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.

Helping older students with DLD gain language skills

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Most research on language treatment looks at younger children, but we know that kids with developmental language disorder (DLD) are likely to struggle with oral language skills in middle school and beyond. This study looked at the effectiveness of narrative and vocabulary treatment for older students with DLD. 

Researchers assigned 12-year-olds (year 7 students in the UK) to one of four groups: narrative treatment, vocabulary treatment, both narrative and vocabulary treatment, or a wait-listed control group. Teaching assistants (similar to paraprofessionals in the US) led treatment sessions with small groups of 2–6 students. Sessions lasted 45–60 minutes and took place 3 times a week for 6 weeks. The assistants used lessons from commercially available narrative and vocabulary treatment programs. Narrative lessons focused on story structure, comprehension, and generation; vocabulary lessons focused on educationally-relevant words taught through categorization, mind-mapping, and word association tasks.

After the six weeks, students in all 3 treatment groups improved on standardized tests of narrative skill, and students in the narrative and combined groups improved on some of the study narrative measures. There was no difference among the groups on standardized vocabulary tests, but on researcher-developed assessments similar to the treatment activities, vocabulary skills improved with intervention too.

These findings suggest that a short period of group treatment delivered by teaching assistants has the potential to improve language skills in older children with DLD. This is a big deal because we don’t have a lot of well-designed studies showing that language therapy actually works for older kids. Even better? The intervention model used here (treatment delivered to groups by paraprofessionals) should be feasible for most school settings.

 

Joffe, V. L., Rixon, L., & Hulme, C. (2019). Improving storytelling and vocabulary in secondary school students with language disorder: A randomized controlled trial. International Journal of Language and Communication Disorders. doi:10.1111/1460-6984.12471

Girls vs. Boys: Communication differences in autism

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If you work with students with autism, chances are you’ve noticed some communication differences between the boys and girls on your caseload. But how do you quantify these differences? Do they impact treatment? Are they even real?

We’ve touched on this topic before, but there isn’t loads of research on it at the moment. This preliminary study by Sturrock et al. takes a deeper dive into examining the language and communication profiles of females and males with autism.

The study explored the language and communication skills of 9–11-year-old children with ASD and IQ scores in the average range*, compared to age and gender matched peers with typical development (TD). Within both groups, female and male performance were examined separately. Note that each of the four groups was relatively small (13 children per group). Overall, though, they found some surprising (and not so surprising) differences among the groups.

The ASD group as a whole scored about the same as the TD group on measures of expressive and receptive language. However, the authors did see a subtle deficit in the ASD group when it came to narrative language tasks (an issue we’ve discussed before).

But what about those gender-related differences? Well, it turns out that within the ASD group, females outperformed males in pragmatic language and semantic language tasks. However, females with ASD still lagged behind matched females with TD. Another interesting difference? Girls in general consistently scored better than boys on “language of emotion” tasks (like listing as many feeling/emotion words as possible in one minute).

So what we do with these preliminary findings? Primarily, this study can help you consider potential areas of strength and weakness to look out for during evaluation and treatment of children with ASD. Young females with ASD may need some pretty high-end support with pragmatic and narrative skills to communicate effectively with peers (and that support may further require careful attention to that child’s social group— hello, individualization!)

Additionally, the authors make the case that by increasing our awareness of the female ASD profile, a historically under-diagnosed and misdiagnosed condition, we may be able to help these girls get identified and get access to services sooner rather than later.

*The authors refer to this as High-Functioning Autism.

 

Sturrock, A., Yau, N., Freed, J., Adams, C. Speaking the same language? A preliminary investigation comparing the language and communication skills of females and males with High-Functioning Autism. Journal of Autism and Developmental Disorders. doi: 10.1007/s10803-019-03920-6.

An incredible inference intervention for children with DLD

So much of story comprehension depends on inferencing, or making assumptions and connections beyond what’s stated in a story. We know that children with developmental language disorder (DLD) struggle with inferencing, but we don’t have (much) good evidence for treatments to target it. Until now, that is—Dawes et al. are here to help with a fabulous, free, feasible treatment for inferential comprehension.

The researchers randomly assigned 5- to 6-year-olds with DLD to an inferential comprehension treatment condition or to a control phonological awareness treatment condition. Both groups attended 30-minute small-group treatment sessions twice a week for 8 weeks. The inferential comprehension treatment used strategies including narrative retell, dialogic reading, think-alouds, and graphic organizers (see Table 2 for full list). And, great news—the activities for all four books used in the intervention are available for free! 

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Children’s inferential comprehension ability was tested before, immediately after, and 8 weeks after the treatment using different stories. (The assessments are ALSO freely available, because these researchers are amazing.) Children in the treatment group improved significantly more than the control group on inferential comprehension measures and maintained their improvement after 8 weeks. This is about as good as it gets—a scripted, free program that you can deliver in groups with strong evidence for improvement after a short period of treatment.

For more info about profiles of children who struggle with inferential comprehension, see this article by the same researchers.

 

Dawes, E., Leitão, S., Claessen, M., & Kane, R. (2018). A randomized controlled trial of an oral inferential comprehension intervention for young children with developmental language disorder. Child Language Teaching and Therapy. Advance online publication. doi: 10.1177/0265659018815736