLUSIONS

SLPs identified several instructional practices inclusive pre-K teachers could be taught to use during professional development programs to support the emergent literacy development of children with DLD. They also discussed the need for ongoing collaboration between SLPs, caregivers, and teachers to maximize children's early language and literacy experiences. Future research should explore the impact of partnerships with caregivers and teachers on children's language and literacy outcomes.

An evaluation of a prescribed joint book reading intervention for preschool children with speech, language and communication needs

Purpose: The aims of the present study were twofold: first, to investigate reading and screen time habits in a large clinical sample of caregivers of children with speech, language and communication needs (SLCN) before and after an 8 week intervention focussed on daily joint book reading and, second, to capture the caregivers' experiences of the activity.Method: Preschool aged children with SLCN and their caregivers were consecutively recruited during their first visit to the department of Speech and Language Pathology, Gävle County Hospital, Sweden. They participated in a survey-based interview before and after receiving an intervention with recommendations of at least 10 minutes of daily book reading with an interactional focus, as an add-on to ordinary speech-language pathology services. The results were analysed using descriptive statistics of the answers to the questions in the interview, as well as a thematic analysis of free-text comments.Result: The 135 families who participated in the pre-intervention interview survey reported variable reading frequency and screen time. The post-intervention interview survey was completed by 107 families. The results demonstrated significant increases in reading frequency and reading time, and a significant decrease in screen time per day. Caregivers also reported positive experiences of the daily interactive book reading.Conclusion: The results of this study demonstrate that a speech-language pathologist-(SLP) managed, caregiver-led book reading intervention is feasible and might have a positive impact on reading, other factors related to reading, and screen time in families of children with SLCN.

Recast Therapy for Treating Syntax in Bilingual Children With Developmental Language Disorder: A Feasibility and Early Efficacy Study Examining the Role of Language of Intervention on Outcomes

PURPOSE

The purpose of this study is to examine the feasibility of the delivery of complex syntax recast therapy via telepractice to Spanish-English bilingual children and provide preliminary evidence of the efficacy of this approach.

METHOD

Fifteen bilingual children with developmental language disorders were stratified based on language proficiency and randomized to one of three treatment conditions: Spanish only (n = 5), English only (n = 6), or Spanish + English (n = 4). Using a within-subject design, we hypothesized that we could document treatment efficacy based on change in the treated structure in the absence of change in an untreated comparison structure. All 15 children completed ~16 hr of treatment via telepractice and participated in pre- and posttesting of their production of conditional adverbs (treated structure) and subject relative clauses (untreated structure) carried out by a masked assessor.

RESULTS

Analyses included all participants. Treatment fidelity was high, and participant attendance was remarkable, indicating feasibility. Regarding efficacy, recast therapy led to group-level gains on treated syntactic structures that exceeded those observed for the untreated comparison structure. For the 11 children who received therapy in only one language, approximately equal gains were observed in both the treated and untreated languages for conditional adverbials.

CONCLUSIONS

Preliminary evidence suggests that for highly overlapping structures like conditional adverbials, recast therapy is effective and leads to change in both of the child's languages. Larger studies are required to understand how language of administration and proficiency may affect outcomes.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.23739996.

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.

Supporting adjective learning by children with Developmental Language Disorder: Enhancing metalinguistic approaches

BACKGROUND

Adjectives are essential for communication, conceptual development and academic success. However, they are semantically and syntactically complex and can be particularly challenging for children with Developmental Language Disorder (DLD). Surprisingly, language interventions have not typically focused on this important word class.

AIMS

(1) To provide a supportive and accessible primer on adjectives for practitioners; (2) to explore how the SHAPE CODING^TM system can be adapted to support adjective learning in DLD; and (3) to provide practical recommendations on how to support adjective learning in clinical practice and education.

METHODS/PROCEDURE

We synthesise linguistic and psychological research on adjective semantics, clinical insights into DLD and pedagogical practice supporting this population.

MAIN CONTRIBUTION

We address the lack of specific training in the nature and acquisition of adjectives for speech and language therapists (SLTs) by providing an accessible primer. We also provide an innovative guide detailing how an established metalinguistic intervention might be adapted to support adjective learning.

CONCLUSIONS/IMPLICATIONS

Without targeted support for adjective learning, the communicative potential of children with DLD is compromised. Our recommendations can be used across a range of therapeutic and educational contexts to guide SLTs and teaching staff in developing practice in this area.

WHAT THIS PAPER ADDS

What is already known on the subject Adjectives are an essential word class needed for effective communication. They are also vital to successfully achieve academic objectives across all curriculum areas. For example, most subjects require children to be able to describe, evaluate, compare and discriminate different events, objects or techniques. Children with Developmental Language Disorder (DLD) have deficits in various domains of language that can affect adjective learning and use. What this paper adds to existing knowledge Despite the importance of adjectives, speech and language therapists (SLTs) and other professionals supporting language development rarely receive specific training regarding their structure and meanings, and how to teach and support their use. This article provides an accessible primer on the many subtypes of adjectives and how these behave syntactically and semantically. It explores how adjective teaching could be enhanced for children with DLD by adapting an established metalinguistic technique and provides practical recommendations for implementing this approach. What are the potential or actual clinical implications of this work? By raising awareness of the complexities of adjectives and providing strategies to support their acquisition by children with DLD, this article will enable SLTs and teaching staff to improve their understanding and practice in this area and, with further research, to develop robust, effective interventions for children with DLD. This will contribute to enhancing the long-term academic, social and employment success of children with DLD.

A new dynamic word learning task to diagnose language disorder in French-speaking monolingual and bilingual children

Tools to effectively assess the language performance of bilingual children are lacking. Static tests assessing vocabulary knowledge (e.g., naming task) are not appropriate for testing bilingual children due to different types of bias. Alternative methods have been developed to diagnose bilingual children, including measuring language learning (e.g., word learning) through dynamic assessment. Research conducted with English-speaking children indicates that DA of word learning is effective in diagnosing language disorders in bilingual children. In this study, we examine whether a dynamic word learning task, using shared-storybook reading, can differentiate French-speaking (monolingual and bilingual) children with developmental language disorder (DLD) from those with typical development (TD). Sixty children (4-8 years), 43 with TD and 17 with DLD, participated: 30 were monolinguals and 25 were bilinguals. The dynamic word-learning task used a shared-storybook reading context. The children had to learn four non-words, paired with novel objects, as well as their semantic characteristics (a category and a definition) during the reading of a story. Post-tests assessed the recall of the phonological form and the semantic features of the objects. Phonological and semantic prompts were given if the child was unable to name or describe the objects. Results indicated that children with DLD performed less well than those with TD on phonological recall, leading to fair sensitivity and good specificity at delayed post-test for young children (4-6 years). Semantic production did not differentiate the two groups: all children performed well at this task. In sum, children with DLD have more difficulties encoding the phonological form of the word. Our findings suggest that a dynamic word learning task using shared-storybook reading is a promising approach for diagnosing lexical difficulties in young French-speaking, monolingual and bilingual, children.

Effectiveness of intervention focused on vocational course vocabulary in post-16 students with (developmental) language disorder

BACKGROUND

People with language disorders (including developmental language disorder-DLD) often struggle to learn new words and, for young adults, this could affect their success in future work. Therefore, it is crucial to support their learning of career-specific vocabulary. However, little published evidence exists regarding the effectiveness of speech and language intervention for older adolescents and young adults with (developmental) language disorder (D)LD within a post-16 provision.

AIMS

To investigate whether for students with (D)LD in a post-16 environment, the addition of direct individual intervention from a speech and language therapist (SLT) teaching course-specific vocabulary leads to more progress than just in-course teaching on bespoke vocabulary measures.

METHODS & PROCEDURES

A total of 28 college-aged students (11 female and 17 male) with (D)LD (aged 16.0-19.9) participated in a within-participant study comparing progress with explicit vocabulary intervention plus in-course teaching versus in-course teaching alone. The participants were assessed at four time points (3 months pre-intervention, immediately pre- and post-intervention, 3.5 months after intervention) using bespoke vocabulary assessments with an equal number of nouns, verbs and adjectives. All participants received one-to-one vocabulary intervention from their usual SLT for 30 min per week for 9 weeks. The intervention had four main components: (1) to identify intervention focus, (2) to recap previously taught terms (using an online flashcard program), (3) to explicitly teach new words using word maps to help with: creating definition and pictorial representation, identification of word class and investigation of phonological and morphological properties, and (4) to add new words, with their definition and pictorial representation to online flashcard program.

OUTCOMES & RESULTS

The results showed a stable baseline, then during the intervention term significant progress on words targeted only in lessons and significantly greater progress on words targeted both in lessons and SLT sessions. Progress was maintained for 14 weeks. Individuals with initially lower scores showed smaller intervention effects. In general, performance was higher on verbs and on the definition recognition task and lower on the production tasks, but all tasks improved with intervention.

CONCLUSIONS & IMPLICATIONS

Direct one-to-one vocabulary intervention with an SLT can lead to significant gains in knowledge of course-specific terminology for college-aged students with (D)LD. The effectiveness of speech and language therapy services for this age group in a wider range of areas of language and social communication should also be investigated.

WHAT THIS PAPER ADDS

What is already known on this subject Very few services exist for young adults with DLD, despite their persisting language difficulties and the detrimental impact of these on their academic attainment and employment prospects. Most careers involve specific vocabulary which is crucial to executing a role successfully and these need to be learned by those looking to move into these careers. However, children, adolescents and adults with DLD struggle to learn new words and may need help in this area. What this study adds to existing knowledge The young adults with (D)LD received 9 weeks of intervention targeting individualized course-specific vocabulary (nouns, verbs and adjectives), using word maps to focus on word forms, definitions, morphologically related words and syntactic information such as word class and how to use the word in a sentence. An online learning tool provided regular spaced retrieval practice of previously taught words and their definitions. The participants showed significant progress with learning course-specific vocabulary from attending lessons. However, they made significantly greater progress on those words which were also targeted in individual SLT sessions, regardless of word class. Progress was maintained over 14 weeks. What are the potential or actual clinical implications of this work? Direct one-to-one vocabulary intervention with an SLT can lead to significantly greater gains in the acquisition of targeted course-specific terminology for young adults with (D)LD than the vocabulary teaching available in lessons. Individual intervention delivered by SLTs should therefore be offered to this age group of students with (D)LD to maximize their ability to access the academic curriculum and their future careers. Indeed, the broader role of SLTs in helping these young adults to access the world of work and independent living should be further investigated and supported.

Contributions of early motor deficits in predicting language outcomes among preschoolers with developmental language disorder

Purpose: We assessed the extent to which language, speech, and fine/gross motor skills in preschoolers with developmental language disorder (DLD; also referred to as specific language impairment) predicted language outcome two years later.Method: Participants with DLD (n = 15) and typical development (TD; n = 14) completed language, speech, and fine/gross motor assessments annually, beginning as 4- to 5-year-olds (Year 1 timepoint) and continuing through 6 to 7 years of age (Year 3 timepoint). We performed Pearson correlation and hierarchical regression analyses to examine the relative contributions of Year 1 language, speech, and motor skills to Year 3 language outcome in each group.Result: Among children with DLD, Year 1 fine/gross motor scores positively correlated with Year 3 language scores, uniquely explaining 40% of the variance in language outcomes. Neither Year 1 language, speech-sound, nor speech-motor scores predicted language outcome in this group. Among children with TD, only Year 1 language predicted language outcome.Conclusion: This small longitudinal study reveals that, among preschoolers with DLD, certain early fine/gross motor deficits predict persistent language impairment. Future research that includes larger sample sizes and motor tasks that incorporate complex sequencing will enhance the understanding of the relationship between language, speech, and motor skills; specifically, whether certain motor deficits simply co-occur with language deficits or whether they are tied to DLD through shared impairments in sequential learning mechanisms.

Peer Effects in Language Therapy for Preschoolers With Developmental Language Disorder: A Pilot Study

PURPOSE

The purpose of this pilot study was to determine the impact of including peers with typically developing language (TDL) in language intervention sessions for preschool children with diagnosed developmental language disorder (DLD).

METHOD

To measure peer effects, participants received 8 weeks of group language intervention in their neighborhood head start. Twenty children with DLD were randomly assigned to one of two conditions. Children in the experimental condition received language intervention with a peer with TDL; children in the control condition received language intervention with another peer with DLD. Pre- and posttest measures of language (semantics, syntax, morphology, and narrative) were collected. Teachers, speech-language pathologists, and assessors were blind to study condition.

RESULTS

All children in the study showed gains from pre- to posttest; there were no statistically significant differences between conditions. However, effect size estimates (Cohen's d) indicated that the children in the experimental condition showed an advantage over the control condition in syntax, morphology, and narrative.

CONCLUSIONS

This study provides preliminary evidence that children with DLD show increased gains in language when paired with peers with TDL. This finding supports previous research in educational literature, suggesting that children's development is influenced by the skills of their peers. Additional research is warranted to further explore and understand the role of peers for children with DLD.

Less Is More: Implementing the Minimal Intervention Needed for Change Approach to Increase Contextual Fit of Speech-Language Interventions

PURPOSE

Speech-language pathologists (SLPs) and researchers face difficulties in moving evidence-based practices from clinical research into widespread practice, in part due to a mismatch between the design of typical intervention research studies and the realities of clinical settings. SLPs must adapt interventions from the literature or established programs to fit the needs of specific clients and settings. Researchers must design studies that better reflect clinical practice.

METHOD

Here, we provide an overview of the Minimal Intervention Needed for Change (MINC) approach, a systematic approach to developing and adapting interventions that focuses on achieving meaningful outcomes within specific contexts. We outline the principles of MINC and illustrate this process through the use of a case study.

RESULTS

MINC can support systematic development and adaptation of interventions in clinical and research settings, particularly settings with resource limitations.

CONCLUSIONS

Researchers should work to align research intervention work with typical clinical settings. This involves both targeting outcomes that are functional and clinically significant and acknowledging resource limitations. SLPs should adapt evidence-based interventions systematically and carefully to meet the needs of clients and settings while retaining the core components of intervention that result in meaningful change for clients.

The Contributions of Immediate Retrieval and Spaced Retrieval to Word Learning in Preschoolers with Developmental Language Disorder

Background and Aims

Children with developmental language disorder (DLD) benefit from word learning procedures that include a mix of immediate retrieval and spaced retrieval trials. In this study, we examine the relative contribution of these two types of retrieval.

Methods

We examine data from Haebig et al. (2019) in their study that compared an immediate retrieval condition and a condition of spaced retrieval that also included immediate retrieval trials. Participants were 4- and 5-year old children with DLD and same-age peers with typical language development. Each child learned novel (made-up) words referring to unusual plants and animals in both conditions. We examined the phonetic accuracy of the novel words used during the final learning trial and during recall tests 5 min and 1 week after learning.

Results

On the final learning trial, the children were more phonetically accurate in using the novel words learned in the immediate retrieval condition. However, recall tests after the learning trials revealed a decrease in accuracy, especially for the children with DLD. After one week, accuracy was much lower for words in the immediate retrieval condition than for words in the mixed spaced-plus-immediate retrieval condition. For words learned in the mixed spaced-plus-immediate retrieval condition, accuracy was very stable across time for both groups.

Conclusions

Immediate retrieval boosts the phonetic accuracy of new words in the short term but spaced retrieval promotes stability and increases the likelihood that short-term gains are maintained.

Implications: When novel word learning is assessed at the level of phonetic accuracy, children with DLD can show declines over time not characteristic of children with typical language development. Spaced retrieval procedures augmented by immediate retrieval opportunities during learning appear to prevent such declines, leading to longer-lasting gains.

Treatment intensity for developmental language disorder: A systematic review

PURPOSE

Research on treatment intensity in children with developmental language disorder (DLD) has undergone substantial development over the last decade. The aim of the present review was to analyse available publications as related to methodological quality, degree of scientific evidence, and the areas/aspects of language involved.

METHOD

A systematic review of the scientific literature was conducted using the PRISMA guidelines. A total of 9 articles from 34 published investigations in the field were selected for review according to our inclusion criteria.

RESULT

The articles addressed the effects of treatment intensity primarily considering expressive morphology and vocabulary. The methodological quality and levels of evidence provided by the studies were high. In general, the effect sizes of dependent variables were considered large.

CONCLUSION

The number of articles investigating treatment intensity in DLD is scarce. High variability of stimuli was associated with improvements in morphology, whereas vocabulary did not demonstrate the same association. Further research on treatment intensity is needed to address transference and generalisation of the treated abilities.

The Impact of Intervention Dose Form on Oral Language Outcomes for Children With Developmental Language Disorder

Purpose The aim of this study was to extract key learning from intervention studies in which qualitative aspects of dosage, dose form, have been examined for children with developmental language disorder (DLD)-in vocabulary, morphosyntax, and phonology domains. This research paper emerged from a pair of systematic reviews, aiming to synthesize available evidence regarding qualitative and quantitative aspects of dosage. While quantitative aspects had been experimentally manipulated, the available evidence for dose form (tasks or activities within which teaching episodes are delivered) was less definitive. Despite this, the review uncovered insights of value to DLD research. Method A preregistered systematic review (PROSPERO ID: CRD42017076663) adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was completed. Included papers were quasi-experimental, randomized controlled trial, or cohort analytic studies, published in any language between January 2006 and May 2019; oral language interventions with vocabulary, morphosyntax, or phonology outcomes; and participants with DLD (M = 3-18 years). The intention was to include papers in which dose form was experimentally manipulated or statistically analyzed, while quantitative dosage aspects were controlled, such that definitive conclusions about optimal dose form could be drawn and gaps in the evidence identified. Results Two hundred and twenty-four papers met the above inclusion criteria; 27 focused on dose form. No study controlled for all quantitative aspects of dosage such that we could effectively address our original research questions. Despite this, key points of learning emerged with implications for future research. Conclusions There is tentative evidence of advantages for explicit over implicit instruction and of the benefits of variability in input, elicited production, and gestural and other visual supports. With careful design of dose form, there is potential to design more efficient interventions. Speech-language pathology research would benefit from an agreed taxonomy of dose form components and standardized reporting of intervention studies, to enable cross-study comparisons and a systematic accrual of knowledge to identify optimal dose form for clinical application.

Spoken Word Learning in Children With Developmental Language Disorder or Dyslexia

Purpose Word learning difficulties have been documented in multiple studies involving children with dyslexia and developmental language disorder (DLD; see also specific language impairment). However, no previous studies have directly contrasted word learning in these two frequently co-occurring disorders. We examined word learning in second-grade students with DLD-only and dyslexia-only as compared to each other, peers with both disorders (DLD + dyslexia), and peers with typical development. We hypothesized that children with dyslexia-only and DLD-only would show differences in word learning due to differences in their core language strengths and weaknesses. Method Children (N = 244) were taught eight novel pseudowords paired with unfamiliar objects. The teaching script included multiple exposures to the phonological form, the pictured object, a verbal semantic description of the object, and spaced retrieval practice opportunities. Word learning was assessed immediately after instruction with tasks requiring recall or recognition of the phonological and semantic information. Results Children with dyslexia-only performed significantly better on existing vocabulary measures than their peers with DLD-only. On experimental word learning measures, children in the dyslexia-only and DLD + dyslexia groups showed significantly poorer performance than typically developing children on all word learning tasks. Children with DLD-only differed significantly from the TD group on a single word learning task assessing verbal semantic recall. Conclusions Overall, results indicated that children with dyslexia display broad word learning difficulties extending beyond the phonological domain; however, this contrasted with their relatively strong performance on measures of existing vocabulary knowledge. More research is needed to understand relations between word learning abilities and overall vocabulary knowledge and how to close vocabulary gaps for children with both disorders. Supplemental Material https://doi.org/10.23641/asha.14832717.

The Challenge of Rich Vocabulary Instruction for Children With Developmental Language Disorder

Purpose The aims of the study were to explore responses of children with developmental language disorder (DLD) to rich vocabulary instruction and to identify potential factors that contribute to outcomes. Method Children with DLD participated in a language intervention embedded within a science camp. Using parent and clinician reports, standardized tests, probes, notes, and video, we derived descriptions of seven of the campers who received a vocabulary intervention that incorporated principles of rich instruction. We present them here as a case series. Results Five cases responded to the intervention with modest gains in Tier 2 science vocabulary and science knowledge. One case demonstrated no response, and another was unable to complete the intervention. The latter two cases presented with triple risks: DLD, executive function deficits, and stressors associated with poverty. In comparison, the best responder also lived in poverty and had DLD, but he had intact executive function, strengths in extant vocabulary, stronger knowledge of science, better engagement in the science and language intervention activities, and was older. Other factors that seemed to contribute to outcomes included the complexity of the word forms and dosage. Conclusions Translating research on rich instruction to clinical practice is challenging. This case series motivated hypotheses about the nature of the challenge and what to do about it, the primary one being that the modest success of rich vocabulary instruction for children with DLD is not a limitation of the approach itself but rather a reflection of the difficulty of delivering the intervention while tailoring the targets, approach, and dosage to the needs of individual children with DLD. Supplemental Material https://doi.org/10.23641/asha.13667699.

The Influence of Quantitative Intervention Dosage on Oral Language Outcomes for Children With Developmental Language Disorder: A Systematic Review and Narrative Synthesis

Purpose The aim of this study was to examine the degree to which quantitative aspects of dosage (dose, dose frequency, and total intervention duration) have been examined in intervention studies for children with developmental language disorder (DLD). Additionally, to establish the optimal quantitative dosage characteristics for phonology, vocabulary, and morphosyntax outcomes. Method This registered review (PROSPERO ID CRD42017076663) adhered to PRISMA guidelines. Search terms were included in seven electronic databases. We included peer-reviewed quasi-experimental, randomized controlled trial or cohort analytical studies, published in any language between January 2006 and May 2020. Included articles reported on participants with DLD (M = 3-18 years); oral language interventions with phonology, vocabulary, or morphosyntax outcomes; and experimental manipulation or statistical analysis of any quantitative aspect of dosage. Studies were appraised using the Cochrane risk-of-bias tool. Results Two hundred forty-four articles reported on oral language interventions with children with DLD in the domains of interest; 13 focused on experimentally/statistically manipulating quantitative aspects of dosage. No article reported phonological outcomes, three reported vocabulary, and eight reported morphosyntax. Dose frequency was the most common characteristic manipulated. Conclusions Research is in its infancy, and significant further research is required to inform speech-language pathologists in practice. Dosage characteristics are rarely adequately controlled for their individual effects to be identified. Findings to date suggest that there is a point in vocabulary and morphosyntax interventions after which there are diminishing returns from additional dosage. If dose is high (number of learning opportunities within a session), then the literature suggests that session frequency can be reduced. Frequent, short sessions (2/3 × per week, approximately 2 min) and less frequent, long sessions (1 × per week, approximately 20 min) have yielded the best outcomes when composite language measures have been used; however, replication and further research are required before clinicians can confidently integrate these findings into clinical practice. Supplemental Material https://doi.org/10.23641/asha.13570934.

Word learning and verbal working memory in children with developmental language disorder

BACKGROUND AND AIMS

Previous research into word learning in children with developmental language disorder (DLD) indicates that the learning of word forms and meanings, rather than form-referent links, is problematic. This difficulty appears to arise with impaired encoding, while retention of word knowledge remains intact. Evidence also suggests that word learning skills may be related to verbal working memory. We aimed to substantiate these findings in the current study by exploring word learning over a series of days.

METHODS

Fifty children with DLD (mean age 6; 11, 72% male) and 54 age-matched typically developing (TD) children (mean age 6; 10, 56% male) were taught eight novel words across a four-day word learning protocol. Day 1 measured encoding, Days 2 and 3 measured re-encoding, and Day 4 assessed retention. At each day, word learning success was evaluated using Naming, Recognition, Description, and Identification tasks.

RESULTS

Children with DLD showed comparable performance to the TD group on the Identification task, indicating an intact ability to learn the form-referent links. In contrast, children with DLD performed significantly worse for Naming and Recognition (signifying an impaired ability to learn novel word forms), and for Description, indicating problems establishing new word meanings. These deficits for the DLD group were apparent at Days 1, 2, and 3 of testing, indicating impairments with initial encoding and re-encoding; however, the DLD and TD groups demonstrated a similar rate of learning. All children found the retention assessments at Day 4 difficult, and there were no significant group differences. Finally, verbal working memory emerged as a significant moderator of performance on the Naming and Recognition tasks, such that children with DLD and poor verbal working memory had the lowest levels of accuracy.

CONCLUSIONS

This study demonstrates that children with DLD struggle with learning novel word forms and meanings, but are unimpaired in their ability to establish new form-referent links. The findings suggest that the word learning deficit may be attributed to problems with encoding, rather than with retention, of new word knowledge; however, further exploration is required given the poor performance of both groups for retention testing. Furthermore, we found evidence that an impaired ability to learn word forms may only be apparent in children who have DLD and low levels of verbal working memory.

IMPLICATIONS

When working with children with DLD, speech-language pathologists should assess word learning using tasks that evaluate the ability to learn word forms, meanings, and form-referent links to develop a profile of individual word learning strengths and weaknesses. Clinicians should also assess verbal working memory to identify children at particular risk of word learning deficits. Future research should explore the notion of optimal intervention intensity for facilitating word learning in children with poor language and verbal working memory.

Feasible Implementation Strategies for Improving Vocabulary Knowledge of High-Risk Preschoolers: Results From a Cluster-Randomized Trial

Purpose Many children begin school with limited vocabularies, placing them at a high risk of academic difficulties. The goal of this study was to examine the effects of a vocabulary intervention program, Story Friends, designed to improve vocabulary knowledge of at-risk preschool children. Method Twenty-four early-childhood classrooms were enrolled in a cluster-randomized design to evaluate the effects of a revised Story Friends curriculum. In each classroom, three to four preschoolers were identified as having poor language abilities, for a total of 84 participants. In treatment classrooms, explicit vocabulary instruction was embedded in prerecorded storybooks and opportunities for review and practice of target vocabulary were integrated into classroom and home practice activities. In comparison classrooms, prerecorded storybooks included target vocabulary, but without explicit instruction, and classroom and home strategies focused on general language enrichment strategies without specifying vocabulary targets to teach. Intervention activities took place over 13 weeks, and 36 challenging, academically relevant vocabulary words were targeted. Results Children in the treatment classrooms learned significantly more words than children in the comparison classrooms, who learned few target words based on exposure. Large effect sizes (mean d = 1.83) were evident as the treatment group averaged 42% vocabulary knowledge versus 11% in the comparison group, despite a gradual decline in vocabulary learning by the treatment group over the school year. Conclusions Findings indicate that a carefully designed vocabulary intervention can produce substantial gains in children's vocabulary knowledge. The Story Friends program is feasible for delivery in early childhood classrooms and effective in teaching challenging vocabulary to high-risk preschoolers. Supplemental Material https://doi.org/10.23641/asha.13158185.

Promoting Reading Achievement in Children With Developmental Language Disorders: What Can We Learn From Research on Specific Language Impairment and Dyslexia?

Purpose Specific language impairment (SLI; see also developmental language disorder) and dyslexia are separate, yet frequently co-occurring disorders that confer risks to reading comprehension and academic achievement. Until recently, most studies of one disorder had little consideration of the other, and each disorder was addressed by different practitioners. However, understanding how the two disorders relate to each other is important for advancing theories about each disorder and improving reading comprehension and academic achievement. The purpose of this clinical focus article is to integrate research on SLI and dyslexia as well as advocate for the consideration of comorbidities in future research and clinical practice. Method The first section reviews definitions as well as inclusionary and exclusionary criteria for SLI and dyslexia. The second section reviews research demonstrating that SLI and dyslexia are different disorders that often co-occur. Studies examining language, working memory, and academic achievement in children with separate versus co-occurring SLI and dyslexia are reviewed. The final section compares and contrasts school identification frameworks for children with SLI and dyslexia and considers the potential benefits of incorporating broad language skills into response to intervention (RTI) assessment frameworks. Conclusions Children with weak language skills are at a high risk of experiencing reading problems, but language difficulties are often hidden from view. Directly addressing language skills within school RTI frameworks can help improve the identification and treatment of children with SLI and dyslexia as well as support improved reading comprehension and academic achievement for all students. Presentation Video https://doi.org/10.23641/asha.13063793.

The Fast-Mapping Abilities of Adults With Developmental Language Disorder

Purpose The aim of the study was to determine the integrity of fast mapping among adults with developmental language disorder (DLD). Method Forty-eight adults with DLD or typical language development (TD) were presented with 24 novel words and photos of their unfamiliar referents from the semantic categories of mammal, bird, fruit, or insect in two conditions. In the fast-mapping condition, 12 of the 24 unfamiliar referents were presented, one at a time alongside a familiar referent (e.g., a dog) and a question (e.g., Is the tail of the torato up?). In the explicit-encoding condition, the other 12 unfamiliar referents were presented alone, one at a time, with a label (e.g., This is a spimer). Immediately after exposure (T1) and again after a 1-day interval (T2), memory for the word-to-exemplar link was measured with a three-alternative forced-choice test, requiring the participant to match a spoken word to one of three pictured referents from the training set. At T2, memory for semantic category information was measured with a four-alternative forced-choice test, requiring the participant to match a spoken word to one of four prototypical silhouettes representing each of the semantic categories. Results Performance on word-to-exemplar link recognition was stronger for words learned in the explicit-encoding than the fast-mapping condition and stronger for the TD group than the DLD group. Time was not a significant factor as both groups maintained posttraining levels of performance after a 1-day retention interval. Performance on semantic category recognition was stronger for words learned in the explicit-encoding than the fast-mapping condition and stronger for the TD group than the DLD group. The lower category recognition performance of the DLD group was related to their lower nonverbal IQ scores. Conclusion Contexts that allow for explicit encoding yield better learning of word-to-referent links than contexts that allow for fast mapping in both stronger and weaker learners. Adults with DLD have difficulty learning the link between words and referents, whether trained via fast mapping or explicit encoding and whether tested with exemplar or category referents. Retention is a relative strength for adults with DLD. Supplemental Material https://doi.org/10.23641/asha.12765551.

Capitalizing on cross-language similarities in intervention with bilingual children

PURPOSE

This study examined the effects of a vocabulary intervention for bilingual children that was conducted in children's first language, Spanish, and included explicit instruction on cognates. We measured effects in terms of change from pre- to post-intervention in Spanish as well as associations with the non-target language, English.

METHOD

Participants were 12 Spanish-English bilingual children, aged 6-8 years, with and without Developmental Language Disorder. Children completed the intervention in pairs (one child with DLD and a typically developing peer) for 70-minute sessions, 3 days a week, for four weeks. Intervention targeted 32 words (16 cognates, 16 non-cognates) using four storybooks (8 words/book) and interactive activities that highlighted similarities across languages. Pre- and post-intervention measures in Spanish and English included tasks of word definition and cognate facilitation.

RESULTS

As a group, children showed improvement in definition quality and cognate naming in Spanish. There was a positive correlation between definition quality and cognate naming for the typically developing children, but not for the children with DLD. All children showed positive cross-language correlations on post-intervention measures.

CONCLUSIONS

Bilingual children, with and without DLD, have the capacity to improve in their awareness and use of cognates. Explicit teaching of cognates can be an effective tool for building vocabulary skills. Children with DLD may need additional time and support to apply their knowledge of cognates to vocabulary learning.

Diagnosis of Developmental Language Disorder in Research Studies

Purpose The aim of this study was to investigate the extent to which researchers in the field of developmental language disorder are utilizing validated methods to diagnose their research participants. Method We examined 90 research articles published from 2015 to 2019 that included English-speaking participants from the United States who were identified as having a developmental language disorder or specific language impairment. From these articles, we identified the tests and measures used to identify participants and classify them as healthy or impaired. We then consulted the test manuals and the literature to find information on sensitivity and specificity of the test and the evidence-based cut score that maximized identification accuracy. Results Of the 90 articles examined, 38 (42%) were found to reflect validated diagnostic methods, and 51 (58%) did not. Conclusion Our results illustrate that validated methods are used less than half of the time even by those who should have a high level of expertise and despite calls for increasing scientific rigor in research practices.

The Advantages of Retrieval-Based and Spaced Practice: Implications for Word Learning in Clinical and Educational Contexts

Purpose Researchers in the cognitive sciences have identified several key training strategies that support good encoding and retention of target information. These strategies are retrieval-based practice, also known as learning through testing, and spaced practice. The recent resurgence of research on retrieval-based and spaced practice has been extended to investigate the effectiveness of these strategies to support learning in individuals with language disorders. The purpose of the current article is to review key principles of retrieval-based and spaced practice that can be used to support word learning in individuals within clinical and educational contexts. Conclusion Current research provides evidence that principles of retrieval-based and spaced practice can enhance word learning for individuals with language disorders. Current research provides guidance for clinicians on how to implement these strategies both within and across sessions to support encoding and retention of target information. Additional research should be conducted to provide a better understanding of how to optimize encoding and retention in clinical and educational contexts. Most notably, research that examines long-term retention after interventions are withdrawn would further our understanding of how these principles can be optimally applied to improve outcomes for individuals with language disorders.

Prologue to the Forum: Vocabulary Across the School Grades

Purpose This prologue introduces the LSHSS Forum: Vocabulary Across the School Grades. The goals of the forum are to provide an overview of the importance of vocabulary to literacy and academic achievement, to review evidence regarding best practices for vocabulary instruction, and to highlight recent research related to word learning with students across different grade levels. Method The prologue provides a foundational overview of vocabulary's role in literacy and introduces the topics of the other ten articles in the forum. These include clinical focus articles, research reviews, and word-learning and vocabulary intervention studies involving students in elementary grades through college. Conclusion Children with language and reading disorders experience specific challenges learning new words, but all students can benefit from high-quality vocabulary instruction. The articles in this issue highlight the characteristics of evidence-based vocabulary interventions for children of different ages, ability levels, and language backgrounds and provide numerous examples of intervention activities that can be modified for use in individual, small-group, or large-group instructional settings.