It’s not too late to work on word finding with older students

Most of our research on language treatment is done with younger children, despite the fact that challenges for people with language disorders persist into adulthood. One of these challenges might be word finding difficulties, or being unable to say a known word when needed. Previous research has given us proven treatments for word finding difficulties in children and young adolescents, but the authors of this study wanted to see if they could also improve word finding in older students.

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The researchers gave students aged 16–19* a standardized word finding test before the study started, after a period of no treatment, and after a short period of treatment. In eight 30-minute treatment sessions, students boosted their semantic knowledge of nouns by sorting them into categories and answering questions about them (see Appendix 5 for examples).  Students’ improvement on the word finding test was higher across the treatment period than the no-treatment period, suggesting that the treatment improved their general word finding ability. The study wasn’t experimental, so we can’t make strong conclusions, but it does suggest that teenage students can still make progress on word finding skills.

*College students in the UK, where the study was conducted; high school students in the US

 

Campbell, L., Nicoll, H., & Ebbels, S. H. (2019). The effectiveness of semantic intervention for word-finding difficulties in college-aged students (16–19 years) with persistent Language Disorder. Autism & Developmental Language Impairments. doi:10.1177/2396941519870784

Percent grammatical utterances: Meet your new go-to LSA measure

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We know that few SLPs use language sample analysis. And, real talk, we get it—transcribing and analyzing language samples takes forever, and sometimes you end up with a whole bunch of numbers and no idea what they mean. To help with that, this study gives us a little more guidance for analyzing narrative language samples using percent grammatical utterances (PGU).

The authors used data from 4- to 9-year-old children who took the Edmonton Narrative Norms Instrument (ENNI). As part of the ENNI, children generated stories for six picture sequences, which were transcribed and coded. PGU coding is pretty straightforward. You:

  1. Divide the sample into C-units

  2. Decide whether each C-unit has a verb

  3. Mark each C-unit with a verb as grammatical or ungrammatical

  4. Divide the number of grammatical C-units by total eligible C-units (those with a verb) to get PGU

That’s it—no complex coding, no lengthy rubrics, just a yes/no decision for each utterance (see the article and supplemental material for more examples and guidance). And as easy as it is, PGU is also a good measure. The authors found that PGU was reliable, valid, and able to distinguish children with and without developmental language disorder (DLD) with acceptable diagnostic accuracy. Using the data in the article, you can supplement diagnostic decisions (Table 5) or track progress (Supplemental File S4). Note that you should use the same language sample context that they did; luckily, the ENNI pictures are freely available. And for an even faster measure to use with 3-year-olds, check out these researchers’ previous work on percent grammatical responses (PGR).  

*Note that we shouldn’t use PGU to score samples from speakers of non-mainstream dialects of American English because the scoring rules don’t (yet) account for dialect differences.

 

Guo, L., Eisenberg, S., Schneider, P., & Spencer, L. Percent grammatical utterances between 4 and 9 years of age for the Edmonton Narrative Norms Instrument: Reference data and psychometric properties. American Journal of Speech–Language Pathology. doi:10.1044/2019_AJSLP-18-0228

Half the minutes for the same morphology outcomes? Yes, please

We’ve talked before about dose, or how much of the “active ingredients” of therapy a child is getting. In a new study, researchers wanted to find out if the intensity of the dose within a single session affected outcomes. They tested two groups of preschoolers with developmental language disorder (DLD). For each child, the researchers chose two morphemes—one to treat and one to monitor without treatment. All children got Enhanced Conversational Recast* treatment, which calls for 24 unique recasts (correct clinician repetitions of the child's attempt to use their treated morpheme) while the child attends to the clinician. Half of the children had “sparse” sessions, where recasts were spread out over 30 minutes (0.8 recasts per minute). The other half had “dense” sessions, where recasts were crammed into only 15 minutes (1.6 recasts per minute).

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After six weeks of daily sessions, both groups improved their average accuracy for their treated (but not their untreated) morphemes. The results weren’t significantly different across groups though—it didn’t matter whether children had sparse or dense sessions.

So for Enhanced Conversational Recast treatment, the dose of 24 unique recasts is crucial but the length of the session is not. The authors point out that this means we could split a pair of antsy kiddos seen together for 30 minutes into individual 15-minute sessions and likely see the same progress, as long as the dose number stays the same.

*For more on Enhanced Conversational Recast treatment see reviews here, here, and here

 **Also, read the comments below for a pro tip for implementing this from Dr. Plante!

Plante, E., Mettler, H. M., Tucci, A., & Vance, R. (2019). Maximizing treatment efficiency in developmental language disorder: Positive effects in half the time. American Journal of Speech-Language Pathology. doi:10.1044/2019_AJSLP-18-0285.

How do we test narrative listening comprehension and inferencing?

We’ve talked before about the importance of listening comprehension skills for children’s reading outcomes. But listening comprehension can be tricky to assess. How do we know whether our client is struggling more than the average preschooler? The authors of this study have it covered, with a quick, cheap narrative listening comprehension and inferencing test— AND performance data from children ages 4–6. They used the Squirrel Story Narrative Comprehension Assessment (NCA; available here, paired with the book or app), which requires children to listen to an illustrated short story and answer literal and inferential comprehension questions at the end.  

Literal Comprehension

understanding details from the story

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Inferential Comprehension

making connections beyond the story

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Based on this study, the NCA looks like a useful measure of narrative listening comprehension. The researchers found that scores increase over the preschool years, are lower in kids with DLD, and are sensitive to changes after intervention (as found in this previous study). You can give the NCA, compare to other children age 4–6 using the data from Table I in the paper, and see whether your clients’ literal and inferential comprehension skills might warrant treatment (or whether your treatment is working).

Note that this is guideline data— with a small sample size, these aren’t definitive norms, but do provide us with a good start. See more research on development of inference skills here, and how to work on inferencing here and here.

 

Dawes, E., Leitão, S., Claessen, M., & Lingoh, C. (2019). Oral literal and inferential narrative comprehension in young typically developing children and children with developmental language disorder. International Journal of Speech-Language Pathology. doi: 10.1080/17549507.2019.1604803.

What we need to know about childhood trauma and narrative language skills

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Childhood maltreatment is an unfortunate reality, and we know that children who have experienced trauma are also likely to have lower language skills. The authors of this study looked specifically at narrative language skills in children removed from their homes because of maltreatment. Why narrative? Victims of suspected maltreatment are likely to be interviewed as part of criminal cases, and the interviews may be the only evidence of what happened to them. When the stakes are that high, it’s crucial that we know about these children’s narrative ability.

The authors tested a group of elementary-aged children who were living away from their biological parents (with a relative, in foster care, or in a care facility) due to neglect and/or abuse. Children completed standardized tests of narrative and general language ability. Children’s narrative results were mixed, but 42% scored in the lower range, and they showed the most difficulty with producing (vs. comprehending) narratives. General language ability was related to narrative ability, but not perfectly. Children whose caregivers had lower levels of education also tended to have lower narrative skills. 

So what can we do about this? As a field, we can increase awareness about the impact of early experiences on language development and on children’s ability to report their experiences. In our practice, we can assess narrative production in children who’ve experienced trauma or who’ve had difficult home lives and help those children build crucial narrative skills. And of course, we can be part of the village that steps in to give support to the children who need it most. 

 

Snow, P. C., Timms, L., Lum, J. A. G., & Powell, M. B. (2019). Narrative language skills of maltreated children living in out-of-home care. International Journal of Speech-Language Pathology. doi:10.1080/17549507.2019.1598493.