Characteristics of culturally- and linguistically-responsive interventions

Although we do our best to review EBP for culturally and linguistically diverse students, the reality is that most interventions are researched using monolingual English speakers. There’s even fewer studies out there about interventions for really young kids, even though we know that early intervention is vital for later academic and language outcomes. The authors of this new study reviewed high-quality, culturally/linguistically-responsive language interventions for kids under five to see what we DO know. But first, what counts as a responsive intervention, anyway? 

Linguistically-responsive interventions encourage the use of the home language or language variety. This doesn’t mean SLPs have to be bilingual. Coaching parents on language stimulation strategies to use in their native language counts.

Culturally-responsive interventions incorporate the values, beliefs, practices, experiences and materials relevant to the cultural backgrounds of children and their families. Culturally-responsive interventions can take many forms, but might include strategies centered around the way people from the family's culture typically interact with young children, or using materials that represent the family’s background. 

So what seems to work? Explicit instruction of target skills was particularly effective, with 100% of studies reporting an increase in English skills and 78% reporting an increase in home language skills. These interventions, delivered individually or in small groups, tended to be especially useful for vocabulary growth. Classroom curriculum and book reading interventions, delivered in the home or school, were also promising (especially when delivered in the students’ home languages), but with a wider range of effect sizes. 

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Importantly, interventions that met the criteria for being both linguistically and culturally responsive were the most effective for improving children’s language abilities in English and the home language. Including the child’s home language did not detract from the effectiveness of the interventions. Unfortunately, less than a third of the studies reviewed used culturally-responsive interventions! SLPs can (and need to) do better to use interventions that match families' backgrounds.

 

Larson, A.L., Cycyk, L.M., Carta, J.J., Hammer, C.S., Baralt, M., Uchikoshi, Y., … Wood. C. (2019). A systematic review of language-focused interventions for young children from culturally and linguistically diverse backgrounds. Early Childhood Research Quarterly. doi: 10.1016/j.ecresq.2019.06.001

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.

Throwback (2010): Supporting preschool vocabulary growth with “talking buddies”

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We know that it’s important to support breadth and depth of vocabulary development in our school-aged kids.

(We’ve talked about this before here and here.)

But, did you know that it might be even more important if you work with preschoolers, specifically? There’s actually evidence that typical preschool classrooms lack quantity and quality of talk (Wells & Wells, 1984; Wilcox-Herzog & Kontos, 1998). And, kids who have lower verbal abilities are talked to less in the preschool setting (!!!!) (Kontos & Wilcox-Herzog, 1997). So, obviously if you’re a preschool-based SLP, vocabulary development definitely should be on your radar!

This study provides a simple, yet effective, way to embed word learning in everyday conversation. If you’re looking for a low stress, low prep, naturalistic method of teaching kids new words, this is it.

For the intervention, the researchers trained undergrads to be “talking buddies”. The buddies worked with 3- and 4-year-olds in pairs to…

use recasts to expose them to rare words,

Child: Look, that one’s really small!

Adult: Small! What’s another word for small?....How about tiny?

expand and restate their utterances,

Child: Red car go.

Adult: The red car is going fast!

and ask open-ended questions to encourage further conversation.

Child: See this?

Adult: I do see that! Can you tell me more about it?

After talking with the buddies for 25 minutes a week for 10 weeks, the kids who received the intervention (even those with initially low vocabulary skills!) improved in the number and variety of words that they used.

And, possibly the best part? The talking buddies only received 4 hours of training in general techniques to stimulate conversation as well as the specific strategies that were used to introduce new vocabulary. For this study, undergrads worked with the kids, but it would likely be just as easy to train day care providers, classroom aides, or preschool teachers. Any of these professionals could include these focused conversations in their interactions with small groups of kids during snack time, on the playground, or during center activities. This type of easy-to-implement, inter-professional collaboration is exactly what we need to make sure that the preschoolers on our caseloads are achieving their vocabulary goals!

 

Ruston, H. & Schwanenflugel, P. (2010). Effects of a conversation intervention on the expressive vocabulary development of prekindergarten children. Language, Speech, and Hearing Services in Schools. doi: 10.1044/0161-1461(2009/08-0100).