PROTOCOL: Language interventions for improving oral language outcomes in children with neurodevelopmental disorders: A systematic review

This protocol presents the plan for a systematic review that will investigate the effect of oral language interventions for children with intellectual disability (ID), language disorder (LD), autism spectrum disorder (ASD), Down syndrome (DS), Williams syndrome (WS), and fragile X syndrome (FXS). Language development is a highly frequent area of difficulty for children within these diagnostic groups, and oral language interventions are therefore important. However, to provide better evidence‐informed practice, we need to investigate what oral language interventions are effective and for whom. The systematic review will not only investigate the effect of oral language interventions targeted at specific disorders but also identify interventions that may be yield similar improvements in different neurodevelopmental disorders.publishedVersio

Oral language interventions can improve language outcomes in children with neurodevelopmental disorders: A systematic review and meta-analysis

Background Young people who fail to develop language as expected face significant challenges in all aspects of life. Unfortunately, language disorders are common, either as a distinct condition (e.g., Developmental Language Disorder) or as a part of another neurodevelopmental condition (e.g., autism). Finding ways to attenuate language problems through intervention has the potential to yield great benefits not only for the individual but also for society as a whole. Objectives This meta-analytic review examined the effect of oral language interventions for children with neurodevelopmental disorders. Search Methods The last electronic search was conducted in April 2022. Selection Criteria Intervention studies had to target language skills for children from 2 to 18 years of age with Developmental Language Disorder, autism, intellectual disability, Down syndrome, Fragile X syndrome, and Williams syndrome in randomised controlled trials or quasi-experimental designs. Control groups had to include business-as-usual, waiting list, passive or active conditions. However, we excluded studies in which the active control group received a different type, delivery, or dosage of another language intervention. Eligible interventions implemented explicit and structured activities (i.e., explicit instruction of vocabulary, narrative structure or grammatical rules) and/or implicit and broad activities (i.e., shared book reading, general language stimulation). The intervention studies had to assess language skills in receptive and/or expressive modalities. Data Collection and Analysis The search provided 8195 records after deduplication. Records were screened by title and abstract, leading to full-text examinations of 448 records. We performed Correlated and Hierarchical Effects models and ran a retrospective power analysis via simulation. Publication bias was assessed via p-curve and precision-effect estimate. Main Results We examined 38 studies, with 46 group comparisons and 108 effects comparing pre-/post-tests and eight studies, with 12 group comparisons and 21 effects at follow-up. The results showed a mean effect size of d = 0.27 at the post-test and d = 0.18 at follow-up. However, there was evidence of publication bias and overestimation of the mean effects. Effects from the meta-analysis were significantly related to these elements: (1) receptive vocabulary and omnibus receptive measures showed smaller effect sizes relative to expressive vocabulary, grammar, expressive and receptive discourse, and omnibus expressive tests; and (2) the length of the intervention, where longer sessions conducted over a longer period of time were more beneficial than brief sessions and short-term interventions. Neither moderators concerning participants’ characteristics (children's diagnosis, diagnostic status, age, sex, and non-verbal cognitive ability and severity of language impairment), nor those regarding of the treatment components and implementation of the language interventions (intervention content, setting, delivery agent, session structure of the intervention or total number of sessions) reached significance. The same occurred to indicators of study quality. The risk of bias assessment showed that reporting quality for the studies examined in the review was poor. Authors’ Conclusions In sum, the current evidence base is promising but inconclusive. Pre-registration and replication of more robust and adequately powered trials, which include a wider range of diagnostic conditions, together with more long-term follow-up comparisons, are needed to drive evidence-based practice and policy.publishedVersio

A cross-linguistic, longitudinal study of the foundations of decoding and reading comprehension ability

The present study investigated the moderating role of orthographic consistency on the development of reading comprehension in four language groups (English, n = 179; Spanish, n = 188; Czech, n = 135; Slovak, n = 194) from kindergarten to Grade 2. In all languages, early variations in phoneme awareness/letter knowledge, rapid automatised naming, and emerging decoding skills, but not oral language, predicted variations in decoding skills at the end of Grade 1; these in turn predicted reading comprehension in Grade 2. For the three consistent orthographies (Spanish, Slovak, and Czech), kindergarten language skills were another significant predictor of Grade 2 reading comprehension. This effect was absent in the English sample, where variations in decoding skills were a more powerful predictor. These results provide the first longitudinal evidence for effects of orthographic consistency on the development of reading comprehension and provide support for the simple view of reading

Structural validity of the Norwegian version of the Strengths and Difficulties Questionnaire in children aged 3–6 years

IntroductionThis study examined the structural validity of the teacher-report Strength and Difficulties Questionnaire (SDQ) in Norwegian preschoolers aged 3–6 years. We tested the original five-factor structure, the five-factor structure with two broader second-order factors, and a three-factor structure, all suggested in the literature. Since the positively worded items in SDQ have been shown to introduce noise, we also examined all three structures with a positive construal method factor for these items.MethodsPreschool teachers from 43 preschools completed the SDQ questionnaire for 1,142 children [48% girls, mean age 4.3 (SD 0.9) years]. Confirmatory factor analyses were used to estimate and compare the six models. Measurement invariance was tested across sex (multi-group approach) and age (multiple-indicator multiple-cause approach).ResultsThe original five-factor structure of SDQ was supported, where the model fit improved when including a method factor for positively worded items. Both models showed scalar invariance across sex and age. The second-order and the three-factor structures were not supported.ConclusionWe recommend using the original five-factor structure when using SDQ for both clinical and research purposes in young children and adding a method factor when using structural equation modeling

Oral language enrichment in preschool improves children's language skills : a cluster randomised controlled trial

Background. Oral language skills provide the foundation for formal education, yet many children enter school with language weaknesses. This study evaluated the efficacy of a new language enrichment programme, the Nuffield Early Language Intervention—Preschool (NELI Preschool), delivered to children in the year before they enter formal education. Methods. We conducted a preregistered cluster randomised controlled trial in 65 nursery schools in England (https://doi.org/10.1186/ISRCTN29838552). NELI Preschool consists of a 20-week whole-class language enrichment programme delivered by a teacher each day for 20 min. In addition, children with the weakest language skills in each class are allocated to receive additional targeted support delivered by classroom assistants (whole-class + targeted). The language skills of all children (n = 1,586) in participating classrooms were assessed using the LanguageScreen automated app (https://oxedandassessment.com/languagescreen/). Settings were then randomly allocated to an intervention or control group. The children with the weakest language in each class (whole-class + targeted children n = 438), along with four randomly selected children in each class allocated to the whole-class only programme (n = 288) were individually tested on a range of language measures. Results. Children receiving NELI Preschool made larger gains than children in the control group on an oral language latent variable (whole-class children d = .26; whole-class + targeted children d = .16). Conclusions. This study provides good evidence that whole-class intervention delivered in preschool can produce educationally significant improvements in children's language skills. The intervention is scaleable and relatively low cost. These findings have important implications for educational and social policy

The Foundations of Literacy Development in Children at Familial Risk of Dyslexia

The development of reading skills is underpinned by oral language abilities: Phonological skills appear to have a causal influence on the development of early word-level literacy skills, and reading-comprehension ability depends, in addition to word-level literacy skills, on broader (semantic and syntactic) language skills. Here, we report a longitudinal study of children at familial risk of dyslexia, children with preschool language difficulties, and typically developing control children. Preschool measures of oral language predicted phoneme awareness and grapheme-phoneme knowledge just before school entry, which in turn predicted word-level literacy skills shortly after school entry. Reading comprehension at 8½ years was predicted by word-level literacy skills at 5½ years and by language skills at 3½ years. These patterns of predictive relationships were similar in both typically developing children and those at risk of literacy difficulties. Our findings underline the importance of oral language skills for the development of both word-level literacy and reading comprehension

Reading Comprehension and its Underlying Components in Second Language Learners: A Meta-analysis of Studies Comparing First and Second Language Learners

We report a systematic meta-analytic review of studies comparing reading comprehension and its underlying components (language comprehension, decoding, and phonological awareness) in first- and second-language learners. The review included 82 studies, and 576 effect sizes were calculated for reading comprehension and underlying components. Key findings were that, compared to first-language learners, second-language learners display a medium-sized deficit in reading comprehension (pooled effect size d = -0.62), a large deficit in language comprehension (pooled effect size d = -1.12), but only small differences in phonological awareness (pooled effect size d = –0.08) and decoding (pooled effect size d = –0.12). A moderator analysis showed that characteristics related to the type of reading comprehension test reliably explained the variation in the differences in reading comprehension between first- and second-language learners. For language comprehension, studies of samples from low socioeconomic backgrounds and samples where only the first language was used at home generated the largest group differences in favor of first-language learners. Test characteristics and study origin reliably contributed to the variations between the studies of language comprehension. For decoding, Canadian studies showed group differences in favor of second-language learners, whereas the opposite was the case for U.S. studies. Regarding implications, unless specific decoding problems are detected, interventions that aim to ameliorate reading comprehension problems among second-language learners should focus on language comprehension skills. Published Open Access, Copyright 2013 American Psychological Associatio

Early prediction of learning outcomes in reading

This chapter focuses on the processes involved in the development of children’s decoding skills: the ability to translate printed words into a speech code, typically assessed by the accuracy and speed of reading aloud. If children struggle in developing this ability, they are often characterized as having dyslexia, but since decoding skills are normally distributed in the population, the cut-off for this diagnosis is somewhat arbitrary (Melby-Lervåg et al. 2012). During the first two years of school, the main aim for children is to develop accurate and fluent early reading abilities that will lay the foundation for the main goal of reading – to be able to extract meaning from text. Thus, though insufficient by itself, efficient word reading is, in turn, a necessary condition for the development of reading comprehension. Research on the foundations of learning to read has burgeoned in the last twenty-five years, with important theoretical and practical consequences

Modeling the Development of Reading Comprehension

A skilled reader can derive the meaning from a printed text rapidly and effortlessly. Becoming a skilled reader takes time and practice and is one of the main goals of primary school education. Since the previous edition of this book in 2005, research in this area has flourished and there are now many longitudinal studies examining how reading comprehension develops. This chapter will focus on what we know about the development of reading comprehension in the early school years, with a particular emphasis on understanding causal processes