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

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).

Input–output symmetry: why it matters for AAC users, and a word list to help

Child output = speech

Adult input = speech

Child output = AAC

Adult input = speech……. Whoops!? See how that might be a problem for learning?

How about:

Child output = AAC

Adult input = aided input (pointing to graphic symbols during speech)

“Among children with complex communication needs, vocabulary selection for aided AAC has almost exclusively been driven by consideration of expressive language needs. However, receptive language is critical to expres.png

No matter a child’s mode(s) of expressive communication, it’s our job to help ensure that they are getting receptive examples that match their expressive output, as often as possible. How? Encourage parents to use aided input, right? Simple!

Not simple. Consider this—are the words the family uses most frequently on the child’s device? Often times children’s AAC is programmed only for the child’s lexicon. But shouldn’t it also be set up for the words s/he is learning?

To help tackle the input–output asymmetry issue, this paper provides a list of words you may want to consider for programming young clients’ communication systems. The list is a compilation and comparison of data from three large sets, identifying words mothers use most frequently when speaking to their toddlers, as well as words most commonly spoken by toddlers and preschoolers.

They found that just over 250 words comprise most of mothers’ child-directed speech, with considerable overlap between mothers’ most frequent words and the words used by children (and this includes children unrelated to the mothers!… but arguably from similar cultural backgrounds). Another interesting finding: some mothers talk more than others (like, four times more), but the difference in lexical diversity among mothers (that is, number of different words) isn’t so high.

Though limitations include the fact that this research was done on typically-developing children, and it’s a new analysis of a ton of old data (from the late 80s forward), it “…provides a beginning place for guiding vocabulary selection.” So, basically, this list could be very useful as long as you take generational and cultural considerations in mind. So maybe add words like “tablet”? And please just ignore the fact that the data is on “mothers”, not parents in general—the world wasn’t as woke 20 years ago. 

This review is published in both the Early Intervention & Preschool & School-Age sections. 

Quick, N., Erickson, K., Mccright, J. (2019). The most frequently used words: Comparing child-directed speech and young children's speech to inform vocabulary selection for aided input. Augmentative and Alternative Communication. doi: 10.1080/07434618.201

Note: You can also find a link to this research at the author’s institutional repository, here.

Tutorial Throwback (2014): Am I doing this right? Some under-the-hood tips to structuring language therapy

SLPs have to make LOTS of decisions about how to structure our therapy:

How many minutes do you see each student?

How much time should you spend on a single goal?

What type of activities should you use to target a specific goal?

 The list goes on…

The answer to these questions isn’t always clear (even when you consult the available research), so when an article comes along that tackles these issues, we get pretty excited! This 2014 article by Eisenberg reviewed the research to break down what SLPs need to know about treatment dosage, dose form (type of treatment the student receives), and treatment procedures. Note that the author decided to focus on specific aspects of language therapy rather than any particular packaged approach, which helps us think critically about what’s making a difference in children’s success.

Language and education researchers have borrowed the concept of dose from our friends in medicine. While we might not typically talk about language services in terms of dosage, this analogy actually works really well in helping us think about our therapy and its “active ingredients.”  Imagine a kindergarten student with a goal of using progressive forms who is seen weekly for 30 minutes. In this case, dose would be the number of targets given per session (“Spiderman is swinging” and “Minnie is laughing” would be two), and frequency would be the amount of time the dose is given (30-minute weekly sessions).

We know that children with developmental language disorders (DLD) need a higher dosage than their typically-developing peers to learn new words and new grammatical forms, but just how much more? The article provides some numbers for comparison:

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For frequency, it seems that spaced exposure (compared to mass exposure) leads to better learning. So a student receiving a consecutive 60-minute session (mass exposure) may not be benefiting as much as a peer who receives two 30-minute sessions (spaced exposure).

So now we can talk about what the dose (language input) should actually look like. Here are some general guidelines for teaching specific grammatical targets (e.g., passives, bound morphemes). You should:

Vary the surrounding vocabulary

  • Children learn forms better when they’re combined with different vocabulary

  • e.g. The boy was scolded. This cat was licked.

Keep the target consistent across trials

  • Children acquire rules better when exceptions are limited 

  • e.g. She walks. / He runs……….. Instead of: She walks. / I walk.

Speak in grammatical (not telegraphic) sentences

  • There’s no compelling evidence that telegraphic speech improves comprehension

  • Children need grammatical models to produce grammatical forms

  • Children use grammatical knowledge to understand sentences and learn new words

  • e.g. The boy helps his mama…….. Instead of: Help mama.

Finally, for treatment procedures, therapy activities range from least natural (e.g., drills) to most natural (e.g., literacy based interventions or conversation activity). There seems to be a trade-off, with imitation training giving you quicker short-term gains, but activities like recasts being more important for spontaneous productions.

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Lots to think about, right? Now, while this information certainly doesn’t answer all our questions, it’s a good framework that can help SLPs think about why something in therapy may (or may not) be working and making meaningful improvements to our sessions.

Looking for more about dose and treatment intensity? Check out our blog post on that topic from 2018.

Eisenberg, S. (2014). What works in therapy: Further thoughts on improving clinical practice for children with language disorders. Language, Speech, and Hearing Services in Schools. doi:10.1044/2014_LSHSS-14-0021

Better word learning through repeated retrieval

With vocabulary, there’s a tendency to talk about “teaching” and “probing” as two separate things, with too much of the latter getting in the way of the former. But as it turns out, asking your students to recall words you’ve recently taught them can be an important part of teaching. Depending on where you got your SLP training, concepts like “spaced retrieval” may have been part of your curriculum in adult cognitive therapy, but we can apply those same ideas to working with our preschool-aged friends with developmental language disorder (DLD) as well! We know our young clients with DLD struggle to learn new words, and vocabulary deficits can snowball over time, with negative effects on literacy and language, so anything we can do to improve that process is definitely worth knowing about.

In the first of a pair of studies from Leonard, Haebig, and colleagues, the authors taught novel (meaning, invented) words to a group of preschoolers (about age 5) with and without DLD. Half the words were taught with a procedure called repeated retrieval with contextual reinstatement (RRCR), that worked like this:

  1. Learn a new target word (see a picture paired with 3 exposures to the word and a simple definition)

  2. Prompt to recall (retrieve) that word, then hear the name/definition again (study the word)

  3. Learn 3 more words

  4. Retrieve the target word again, then study the word

  5. Learn 3 more words

  6. Retrieve the target word a third time, then study the word

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The “contextual reinstatement” part of RRCR comes from the fact that the attempts to retrieve the word are broken up by exposures to different words (in steps 3 and 5 above). The other half of the words were taught with the same procedure, but without the prompts to recall the word, so at steps 2, 4, and 6, the children just got the additional chances to study the target word.

For children with and without DLD, the repeated retrieval condition resulted in better word learning (about 2.5 more word forms recalled out of 8 in a labeling task, and 1 more definition) both 5 minutes and 1 week after teaching. Note that the same advantage didn’t hold if they were tested using a multiple-choice format (think the PPVT), which is an easier task than naming pictures. An even cooler part of the results? The children with DLD did just as well as the typically-developing kids, with the same number of exposures to the target words.

And how important is that “contextual reinstatement” piece, anyway? That’s the question the second of the two studies examined. They compared a slightly different RRCR protocol with immediate retrieval, where kids needed to recall taught words right after learning them, without other words being presented in between:

  • Immediate retrieval: Learn a word, retrieve and study that word three times, then repeat with two other words. 

  • RRCR: Learn a word, retrieve and study that word once, then repeat with two other words. Then retrieve/study the three words alternately, twice through (1, 2, 3, 1, 2, 3). 

Similar to the previous results, the kids were much better at remembering words learned via RRCR. So it’s not just the retrieval aspect that’s important, but needing to retrieve information after thinking about something else in between. So while there’s still more to learn (How many words can you teach at a time via this method? What’s the best retrieval schedule to use?), this is a powerful concept that you can bring to your own intervention.

 

Leonard, L. B., Karpicke, J., Deevy, P., Weber, C., Christ, S., Haebig, E., … Krok, W. (2019). Retrieval-Based Word Learning in Young Typically Developing Children and Children With Developmental Language Disorder I: The Benefits of Repeated Retrieval. Journal of Speech, Language, and Hearing Research. doi:10.1044/2018_JSLHR-L-18-0070

Haebig, E., Leonard, L. B., Deevy, P., Karpicke, J., Christ, S. L., Usler, E., … Weber, C. (2019). Retrieval-Based Word Learning in Young Typically Developing Children and Children With Development Language Disorder II: A Comparison of Retrieval Schedules. Journal of Speech, Language, and Hearing Research. doi:10.1044/2018_JSLHR-L-18-0071