Throwback (2013): Practice those inferences!

It’s no surprise that children need to be able to comprehend language to succeed in school. They need to understand both what is explicitly stated (referential comprehension) and what is implied (inferential comprehension). Those pesky inferences! They’re so important for boosting language comprehension, but the literature tells us more about assessment and treatment of expressive deficits than it does about comprehension in kids with Developmental Language Disorder (DLD), so we don’t really know the best way to address them. This study helps tip that balance and gives an option for treatment.

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Preschool-aged children (all diagnosed with DLD* and receiving weekly services from SLPs) were tested using an informal questionnaire and the Reasoning subtest from the PLAI (Preschool Language Assessment Instrument) both before and after a dialogic reading intervention. To increase the chances that this treatment and its results could be generalized to other settings, the students’ regular SLPs implemented the intervention! Here’s how they did it: they added 20 minutes of dialogic reading, using commercially available books and researcher-developed questions, to the beginning of each speech–language session. Some questions checked referential comprehension (e.g., “What color are Mrs. Dupre’s boots?”) and some questions were inferential (e.g., “What do you think John is going to do with his tools?”). Each book was presented for two consecutive sessions. For incorrectly answered questions, the SLPs scaffolded support using a “least-to-most” cueing hierarchy (e.g. rephrasing the question all the way up to phonemic cues to the answer).

After 10 weeks, the children seemed to infer better than before the intervention (and maintained the skill), but the authors hesitated to attribute the change only to the intervention because of the order they administered the informal questionnaires (see the results section for specifics). That detail aside, here’s a useful finding for clinicians: overall, the preschoolers improved the quality of their responses to questions. We’ve all worked with the kid who makes us think, “Well, he’s not wrong, but he didn’t exactly get it, either.” How do you even score that? In this case, the authors modeled their scoring scale after the PLAI Reasoning subtest. The following points were assigned per answers that were:

  • Correct/Adequate = 4 points

  • Acceptable = 3 points

  • Ambiguous = 2 points

  • Incorrect/Inadequate = 1 point  

A scoring scale like this is great because it can help us see the small changes a child makes over the course of intervention. The authors stated that “as intervention progressed, their responses, while not always completely correct, improved in quality.” That’s a trend in the right direction, and exactly what we want to see from progress report to progress report!

The takeaway: we still need more research on how to assess and treat inferential comprehension in young children, but dialogic reading intervention (including inferential questions) is a promising option for improving the quality of children’s answers to inferential questions.

Want to know more? See this study and a previous study by van Kleeck, Vander Woude, & Hammett (2006) for examples of questions and scripts for this intervention.

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

 

Desmarais, C., Nadeau, L., Trudeau, N., Filiatrault-Veilleux, P., & Maxes-Fournier, C. (2013). Intervention for improving comprehension in 4-6 year old children with specific language impairment: Practicing inferencing is a good thing. Clinical Linguistics & Phonetics, 27, 540–552.