Search

Guidelines recommend routine discourse assessment and treatment in paediatric acquired brain injury (ABI) but provide little guidance for clinical practice. The degree to which this has influenced the nature of discourse assessment and treatment in clinical practice has not been examined in detail. Speech-language pathologists working in paediatric ABI (clients aged <18 years) in Australia, New Zealand, the UK, the USA, Canada, and the Asia Pacific region were invited to complete a survey of discourse assessment and intervention practices (n = 77). Clinicians from Australia and New Zealand comprised over half of a responses (53%). The largest proportion had over 10 years' experience (60%), worked in the metropolitan area (58%), and with secondary school-age children (64%). Routine discourse assessment was undertaken by 80% of respondents, focussing on a limited range of genres. No preferred intervention approach was identified. One-quarter of clinicians routinely considered holistic factors during clinical decision-making. Limited normative data and treatment evidence, insufficient time and training were identified as clinical barriers. Assessment practices were consistent with guidelines, yet interventions were highly variable, reflecting limited evidence, client heterogeneity, time constraints, and limited training. A biopsychosocial approach to practice was evident, yet a focus on impairment level factors was prominent. Findings support the need for standardised discourse assessment and discourse intervention methods. Translation into practice guidelines would promote consistency and confidence in clinical practice. [ABSTRACT FROM AUTHOR]

Aims: This study compared two dose frequency conditions of an explicit intervention with 50 trials per session designed to improve past tense marking in early school‐aged children with developmental language disorder (DLD). The influence of allomorphs on intervention effects was also examined. Methods: Data from previously conducted intervention studies were combined and analysed. Participants included nine children (mean age = 6;5 years) who received 20–30‐min intervention sessions provided twice per week for 10 weeks (1000 trials; 400–600 min) and 20 children (mean age = 6;6) who received 20–30‐min intervention sessions provided once per week for 10 weeks (500 trials; 200–300 min). Repeated measures included criterion‐referenced probes for production of untrained past tense verbs collected throughout baseline, intervention, and maintenance phases. The rate of progress in each phase was analysed using logistic regression. The proportion of participants who produced past tense allomorphs correctly at pre‐intervention, post‐intervention, and maintenance testing points was analysed. Results: Logistic regression showed a stable baseline, highly significant progress during the intervention phase, and a marginally significant shallow decline during the maintenance phase. Those in the twice per week group showed a greater rate of progress during the intervention phase leading to significantly higher scores in the maintenance period when compared with the once per week group. The allomorphic category of past tense verbs did not appear to influence outcomes. Conclusions: Participants receiving intervention twice per week appeared to demonstrate a greater rate of progress with intervention than those receiving it once per week, although once per week was also effective. However, these results should be interpreted with caution. Limitations to study design indicate that a larger randomised controlled trial is required. All past tense allomorphs improve to a similar degree when treated with this intervention. What this paper adds: What is already known on the subject: Understanding the parameters of dosage and intensity are important for clinical practice.Research evaluating the efficacy and/or effectiveness of interventions delivered in different dose/intensity conditions is scarce.There appears to be different interpretations of what constitutes dosage and intensity in published research. What this paper adds to existing knowledge: This study retrospectively compared dosage and intensity conditions of intervention provided twice per week to intervention provided once per week. Both dose frequencies could be delivered in clinical settings.Results from this study were analysed by grouping data from multiple testing points, rather than comparing pre‐post results. This approach demonstrated the variability of individual performance that would otherwise be lost with conventional methods of analysis.This study demonstrated that all past tense allomorphs improve to a similar degree when treated with this intervention. What are the potential or actual clinical implications of this work?: Parameters of dosage and intensity are still not clearly defined well enough for translation to clinical practice. In consideration of current research, this intervention may be more effective if delivered twice per week.If clinicians are treating past tense, all allomorphs should be considered as priorities for intervention targets. [ABSTRACT FROM AUTHOR]

Purpose: Oral discourse comprehension is a fundamental skill that is predictive of future reading comprehension. The ability to identify important semantic propositions, in a narrative text, and their attachment to a mental model is an essential component of discourse comprehension. This study aimed to pilot a measure of free-recall in a narrative retell across three age groups to explore development. A secondary aim compared measures of free-recall and cued-recall. Method: One hundred and thirty-two (132) typically developing children aged 4–7 years provided a retell of the Squirrel Story narrative and completed the Narrative Comprehension Assessment (NCA). The Squirrel Story Information Score (SSIS) was used as a novel measure of free-recall calculated from the narrative retells. The NCA, which involves literal and inferential comprehension questions, was used as a measure of cued-recall. Scoring reliability was calculated to ensure test–retest validity. Result: Correlation analysis found excellent reliability of the SSIS measure. The difference between 4 and 5 year olds, and 5 and 6 year olds, was significant, with a large effect size. The difference between the 5 and 6 year olds was not significant. A large positive correlation was found between the measures of SSIS and NCA. Conclusion: The measure of SSIS proved sensitive to developmental progression, with a positive relationship found between the measures of free-recall and cued-recall. Variability between the measures highlights the need to consider both measures to ensure an accurate representation of discourse comprehension skills. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluated the efficacy of an explicit, combined metalinguistic training and grammar facilitation intervention aimed at improving regular past tense marking for nine children aged 5;10-6;8 (years;months) with developmental language disorder. Method: This study used an ABA across-participant multiple-baseline single-case experimental design. Participants were seen one-on-one twice a week for 20- to 30-min sessions for 10 weeks and received explicit grammar intervention combining metalinguistic training using the SHAPE CODING system with grammar facilitation techniques (a systematic cueing hierarchy). In each session, 50 trials to produce the target form were completed, resulting in a total of 1,000 trials over 20 individual therapy sessions. Repeated measures of morphosyntax were collected using probes, including trained past tense verbs, untrained past tense verbs, third-person singular verbs as an extension probe, and possessive 's as a control probe. Probing contexts included expressive morphosyntax and grammaticality judgment. Outcome measures also included pre-poststandard measures of expressive and receptive grammar. Results: Analyses of repeated measures demonstrated significant improvement in past tense production on trained verbs (eight of nine children) and untrained verbs (seven of nine children), indicating efficacy of the treatment. These gains were maintained for 5 weeks. The majority of children made significant improvement on standardized measures of expressive grammar (eight of nine children). Only five of nine children improved on grammaticality judgment or receptive measures. Conclusion: Results continue to support the efficacy of explicit grammar interventions to improve past tense marking in early school-aged children. Future research should aim to evaluate the efficacy of similar interventions with group comparison studies and determine whether explicit grammar interventions can improve other aspects of grammatical difficulty for early school-aged children with developmental language disorder. [ABSTRACT FROM AUTHOR]

Language sample analysis (LSA) is highly recommended in the literature as a clinical tool for diagnosis, goal-setting and measuring effectiveness. This paper describes a project undertaken by a team of speech-language pathologists in a school context, whereby language samples of a narrative retell task from 91 children with developmental language disorder (DLD) were analysed using systematic analysis of language transcription (SALT) at two testing points. This was done in an effort to streamline usual narrative analysis processes and to evaluate the effectiveness of whole school narrative programming. Children's linguistic performance on narrative macrostructure and microstructure measures, and suggestions for future directions are discussed. Conclusions from the project suggest SALT is a valuable clinical tool for evaluating intervention program effectiveness that is transferable to the school context. [ABSTRACT FROM AUTHOR]

Background Children with specific language impairment (SLI) often experience word-learning difficulties, which are suggested to originate in the early stage of word learning: fast mapping. Some previous research indicates significantly poorer fast mapping capabilities in children with SLI compared with typically developing (TD) counterparts, with a range of methodological factors impacting on the consistency of this finding. Research has explored key issues that might underlie fast mapping difficulties in children with SLI, with strong theoretical support but little empirical evidence for the role of phonological short-term memory (STM). Additionally, further research is required to explore the influence of receptive vocabulary on fast mapping capabilities. Understanding the factors associated with fast mapping difficulties that are experienced by children with SLI may lead to greater theoretically driven word-learning intervention. Aims To investigate whether children with SLI demonstrate significant difficulties with fast mapping, and to explore the related factors. It was hypothesized that children with SLI would score significantly lower on a fast mapping production task compared with TD children, and that phonological STM and receptive vocabulary would significantly predict fast mapping production scores in both groups of children. Methods & Procedures Twenty-three children with SLI (mean = 64.39 months, SD = 4.10 months) and 26 TD children (mean = 65.92 months, SD = 2.98) were recruited from specialist language and mainstream schools. All participants took part in a unique, interactive fast-mapping task whereby nine novel objects with non-word labels were presented and production accuracy was assessed. A non-word repetition test and the Peabody Picture Vocabulary Test-Fourth Edition (PPVT-IV) were also administered as measures of phonological STM capacity and receptive vocabulary, respectively. Outcomes & Results Results of the fast-mapping task indicated that children with SLI had significantly poorer fast mapping production scores than TD children. Scores from the non-word repetition task were also significantly lower for the SLI group, revealing reduced phonological STM capacity. Phonological STM capacity and receptive vocabulary emerged as significant predictors of fast mapping performance when the group data were combined in a multiple regression analysis. Conclusions & Implications These results suggest that the word-learning difficulties experienced by children with SLI may originate at the fast mapping stage, and that phonological STM and receptive vocabulary significantly predict fast mapping ability. These findings contribute to the theoretical understanding of word-learning difficulties in children with SLI and may inform lexical learning intervention. [ABSTRACT FROM AUTHOR]