Search

Purpose: The aim of this study was to extract key learning from intervention studies in which qualitative aspects of dosage, "dose form," have been examined for children with developmental language disorder (DLD)--in vocabulary, morphosyntax, and phonology domains. This research paper emerged from a pair of systematic reviews, aiming to synthesize available evidence regarding qualitative and quantitative aspects of dosage. While quantitative aspects had been experimentally manipulated, the available evidence for "dose form" (tasks or activities within which teaching episodes are delivered) was less definitive. Despite this, the review uncovered insights of value to DLD research. Method: A preregistered systematic review (PROSPERO ID: CRD42017076663) adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was completed. Included papers were quasi-experimental, randomized controlled trial, or cohort analytic studies, published in any language between January 2006 and May 2019; oral language interventions with vocabulary, morphosyntax, or phonology outcomes; and participants with DLD (M = 3-18 years). The intention was to include papers in which dose form was experimentally manipulated or statistically analyzed, while quantitative dosage aspects were controlled, such that definitive conclusions about optimal dose form could be drawn and gaps in the evidence identified. Results: Two hundred and twenty-four papers met the above inclusion criteria; 27 focused on dose form. No study controlled for all quantitative aspects of dosage such that we could effectively address our original research questions. Despite this, key points of learning emerged with implications for future research. Conclusions: There is tentative evidence of advantages for explicit over implicit instruction and of the benefits of variability in input, elicited production, and gestural and other visual supports. With careful design of dose form, there is potential to design more efficient interventions. Speech-language pathology research would benefit from an agreed taxonomy of dose form components and standardized reporting of intervention studies, to enable cross-study comparisons and a systematic accrual of knowledge to identify optimal dose form for clinical application.

Purpose: The aim of this study was to examine the degree to which quantitative aspects of dosage (dose, dose frequency, and total intervention duration) have been examined in intervention studies for children with developmental language disorder (DLD). Additionally, to establish the optimal quantitative dosage characteristics for phonology, vocabulary, and morphosyntax outcomes. Method: This registered review (PROSPERO ID CRD42017076663) adhered to PRISMA guidelines. Search terms were included in seven electronic databases. We included peer-reviewed quasi-experimental, randomized controlled trial or cohort analytical studies, published in any language between January 2006 and May 2020. Included articles reported on participants with DLD (M = 3-18 years); oral language interventions with phonology, vocabulary, or morphosyntax outcomes; and experimental manipulation or statistical analysis of any quantitative aspect of dosage. Studies were appraised using the Cochrane risk-of-bias tool. Results: Two hundred forty-four articles reported on oral language interventions with children with DLD in the domains of interest; 13 focused on experimentally/statistically manipulating quantitative aspects of dosage. No article reported phonological outcomes, three reported vocabulary, and eight reported morphosyntax. Dose frequency was the most common characteristic manipulated. Conclusions: Research is in its infancy, and significant further research is required to inform speech-language pathologists in practice. Dosage characteristics are rarely adequately controlled for their individual effects to be identified. Findings to date suggest that there is a point in vocabulary and morphosyntax interventions after which there are diminishing returns from additional dosage. If dose is high (number of learning opportunities within a session), then the literature suggests that session frequency can be reduced. Frequent, short sessions (2/3 × per week, approximately 2 min) and less frequent, long sessions (1 × per week, approximately 20 min) have yielded the best outcomes when composite language measures have been used; however, replication and further research are required before clinicians can confidently integrate these findings into clinical practice.

In Experiment 1, "more" and "less" relations were trained for arbitrary Stimuli A1 and A2 with 3 children with autism. The following conditional discriminations were then trained: A1-B1, A2-B2, B1-C1, B2-C2. In subsequent tests, participants showed derived more-less mands (mand with C1 for more and mand with C2 for less). A training procedure reversed the B-C conditional discriminations, and participants then showed derived reversed more-less mands (mand with C1 for less, C2 for more). Baseline B-C relations were retrained, and participants subsequently demonstrated a return to the original derived manding. A second experiment with 1 prior participant and 1 naive participant removed a possible confounding effect. Establishing derived manding may be an advantageous component when teaching a mand repertoire in applied settings. (Contains 8 figures.)

Participants were 2 typically developing children, aged 9 and 10 years, and 1 child, aged 4 years, with a reported severe speech delay. Five specific mand functions were trained such that participants learned to mand for the delivery or removal of tokens to the value of -2, -1, 0, +1, and +2, by presenting an arbitrary stimulus (A1, A2, A3, A4, and A5, respectively). The A stimuli were then incorporated into a series of interrelated conditional discriminations (A1-B1, B1-C1, A2-B2, B2-C2, A3-B3, B3-C3, A4-B4, B4-C4, A5-B5, B5-C5). Subsequent tests determined if participants derived 5 specific mands, presenting C1, C2, C3, C4, and C5 as mands for -2, -1, 0, +1 and +2 tokens. Three participants demonstrated derived manding, and derived manding altered in accordance with newly trained relations across two reversal procedures. (Contains 1 table and 5 figures.)

This study provides an in-depth analysis of children's use of a taught mental calculation strategy. Three children (aged eight to nine years) who demonstrated contrasting spontaneous calculation approaches, were interviewed following the direct instruction of a calculation strategy. Their responses are explored in relation to constructivist and participation perspectives of learning. In response to a unified view of these theories, hypotheses are generated that ask fundamental questions related to the didactics of mental calculation strategies.

Background: Phonological difficulties are prevalent in children with speech and/or language disorders and may hamper their later language outcomes and academic achievements. These children often form a significant proportion of speech and language therapists' caseloads. There is a shortage of information on evidence‐based interventions for improving phonological skills in children and adolescents with speech and language disorder. Aims: The aim of this systematic literature review and meta‐analysis was to systematically examine the effects of different intervention approaches on speech production accuracy and phonological representation skills in children with speech and language disorders. Methods: A preregistered systematic review (International Prospective Register of Systematic Reviews ID: CRD42017076075) adhering to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines was completed. Seven electronic databases (PubMed, Web of Science, ERIC, PsychINFO, Cochrane Library, SCOPUS and Linguistics & Language Behavior Abstracts) were searched for studies related to oral language interventions with children with developmental speech and/or language disorder (mean age ranging from 3–18 years) published between January 2006 and August 2022. The included articles reported intervention studies with a group design in which speech production accuracy was the outcome measure. Studies were appraised using the Cochrane risk of bias tool, and individual effect sizes were calculated using standardised means differences when enough data was available. A meta‐analysis was conducted obtaining the average standardised mean difference d. Heterogeneity, influence of possible moderator variables and publication bias were explored. Results: The 23 studies that met the inclusion criteria presented low‐medium risk of bias. Nine effect sizes were obtained from seven of these studies that presented a pre‐post‐test with a control group design. Medium‐high average effect sizes were found in phonological accuracy. Heterogeneity was found between individual effect sizes. Significant moderator variables and publication bias were not detected. Conclusions: The results of this meta‐analysis indicate positive effects on speech production accuracy. Based on this review, further improvements in the quality of reporting for intervention research are required in developing the evidence base for practice. What this paper adds: What is already known on the subject: An increasing number of interventions is available for children and adolescents with developmental speech and/or language disorders. Previous reviews suggest relatively low levels of evidence of interventions having phonology as an outcome measure. What this paper adds to the existing knowledge: This review and meta‐analysis summarise the intervention evidence from a substantial body of group design studies, indicating positive results from a range of interventions with phonological outcomes. It highlights the need to systematically implement and replicate different intervention procedures to understand factors that will maximise positive outcomes and to grow the evidence base for best practice. What are the potential or actual clinical implications of this study?: Tentative evidence is emerging for the effectiveness of various approaches in enhancing speech production accuracy skills of children and adolescents with developmental speech and/or language disorder. [ABSTRACT FROM AUTHOR]

Purpose: Qualitative engagement with stakeholders in the development of interventions can provide insight into strategies to maximize feasibility in real-life settings. We engaged stakeholders (autistic adults, early childhood educators, early childhood sector leaders and policy influencers, parents of autistic children, and speech-language pathologists) to inform the development of an educator-led peer-mediated intervention (PMI) for autistic preschoolers who use minimal speech that is feasible to implement in inclusive early childhood education and care (ECEC) settings. Method: A qualitative iterative intervention design process was utilized. Stakeholders (N = 15) attended an online workshop and completed a document review exploring the acceptability and feasibility of the proposed embedded PMI. A two-step analysis procedure using the Theoretical Domains Framework and template analysis was conducted to identify the barriers, enablers, and supports to the implementation of embedded PMI in early childhood settings. Results: While embedded PMI was unanimously acceptable to stakeholders, several participants expressed concerns regarding feasibility. Barriers to the successful integration and implementation of PMI in inclusive preschool contexts included access to skills, knowledge, and resources. Participants identified strategies to overcome modifiable barriers and to enhance the existing enablers. These strategies are reflected in the following themes: build on the familiar, build capacity in augmentative and alternative communication, adopt a whole center approach, adapt to meet the needs of the ECEC setting, and engage in proactive implementation. Conclusion: To address barriers to the implementation of embedded PMI, action is needed at various levels: macro (national/policy), meso (organization/ setting), and micro (individual). [ABSTRACT FROM AUTHOR]

In this research note, we report on a follow-up of children with language delay 2 years after their initial clinical identification at 2-3 years of age with receptive/ expressive (R/ELD) [...], Purpose: This study followed up children identified with expressive language delay (ELD) or receptive/ expressive language delay (R/ELD) at 2 years of age, Time 1 (T1), in order to identify their language profiles at 4-5 years, Time 2 (T2), and explore relationships to T1 language, gesture use, and symbolic comprehension. Method: Nineteen of 22 children were seen at follow-up (9 of 10 from R/ELD group, 10 of 12 from ELD group). T1 measures assessed receptive and expressive language, gesture use, and symbolic comprehension. At T2, we assessed receptive and expressive language, sentence repetition, and expressive phonology. Results: Outcomes for the R/ELD group were significantly poorer, with all children continuing to have delay in receptive and/or expressive language compared to just 20% of the ELD group. Expressive phonology delay was common in both groups. T1 receptive language showed the most pervasive correlations with T2 language measures, but categorical performance on all three T1 measures correctly predicted language outcomes in 16-17 of the 19 children. Conclusion: Findings add to evidence that receptive language is a strong predictor of outcomes. Gesture use and symbolic comprehension are also strong predictors and clinically valuable as part of play-based assessments with implications for theoretical understanding and intervention planning.

Current methods for reporting interventions do not allow key questions of importance to practitioners, service providers, policy‐makers and people with DLD to be answered, and hence limit the implementation of effective interventions in the real world. To extend the existing EQUATOR guidelines to the context of speech language therapy/pathology for children with language disorder and to provide more specific guidance on participants, interventions and outcomes within the CONSORT checklist (used to improve the reporting of randomised controlled trials) and TIDieR (Template for Intervention Description and Replication) to ensure consistency of reporting. We will develop a core team to include representatives from each of the key groups who will either use or be influenced by the final reporting guidance across different countries. To achieve each set of aims, we will conduct reviews of the literature (which present typologies of intervention characteristics in (D)LD and related disorders); carry out focus groups; and use systematic consensus methods such as the Delphi technique, nominal group technique or consensus development conferences. Through the development and adoption of standard intervention reporting criteria, we anticipate that we will overcome the numerous barriers for practitioners, services and policy‐makers in applying intervention evidence to practice. We believe that establishing international consensus on reporting guidelines would significantly accelerate progress in DLD research and the ease with which it can be used in clinical practice, by capitalising on the growth in intervention studies to enable international collaboration and new methodologies of data pooling, meta‐analyses and cross‐study comparisons. [ABSTRACT FROM AUTHOR]

Purpose: Considerable progress has been made in recent years in generating external evidence underpinning interventions for children with developmental language disorder (DLD), but less is known about the practitioner decision-making process underpinning such interventions and whether such decisions are context specific or are internationally generalizable. Methods: An online survey about clinical practice was developed by members of COST Action IS1406, an EU-funded research network, which included representation from 39 countries. The participants were 2,408 practitioners who answered questions in relation to their decision making for a specific child of their choosing with DLD. Analysis of open-ended questions was undertaken, and data were converted into codes for the purpose of quantitative analysis. Results: Although a wide range of intervention approaches and rationales were reported, the majority of responses referenced a client-centred approach. Level of functioning was used as a rationale only if a child had severe DLD. Practitioners with university level education or above were less likely to report basing intervention on client-centred factors. A number of differently named interventions with variable theoretical and empirical underpinnings were used in different countries. Conclusions: Specific client and practitioner characteristics have an impact on the intervention approaches and rationales adopted across countries. A limited number of practitioners reported use of external scientific evidence, which suggests that there should be more initiatives in basic training of practitioners and continuing professional development to encourage the uptake of scientific evidence-based practice. [ABSTRACT FROM AUTHOR]

Background: Inter‐professional collaboration (IPC) has been recommended for many years as a means by which the needs of children with developmental language disorders (DLD) can be met at school. However, effective IPC remains difficult to achieve and our knowledge of how to support it is limited. A shared understanding between those involved has been identified as critical to IPC. Aims: To examine the literature, as one source of data, for evidence of a shared understanding between the fields of speech and language therapy (SLT) and education about children with DLD and how such needs can best be met at school. Methods & Procedures: An integrative review of the literature was undertaken. A systematic search of the published, peer‐reviewed literature (between 2006 and 2016) was conducted for empirical and theoretical papers and a manual search was undertaken to obtain a representative sample of policy/professional guidelines. A total of 81 papers across SLT and education were included in the review. The papers were scrutinized using a qualitative content analysis. Main Contribution: Although some commonality between perspectives in the literature was identified, differences between the fields dominated. These differences related to how DLD is conceptualized; how children's needs are assessed; which outcomes are prioritized and how best these outcomes can be achieved. We also found differences about what constitutes useful knowledge to guide practice. We suggest that the nature of the differences we identified in the literature may have negative implications for practitioners wishing to collaborate to meet the needs of children with DLD in school. The perspectives of practising SLTs and teachers need to be sought to determine whether the findings from the literature reflect dilemmas in practice. Conclusions: Effective IPC is essential to meet the needs of children with DLD in school; yet, it remains difficult to achieve. Our review of the literature across SLT and education indicates evidence of a lack of shared understanding about DLD. If these differences are also evident in practice, then a conceptual model to support IPC may be warranted. [ABSTRACT FROM AUTHOR]

In the article, the author discusses the various considerations involved in the implementation of intervention approaches for children with language disorders. Also cited are the key roles played by parents, early childhood educators and public health practitioners to identify early signs of the disorder in children, and the need for speech and language therapists (SLT) to work with other professionals to effectively support children with speech, language and communication needs (SLCN).

This research investigated the efficacy of precision teaching (PT) on the reading fluency of typically developing children, aged 7–8 years. Seven participants were assigned to a PT intervention group and received 6 weeks of fluency training using Say All Fast a Minute Every Day Shuffled (SAFMEDS) fluency cards (Phase 1) and a Dolch story (Phase 2). Outcomes were measured using multiple baseline design (MBD) data, Standard Celeration Charts, and pre‐intervention–post‐intervention fluency scores. The MBD data show increased correct responding for PT participants from baseline to the end of each intervention phase. These improvements were maintained at a 3‐week post‐intervention follow‐up. The MBD clearly demonstrated a replication of intervention effects across participants. The study supports prior research in this area showing that PT can lead to large and socially relevant gains in children's reading fluency. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Mand functions for two stimuli (A1 and A2) were trained for 3 children with autism and were then incorporated into two related conditional discriminations (A1-B1/A2 -B2 and B1-C1/B2- C2). Tests were conducted to probe for a derived transfer of mand response functions from Al and A2 to C1 and C2, respectively. When I participant failed to demonstrate derived transfer of mand response functions, transfer training using exemplars was conducted. When participants had demonstrated derived transfer of mand functions, the X1 and X2 tokens that were employed as reinforcers for mand responses were incorporated into two conditional discriminations Q(1 - Y1 /)(2-Y2 and Y1 -Z1/Y2-Z2). Tests were conducted for derived transfer of reinforcing functions. Finally, tests were conducted to determine if the participants would demonstrate derived manding for the derived reinforcers (present C1 and C2 to mand for Z1 and Z2, respectively). Derived transfer of functions was observed when the sequence of training and testing was reversed (i.e., training and testing reinforcing functions before mand response functions) and when only minimal instructions were provided. [ABSTRACT FROM AUTHOR]