And more...

Esmaeeli et al. found that family history is the biggest predictor of reading disorders in children at the end of second grade, but emergent literacy and oral language skills also played a role. As SLPs, we should always be taking family history into account when screening or testing for reading disorders.

Two studies this month looked at standardized language tests for Spanish–English bilingual children. Fitton et al. studied the sentence repetition task from the Bilingual English–Spanish Assessment (BESA) and found that it was a valid measure of morphosyntax in both Spanish and English. Wood & Schatschneider studied the Peabody Picture Vocabulary Test (PPVT-4) and found that it was biased against Spanish–English dual language learners (see also this review).

Méndez & Simon-Cereijido looked at Spanish–English bilingual preschoolers with developmental language disorder* (DLD) and found that children with better Spanish vocabulary skills also had better English grammar skills. They suggest targeting vocabulary in students’ home language to support English learning.

In a survey of nearly 3000 children, Reinhartsen et al. found that children with autism are significantly more likely to have higher expressive language skills than receptive. Children with this profile tended to have more severe delays and more significantly impaired language overall compared to children without this profile.

Rudolph et al. studied the diagnostic accuracy of finite verb morphology composite (FVMC) scores. Unlike previous studies, they found that FVMC wasn’t good at identifying 6-year-olds with developmental language disorder (DLD). The difference might be due to a larger, more representative sample of children. (NOTE: “The FVMC is derived from a spontaneous language sample, in either a free-play or elicited narrative scenario, and reflects the percent occurrence in obligatory contexts of eight T/A morphemes: regular past tense –ed, 3S, and present tense uncontracted and contracted copula and auxiliary BE forms (am, is, are).” ~Rudolph et al., 2019)

Verschuur et al. studied two types of parent training in Pivotal Response Treatment (PRT), finding that both group and individual training improved parents’ ability to create communication opportunities and increased children’s initiations. Furthermore, group training had additional benefits for parents’ stress levels and feelings of self-efficacy. The authors suggest that combining group and individual sessions might be a good way to build parents’ skills while conserving resources.

Venker et al. surveyed SLPs about their use of telegraphic speech. The vast majority of SLPs reported using telegraphic input for commenting on play, prompting for verbal imitations, and giving directions. However, only 18% of SLPs reported that they felt telegraphic speech is useful, which doesn’t make much sense! More research is needed to help align SLP practices and perspectives for use of telegraphic input. (Editors’ note = Perhaps it’s just a habit that’s hard to break? Even culturally influenced?)

 

*Note: The children in this study were those with Specific Language Impairment (SLI), which refers to children with Developmental Language Disorder (DLD) and normal nonverbal intelligence. We use DLD throughout our website for consistency purposes (read more here).

 

Esmaeeli, Z., Kyle, F.E., & Lundetræ, K. (2019). Contribution of family risk, emergent literacy and environmental protective factors in children’s reading difficulties at the end of second-grade. Reading and Writing. doi:10.1007/s11145-019-09948-5.

Fitton, L., Hoge, R., Petscher, Y., & Wood, C. (2019). Psychometric evaluation of the Bilingual English-Spanish Assessment sentence repetition task for clinical decision making. Journal of Speech, Language, and Hearing Research. doi:10.1044/2019_JSLHR-L-1

Méndez, L. I., & Simon-Cereijido, G. (2019). A view of the lexical-grammatical link in young latinos with specific language impairment using language-specific and conceptual measures. Journal of Speech, Language, and Hearing Research. doi:10.1044/2019_JSLHR-L-18-0315

Reinhartsen, D.B., Tapia, A.L., Watson, L., Crais, E., Bradley, C., Fairchild, J., Herring, A.H., & Daniels, J. (2019). Expressive dominant versus receptive dominant language patterns in young children: Findings from the study to explore early development. Journal of Autism and Developmental Disorders. doi:10.1007/s10803-019-03999-x

Rudolph, J. M., Dollaghan, C. A., & Crotteau, S. (2019). Finite verb morphology composite: Values from a community sample. Journal of Speech, Language, and Hearing Research. doi:10.1044/2019_JSLHR-L-18-0437 

Venker, C.E., Yasick, M., & McDaniel, J. (2019). Using telegraphic input with children with language delays: A survey of speech-language pathologists’ practices and perspectives. American Journal of Speech–Language Pathology. doi:10.1044/2018_AJSLP-18-0140

Verschuur, R., Huskens, B. & Didden, R. (2019). Effectiveness of Parent Education in Pivotal Response Treatment on Pivotal and Collateral Responses. Journal of Autism and Developmental Disorders. doi:10.1007/s10803-019-04061-6

Wood, C., & Schatschneider, C. (2019). Item bias: Predictors of accuracy on Peabody Picture Vocabulary Test-Fourth Edition items for Spanish-English-speaking children. Journal of Speech, Language, and Hearing Research. doi: 10.1044/2018_JSLHR-L-18-0145  

Training natural communication partners how to model AAC

Model, model, model! We all know how important and effective AAC modeling can be (see here and here, for example)—however, modeling is only as good as the partners who are implementing it. If you’re working with kids who use AAC, chances are there are communication partners who need guidance in how to model, and that’s no simple task. If you’re thinking “I agree, but HOW do I teach the partners?”, this review is for you!

The authors of this study gathered 29 studies in which more than 250 communication partners (including peers, teachers, paraprofessionals, parents, and other adults) implemented modeling strategies across various settings. Although they looked at a handful of research questions, the most clinically relevant questions were: How were the communication partners trained and what did they have to say about the training they received?

The most common training strategies were:

  • orally sharing information

  • modeling the strategies, and

  • allowing the partners to practice in controlled settings (role plays), or with a child, while providing feedback

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Overall, partners rated instruction as worth the time, easy to understand, practical, and transferable to other children. Some additionally offered the suggestion to provide more direction on how to model during a child’s regularly occurring activities (something to consider when you are providing training).

Seems pretty straightforward, right? We train the partners using those strategies and then off they go? Not so fast. The authors found that most communication partners also benefited from simultaneous support while learning to model. So after you train the partners, it’s important that you stick around to offer coaching and consultation as necessary.

If this seems daunting (how can I possibly fit this into my already jam-packed day!?), it’s important to remember that teaching communication partners can drastically improve the reach of our interventions—the amount of time we spend with our students is so limited compared to their interactions with natural communication partners.

If partner instruction is something you’d like to improve, be sure to check out the full article (specifically Table 2) for a list of the included studies and the training strategies used in each.

 

Biggs, E. E., Carter, E. W., & Gilson, C. B. (2019). A scoping review of the involvement of children's communication partners in aided augmentative and alternative communication modeling interventions. American Journal of Speech–Language Pathology. doi: 10.1044/2018_AJSLP-18-0024

“I wish…I think…I wonder…”: Improving parents’ shared book readings

Shared book reading can be a sweet moment between parent and child—while also serving to improve a child’s literacy skills. The trick is figuring out how to help parents make the most of these interactions. This pilot study examined the effects of a short training on parent–child storybook readings. While this study focused on Deaf/Hard-of-Hearing preschoolers, most outcomes focused on the changes in the parents’ skills—meaning you can apply this across many populations.

Researchers recorded multiple shared book readings at each of three stages in the experiment: before training parents, in the “intervention period” (the two weeks following the parent training), and eight weeks after training. The training was only twenty minutes long (very do-able for real world clinicians!) and included a very short power point, a two-minute video model, and discussion with the parents. The authors focused on these topics for parent training:

  • Switching mindset from “education” to gaining insight into the child’s thoughts

  • No such thing as right or wrong

  • Increasing use of wait time

  • Increasing conversational turns

  • Making phonemic awareness fun and silly (like making up nonsense words by taking words in the text and changing one phoneme)

  • Using open ended prompts: “I wish…”  “I think…” “I wonder…” “What do you think?”

Parents were also given two booklets from the National Institute for Literacy and a few wordless picture books to add to their home collection.

When measuring parent interaction types, the authors split prompts into two categories:

Open-Ended Prompts

Questions that encourage open-ended discussion: “What do you think…

Indirect prompts such as “I think…” or “I hope…” paired with wait time

Closed-Ended or Right/Wrong Prompts

WH questions about the story text: “What is that?” “Where is her bone?

Questions about the story text that encourage one word answers

Yes/no questions or “how many” questions

For only spending twenty minutes on parent training, researchers saw some encouraging changes! Both the total number of parent–child exchanges and the percentage of open-ended prompts increased from baseline, through the intervention and retention stages. The percentage of words spoken by the child was also higher in the intervention and retention stages (though only the intervention stage showed a statistically significant difference from baseline levels). Because a dip was shown in all outcomes during the retention stage, eight weeks after training, it looks like clinicians will probably need to follow-up with parents periodically.

For more along these lines, check out our reviews about supporting parents to complete literacy programs, teaching vocabulary via shared readings, and improving the narrative comprehension of children with ASD.

Nelson, L. H., Stoddard, S. M., Fryer, S. L., & Muñoz, K. (2019). Increasing Engagement of Children Who Are DHH During Parent–Child Storybook Reading. Communication Disorders Quarterly. doi:10.1177/1525740118819662

Speech homework: The parents’ perspective

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If you are an SLP who works with children with speech sound disorders (SSD), you are aware of: (1) how important home practice is, and (2) how difficult it is to ensure it happens. You send home cute activities and worksheets only to find out they’re never being done. You email parents with suggestions but wonder how much parents actually use them.

Some researchers decided to interview parents about their experiences with home practice in order to better understand their perspective. They wanted to hear from parents how SLPs could better support and encourage their attempts!

The researchers interviewed six parents of children aged 3–6 who had participated in speech–language therapy for an SSD. Several themes emerged throughout the conversations. They boiled them down these: 

Evolution over time

Parents expressed that their experiences with home practice changed over time. At the beginning, parents often felt confused, overwhelmed, and unsure of how to complete the activities. Over time, parents felt increasingly confident in the activities and what was expected of them.

Different roles

Parents saw the SLP as the expert who could provide materials and instruction, but saw themselves as ultimately responsible for supporting their child’s speech and language.

Importance

Parents stressed the importance of several things to them: their child’s speech and communication growth, their own role and involvement in therapy, consistent home practice, and rapport with the SLP. They felt that when there was rapport, they and their child were more motivated to do home practice and they saw more progress.

Managing the practicalities of home practice

Parents expressed difficulty with the logistics of home practice. All parents reported that it was challenging to find the time to do the activities and most admitted that they did not complete the full amount of time suggested by the SLP. Parents described receiving activities that were not motivating to their child or did not suit them as a family. They were often also unsure of how to complete the activities or how to do the technical components of therapy.

Taken together, these findings leave us SLPs with some helpful takeaways. First, it’s important for parents and SLPs to have a clear discussion about both of their expectations at the beginning of therapy. These parents spoke about how their expectations did not always match the realities of what therapy looked like and it took a while for them to adjust and figure out the ropes. Second, it may be beneficial to regularly share data about the child’s progress, as parents found that when their child made progress, they were more motivated to continue home practice. Last, SLPs should work with the family to provide family-appropriate materials as well as sufficient training and clear instructions for how to complete them.

 

Sugden, E., Munro, N., Trivette, C.M., Baker, E., Williams, A.L. (2019) Parents’ experiences of completing home practice for speech sound disorders. Journal of Early Intervention. doi: 10.1177/1053815119828409.

Survivor: Home-based early literacy edition

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Early literacy skills are crucial to set the stage for learning to read. We know that kids with Developmental Language Disorder (DLD) are likely to struggle with skills like print knowledge. There are only so many hours in the (preschool) day, so some early literacy programs are designed to be completed by caregivers at home. However, experience tells us that not all caregivers will complete home literacy activities. In this study, Justice and colleagues wanted to find out which caregivers might finish or not finish a home program. 

The researchers used a technique called survival analysis, which sounds dramatic, but “survival” in this case just means finishing the book reading program (phew). They looked at results from a previous study on the effect of different incentives on caregivers’ participation. Caregivers of 4- to 5-year-old children with DLD were asked to complete the (free!) Sit Together and Read (STAR) program. The program includes 15 books paired with print-focused activities that are completed in 4 sessions per week over 15 weeks. Caregivers recorded their reading sessions and reported back to the researchers regularly. The main findings included:

  • Only 55% of caregivers completed the program

  • Of families who dropped out, a third never started the program at all

  • Families were less likely to drop out early if they received incentives of money ($.50 per session) or encouragement (positive text messages)

  • Higher-SES caregivers were more likely to complete the program than lower-SES caregivers

  • Caregivers of children with higher print knowledge skills were more likely to complete the program than caregivers of children with lower print knowledge skills. 

So what can we do with these findings? When asking caregivers to complete home literacy activities, we need to have realistic expectations for their participation. The biggest barrier seems to be getting started, so we can focus our efforts on supporting caregivers early in the program. While most of us probably can’t pay families for completing a program, sending encouraging texts or notes to remind them how important reading is might help increase participation. And lower-SES caregivers or caregivers of children with low print knowledge skills are likely to need the most support of all.

 

Justice, L. M., Chen, J., Jiang, H., Tambyraja, S., & Logan, J. (2019). Early-literacy intervention conducted by caregivers of children with language impairment: Implementation patterns using survival analysis. Journal of Autism and Developmental Disorders. doi:10.1007/s10803-019-03925-1

AAC carryover: Buy-in is only the beginning

One of the biggest frustrations for clinicians who support AAC are the devices that don’t get used. You know, the ones that sit in the cabinet unless you’re in the room, or the ones that parents ask you not to send home. There are a lot of factors that contribute to this kind of device abandonment (can’t you just picture a lonely device feeling sorry for itself?). We need to understand these factors, so we can focus our work on the key ingredients that will promote AAC device use and help students—and their support teams—be successful.  

You won’t be surprised by two of the most common caregiver-related barriers to device success: 

1)    The adults don’t know how to use the device (or, they lack operational competency).

This includes finding words, programming, troubleshooting, and navigating the device settings. Parents and teachers often report that they don’t get enough training in this stuff.

2)    The adults don’t have positive attitudes about the device (or, they lack buy-in).  

Specific aspects of buy-in can include considering the device the child’s voice and believing that it should be available at all times.

These two barriers are important, for sure, but how important? And what else are we missing? This study delved into this issue, focusing on the operational competency and buy-in of parents and teachers of school-aged (3–16 years) children with autism, and whether they related to how frequently the children’s AAC devices were used. The 33 children in the study all used a personally-owned PRC device or the related LAMP Words for Life app as their main method of communication at both home and school. To measure how much devices were used, the researchers analyzed data from PRC’s Realize Language feature across three school days and one weekend. Parent and teacher surveys were used to measure operational competency and buy-in.

The good news? Overall, buy-in and operational competency was high for everyone. The bad news? No one was using devices that much. In this group, teachers reported greater buy-in (or at least answered their surveys that way, but that’s a whole different topic...), but parents and teachers were equally comfortable operating the devices. The devices were used more frequently at school vs. home (over half of the kids didn’t use the devices at home at all). 

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A big grain of salt here: the study looked at really a pretty small window in time (Is one weekend at your house representative of how your family works?), and only one device company—that uses a relatively complex language system—was in the mix. We also don’t know if looking at students with diagnoses other than autism would make a difference. Even so, it’s clear that something’s going on here. We can see that good intentions, valuing the device, and being trained in its use just isn’t enough. It looks like we need a broader conversation about barriers, including the practicalities of incorporating a device into daily activities and routines, especially at home. We definitely need to address operational competency and buy-in, but our families and other stakeholders are likely to need more support than that. The authors remind us to keep communication at the center of the conversation, rather than the technology. After all, the device is only the tool—communication is the point.

 

DeCarlo, J., Bean, A., Lyle, S., & Cargill, L. P. M. (2019). The Relationship Between Operational Competency, Buy-In, and Augmentative and Alternative Communication Use in School-Age Children With Autism. American Journal of Speech-Language Pathology. doi:10.1044/2018_AJSLP-17-0175

Throwback Pub (2015): How our language may affect their language

The use of telegraphic speech with children who have Autism Spectrum Disorder (ASD), by both parents and clinicians, is common. Is this a good thing or a bad thing? Does it affect language development?

First: What exactly is telegraphic speech anyway? Telegraphic speech is a normal part of a child’s linguistic development. It is the use of primary content words, such as: ball go, daddy jump, want cup. Many intervention approaches for our clients with autism explicitly incorporate the use of telegraphic speech for teaching language, so they can be exposed to telegraphic speech more frequently than other children (Venker et al. 2015, p. 1735).

This study tested children at 3.5 and 4.5 years old by watching interactions with their parents during play. They focused on how many determiners (articles, possessive pronouns) were omitted from noun phrases in which they were needed. For example, “Eat the cookie” became “Eat cookie.” The parents in this study omitted these determiners at varying levels—some often, others rarely. The researchers measured mean length utterance (MLU) and number of different words (NDW) from each interaction and compared them. 

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Here’s what they found: The number of determiners that parents omitted from their speech predicted the diversity and complexity of the child’s language skills (which was evident in the measurements of NDW). Therefore, it is possible that using telegraphic speech could be detrimental to the development of a child’s lexicon. Using grammatically incorrect forms with children overall may possibly slow their language processing and limit opportunities to imitate  grammatically correct forms. However, do note—this study did not determine cause and effect. It could be that parents’ language doesn’t cause the children’s language, but that the relationship is bidirectional. The authors pose another possible explanation: that, “…parents who use higher levels of telegraphic speech may also exhibit other behaviors that negatively affect children’s language learning,” and this is only one of many possible explanations. 

This guest post was written by Lauren Bender-Stringham, a graduate student at Clarion University

Venker, C. E., Bolt, D. M., Meyer, A., Sindberg, H., Ellis Weismer, S., & Tager-Flusber, H. (2015). Parent telegraphic speech use and spoken language in preschoolers with ASD. Journal of Speech, Language, and Hearing Research, 58,1733–1746.

And more...

·      Berry & Oetting describe dialect differences observed in children with Gullah/Geechee heritage (Southeastern United States).

·      Douglas et al. take communication partner training strategies that already have a good evidence base (see Kent-Walsh & McNaughton, 2005 and Douglas et al., 2014), and hosted them online for parents of young children with autism. Results indicate “increased communication by the child”; however, note that this study is small, and “…further replication is necessary before generalizing results.”

·      Hughes et al. provide evidence that having a positive, meaningful relationships with a person who stutters (friend, family member, role model) is, “…associated with high ratings of an average person who stutters as being trustworthy and reliable.” The authors suggest that, “… simply knowing a person who stutters may not improve attitudes toward stuttering,” but that having a bit more meaningful relationship with a person who stutters, may. This prediction requires further investigation, as the study is correlational not experimental.

·      McConachie et al. reviewed the literature to identify outcomes that parents value when monitoring the progress of their young children with autism, and then asked parents to rate those outcomes in order of importance. The top four outcomes were: happiness, anxiety or unusual fears, hypersensitivity (“discomfort with being touched, too much noise, bright lights, certain tastes, etc.”), and self-esteem (“positive views of self”). Check out Table 2 in the study for the additional six outcomes that round out the top 10!

·       Montgomery et al. tested sentence comprehension for different complex sentence types in typically developing (TD) children and children with developmental language disorder (DLD). Meaning cues in the sentences were removed so that children had to rely on word order alone. They found that children with DLD had poorer comprehension than TD children, especially in sentences that violate the usual subject-verb-object word order. They recommend that SLPs consider teaching complex sentences containing familiar words and tons of meaning cues, to compensate for this difficulty with word order.

·       Owen Van Horne et al. taught past tense –ed to children with developmental language disorder by starting with either “easy” or “hard” lists of verbs. Difficulty was based on the likelihood of each verb being used in the past tense (e.g. “jump” commonly used; “rest” less common) plus its phonological features (e.g., words ending in –t or –d are harder to inflect). The children who started with the lists of “hard” verbs showed greater gains in accuracy for past tense –ed on treated verbs and more generalization of –ed to untreated verbs, but did not finish treatment more quickly. The full list of verbs, plus an example treatment script (so you can see exactly what their instruction looked like) is included in the article.

 

Berry, J.R., & Oetting, J.B. (2017). Dialect Variation of Copula and Auxiliary Verb BE: African American English–Speaking Children With and Without Gullah/Geechee Heritage. Journal of Speech, Language, and Hearing Research. Advance online publication. doi:10.1044/2017_JSLHR-L-16-0120

Douglas, S.N., Kammes, R., & Nordquist, E. (2017). Online Communication Training for Parents of Children With Autism Spectrum Disorder. Communication Disorders Quarterly. Advance online publication. doi: 10.1177/1525740117727491.

Hughes, C.D., Gabel, R.M., & Palasik, S.T. (2017). Examining the relationship between perceptions of a known person who stutters and attitudes toward stuttering. Canadian Journal of Speech–Lanugage Pathology and Audiology, 41(3), 237–252.

McConachie, H., Livingstone, N., Morris, C., Beresford, B., Couteur, A. L., Gringas, P. … & Parr, J. R. (2017). Parents suggest which indicators of progress and outcomes should be measured in young children with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders. doi:10.1007/s10803-017-3282-2

Montgomery, J. W., Gillam, R. B., Evans, J. L., & Sergeev, A. V. (2017). “Whatdunit?” Sentence Comprehension Abilities of Children With SLI: Sensitivity to Word Order in Canonical and Noncanonical Structures. Journal of Speech, Language, and Hearing Research. Advance online publication. doi: 10.1044/2017_JSLHR-L-17-0025.

Owen Van Horne, A. J., Fey, M., & Curran, M. (2017). Do the Hard Things First: A Randomized Controlled Trial Testing the Effects of Exemplar Selection on Generalization Following Therapy for Grammatical Morphology. Journal of Speech, Language, and Hearing Research. Advance online publication. doi: 10.1044/2017_JSLHR-L-17-0001.

Perspective Pieces

Recall that TISLP doesn’t review Perspective Pieces. However, we do love them (sometimes our FAVORITE publications each month are Perspective Pieces), and think you should be reading these gems, too. There were a TON published this month. Browse the titles for topics you’re interested in, and enjoy!

·      Understanding Word Reading Difficulties in Children With SLI

·      Practitioner Reflection That Enhances Interprofessional Collaborative Practices for Serving Children Who Are Deaf/ Hard-of-Hearing

·      Using Multilinguistic Strategies to Improve Decoding in Older School-Age Students in a Contextualized and Motivational Approach

·      A Review of Psychosocial Risks and Management for Children with Cleft Lip and/or Palate

·      The Role of Semantic Knowledge in Learning to Read Exception Words

·      Technology Training in Speech-Language Pathology: A Focus on Tablets and Apps

·      Reading Longer Words: Insights Into Multisyllabic Word Reading

·      Small Group Reading Instruction: Activities for Teaching Phonemic Awareness, the Alphabetic Principle, and Phonics in a Tier 2 Setting

·      Speech Assessment in Children With Childhood Apraxia of Speech

·      Does Access to Visual Input Inhibit Auditory Development for Children With Cochlear Implants? A Review ofthe Evidence

·      Efficacious Treatment of Children With Childhood Apraxia of Speech According to the International Classification of Functioning, Disability and Health

·      Beyond Eyes and Ears: The Need for Movement Analysis of Speech and Nonspeech Behaviors in ChildrenWith Cerebral Palsy

·      Leading the Way With Supervision Training: Embracing Change and Transforming Clinical Practice

·      Perceptions of Mentoring SLPs and Clinical Fellows During the Clinical Fellowship

·      How Stuttering Develops: The Multifactorial Dynamic Pathways Theory

·      Examination of Coaching Behaviors Used by Providers When Delivering Early Intervention via Telehealth to Families of Children Who Are Deaf or Hard of Hearing

·      We’ve Got Some Growing Up to Do: An Evidence-Based Service Delivery Model for the Transition of Care for the Young Adult with Cleft Lip and Palate

·      Are We Slipping Them Through the Cracks? The Insufficiency of Norm-Referenced Assessments for Identifying Language Weaknesses in Children With Hearing Loss