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Purpose: Narrative skill represents a higher-level linguistic skill that shows incremental development in the preschool years. During these years, there are considerable individual differences in this skill, with some children being highly skilled narrators (i.e., precocious) relative to peers of their age. In this study, we explored the contribution of three lower-level language skills to a range of narrative abilities, from children performing below expected levels for their age to those performing much higher than the expected levels for their age. We speculated that individual differences in lower-level skills would contribute meaningfully to variability in narrative skills. Method: Using a sample of 336 children between 3 and 6 years of age (M = 4.27 years, SD = 0.65), both multiple regression and quantile regression approaches were used to explore how vocabulary, grammar, and phonological awareness account for variance in children's "narrative ability index" (NAI), an index of how children scored on the Narrative Assessment Protocol--Second Edition relative to the expected performance for their age. Results: Multiple regression results indicated that lower-level language skills explained a significant amount of variance (approximately 13%) in children's NAI scores. Quantile regression results indicated that phonological awareness and vocabulary accounted for significant variance in children's NAI scores at lower quantiles. At the median quantile, vocabulary and grammar accounted for significant variance in children's NAI scores. For precocious narrators, only vocabulary accounted for a significant amount of variance in children's NAI scores. Conclusion: Results indicate that lower-level language skills work in conjunction to support narrative skills at different ability levels, improving understanding of how lower-level language skills contribute across a spectrum of higher-level linguistic abilities.

Purpose: This study aimed to identify child-level characteristics that predict gains in language skills for children with language impairment who were receiving therapy within the public schools. The therapy provided represented business-as-usual speech/language treatment provided by speech-language pathologists in the public schools. Method: The sample included 272 kindergartners and first-graders with language impairment who participated in a larger study titled "Speech-Therapy Experiences in the Public Schools." Multilevel regression analyses were applied to examine the extent to which select child-level characteristics, including age, nonverbal cognition, memory, phonological awareness, vocabulary, behavior problems, and self-regulation, predicted children's language gains over an academic year. Pratt indices were computed to establish the relative importance of the predictors of interest. Results: Phonological awareness and vocabulary skill related to greater gains in language skills, and together they accounted for nearly 70% of the explained variance, or 10% of total variance at child level. Externalizing behavior, nonverbal cognition, and age were also potentially important predictors of language gains. Conclusions: This study significantly advances our understanding of the characteristics of children that may contribute to their language gains while receiving therapy in the public schools. Researchers can explore how these characteristics may serve to moderate treatment outcomes, whereas clinicians can assess how these characteristics may factor into understanding treatment responses.

Purpose: This article includes results from a multistate randomized controlled trial designed to investigate the impacts of a language-focused classroom intervention on primary grade students' proximal language skills and distal reading comprehension skills. Method: The sample included 938 children from 160 classrooms in 4 geographic regions in the United States; each classroom was randomly assigned to 1 of 2 experimental conditions (2 variations of a language-focused intervention) or business-as-usual control. For this study, the 2 experimental conditions were collapsed, as they represented minor differences in the language-focused intervention. All children completed assessments at multiple time points during the academic year. Proximal measures (curriculum-aligned measures of vocabulary, comprehension monitoring, and understanding narrative and expository text) were administered throughout the school year. Distal measures of reading comprehension were administered at the beginning and the end of the school year. Results: Multilevel multivariate regression was conducted with results showing that students receiving the language-focused intervention significantly outperformed those in the control group in comprehension monitoring and vocabulary, with effect sizes ranging from 0.55 to 1.98. A small effect in understanding text (narrative) was found in 3rd grade only. Multilevel path analyses were then conducted to examine if the intervention had a positive impact on reading comprehension through the influence of proximal language outcomes. In all 3 grades, instruction impacted reading comprehension via the mediation of vocabulary, with sizable effects (1.89-2.26); no other indirect pathways were significant. Conclusions: This study provides evidence that a language-focused intervention can positively impact students' performance on language measures that are closely aligned with the intervention, with indirect, large effects on distal reading comprehension measures. Theoretically, this study provides causally interpretable support for the language bases of reading comprehension. [This article was co-written by members of the Language and Reading Research Consortium (LARRC).]

Purpose: This study investigated the longitudinal development of 2 important contributors to reading comprehension, grammar, and vocabulary skills. The primary interest was to examine the trajectories of the 2 skill areas from preschool to 3rd grade. Method: The study involved a longitudinal sample of 420 children from 4 sites. Language skills, including grammar and vocabulary, were assessed annually with multiple measures. Multivariate latent growth curve modeling was used to examine the developmental trajectories of grammar and vocabulary, to test the correlation between the 2 domains, and to investigate the effects of demographic predictors on language growth. Results: Results showed that both grammar and vocabulary exhibited decelerating growth from preschool to Grade 2. In Grade 3, grammar growth further flattened, whereas vocabulary continued to grow stably. Growth of vocabulary and grammar were positively correlated. Demographic characteristics, such as child gender and family socioeconomic status, were found to predict the intercept but not the slope of the growth trajectories. Conclusions: Children's growth in grammar skills is differentiated in a number of important ways from their growth in vocabulary skills. Results of this study suggest the need to differentiate these dimensions of language when seeking to closely examine growth from preschool to primary grades.

Purpose: Practitioners, researchers, and policymakers (i.e., stakeholders) have vested interests in children's language growth yet currently do not have empirically driven methods for measuring such outcomes. The present study established language benchmarks for children with typically developing language (TDL) and children with language impairment (LI) from 3 to 9 years of age. Method: Effect sizes for grammar, vocabulary, and overall language were calculated for children with TDL (n = 20,018) using raw score means and standard deviations from 8 norm-referenced measures of language. Effect sizes for children with LI were calculated using fall and spring norm-referenced language measures for 497 children with LI receiving business-as-usual therapy in the public schools. Results: Considerable variability was found in expected change across both samples of children over time, with preschoolers exhibiting larger effect sizes (d = 0.82 and 0.70, respectively) compared with school-age children (d = 0.49 and 0.55, respectively). Conclusions: This study provides a first step toward establishing empirically based language benchmarks for children. These data offer stakeholders an initial tool for setting goals based on expected growth (practitioners), making informed decisions on language-based curricula (policymakers), and measuring effectiveness of intervention research (researchers).

Purpose: This study presents an application of the theoretical domains framework (TDF; Michie et al., 2005), an integrative framework drawing on behavior-change theories, to speech-language pathology. Methods: A multistep procedure was used to identify barriers affecting caregivers' implementation of shared-reading interventions with their children with language impairment (LI). The authors examined caregiver-level data corresponding to implementation issues from two randomized controlled trials and mapped these to domains in the TDF as well as empirically validated behavior-change techniques. Results: Four barriers to implementation were identified as potentially affecting caregivers' implementation: time pressures, reading difficulties, discomfort with reading, and lack of awareness of benefits. These were mapped to 3 TDF domains: intentions, beliefs about capabilities, and skills. In turn, 4 behavior-change techniques were identified as potential vehicles for affecting these domains: reward, feedback, model, and encourage. An ongoing study is described that is determining the effects of these techniques for improving caregivers' implementation of a shared-reading intervention. Conclusions: A description of the steps to identifying barriers to implementation, in conjunction with an ongoing experiment that will explicitly determine whether behavior-change techniques affect these barriers, provides a model for how implementation science can be used to identify and overcome implementation barriers in the treatment of communication disorders.

Purpose: The existing literature on language outcomes in children born prematurely focuses almost exclusively on standardized test scores rather than discourse-level abilities. The authors of this study looked longitudinally at school-age language outcomes and potential moderating variables for a group of twins born prematurely versus a control group of twins born at full term, analyzing both standardized test results and language sample data from the population-based Western Reserve Reading Project (WRRP; Petrill, Deater-Deckard, Thompson, DeThorne, & Schatschneider, 2006). Method: Fifty-seven children born prematurely, at =32 weeks or <1,500 g, were compared with 57 children born at full term and were matched for age, gender, race, and parental education. Data included discourse-level language samples and standardized test results, collected at average ages 7, 8, and 10 years. The language samples were analyzed to yield a number of semantic and syntactic measures that were consolidated via factor analysis. Results: Regression models showed significant differences between the 2 groups for standardized test results, although the mean score for both groups fell in the normal range. For the discourse-level language measures, however, differences never reached statistical significance. Parental education was significantly associated with improved standardized test scores. Conclusions: These findings suggest that in the absence of frank neurological impairment, sophisticated semantic and syntactic skills may be relatively intact in the discourse-level language of children born prematurely. Implications for assessment, particularly the potential role of attention and executive function in standardized testing tasks, are reviewed.