7 research outputs found
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Discriminating disorder from difference using dynamic assessment with bilingual children
The DAPPLE (Dynamic Assessment of Preschoolers’ Proficiency in Learning English) is currently being developed in response to a clinical need. Children exposed to English as an additional language may be referred to speech and language therapy because their proficiency in English is not the same as their monolingual peers. Some, but not all, of these children are likely to have a core language learning difficulty. Clinicians need to be able to distinguish disorder from difference due to a child’s language learning context. The assessment used a test–teach–test format to examine children’s ability to learn vocabulary, sentence structure and phonology. The assessment, which takes less than 60 minutes to administer, was given to 26 children who were bilingual: 12 currently on a speech and language therapy caseload and 14 children matched for age and socio-economic status who had never been referred to speech and language therapy. The DAPPLE data clearly discriminated the two groups. The caseload group required a greater amount of prompting to identify targeted words in the receptive vocabulary assessment and performed less well in the post-teaching expressive component. For sentence structure, the caseload group required more cues to acquire the targeted clause elements in the teaching phase. The caseload group made more phoneme errors at the initial and final assessments than the controls, and the type of errors made differed. Teaching resulted in greater positive change in percent phonemes correct for the caseload participants. Qualitative analyses of individual children’s performance on the DAPPLE suggested that it has the potential to discriminate core language deficits from difference due to a bilingual language learning context. Future directions for development of the test are considered
Evaluation of a manualised speech and language therapy programme for children with social communication disorder: the SCIP feasibility study
Background: Children with Social (Pragmatic) Communication Disorder (SPCD) have long-3 term needs in using and processing social language and have a high risk of later mental health difficulties. A manualised speech and language therapy programme, the Social Communication Intervention Programme (SCIP) provides therapy content for SPCD. A feasibility study is required to derive more precise estimates of key parameters for a future trial of SCIP.
Aims: To assess the feasibility of conducting a substantive randomized controlled trial of SCIP for children with SPCD.
Methods: A questionnaire was distributed to paediatric speech and language therapists in England. Survey questions addressed number of eligible children, routine intervention provision and trial recruitment factors. In the second phase, a single-arm intervention feasibility study was completed. 15 speech and language practitioners identified 24 children aged 5-11 years with SPCD. Practitioners received training/supervision to deliver 20 SCIP therapy sessions to each child. At Time 1 parents of participating children provided three communication goals; expected steps in each goal were defined. After intervention, parents and practitioners independently rated each goal compared to baseline ability. Two research practitioners compared parent post-intervention commentaries with outcome scores to derive guidance about clinical significance. All practitioners recorded audio commentaries on therapy experiences. Post-intervention interviews were conducted with 6 practitioners and 6 parents. An expert panel completed a Delphi consultation on trial design.
Results: Routine practice for SPCD varies widely. Children tend to be embedded in autism provision. Participation in a future trial was well-supported, provided resources are available to services. Outcomes analysis indicated all children except one made some progress on parent ratings; all children made progress on practitioner ratings. A power analysis for a future trial was carried out using current outcome measure as putative primary endpoint. Practitioners’ audio-diaries provided suggestions for training and adaption in a future trial. Outcomes and therapy methods were acceptable to practitioners and parents.
Conclusions: The feasibility study evaluated a novel outcome measure of social communication skills in SPCD. A power calculation indicated a feasible framework for a trial within a realistic period of time. Recommendations for recruitment methods, adaptation of manual and training were 6 supported by practitioners and an expert panel