Does the order of your therapy activities matter?

You see a kindergartener with developmental language disorder (DLD) for language therapy. You pick some toys, a game, or a book that will elicit lots of examples of the grammar targets you’re working on. While you play, you give her plenty of models, and use recasts to help her correct her own productions. Sounds pretty typical, yes?

This article has a tip to make that intervention even better: if you’re doing auditory bombardment as part of language therapy, do it at the end of your sessions.

So often we read research studies and think, “That sounds great, but how would I EVER implement it in my real practice?” Here, we have a small study examining a specific, practical question on how to make the therapy we’re doing more effective. YAY. More of this, please!

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In the study, a group of 4–6-year-olds with DLD got a half hour of enhanced* conversational recast treatment for targeted morphemes, of which the first or last 2–4 minutes were devoted to an auditory bombardment activity—something like having the child turn over picture cards while the clinician said phrases with the target structure. Overall, the therapy was effective, and the children improved in their use of the focus morpheme compared to controls. But—the researchers found that more children benefited from the therapy when auditory bombardment came last. Why? The authors suggest that it helped “consolidate the child’s internal representation” of the morpheme. Doing the bombardment first didn’t seem to offer any advantage over not doing it at all, based on a comparison with equivalent treatment groups from the authors’ previous work.

*Recasting, where the clinician repeats the child’s utterance, correcting any errors of grammar, is an evidence-based language intervention strategy. The “enhanced” part means that clinicians got the children’s attention before doing the recast, and also that they made sure to use different verbs each time. We know children learn better from a wider variety of examples. Check out the paper for more details on how the actual therapy worked!

Plante, E., Tucci, A., Nicholas, K., Arizmendi, G. D., & Vance, R. (2018). Effective Use of Auditory Bombardment as a Therapy Adjunct for Children With Developmental Language Disorders. Language, Speech, and Hearing Services in Schools, 49(2), 320–333. doi:10.1044/2017_LSHSS-17-0077.