Evaluating two different dose frequencies and cumulative intervention intensities to improve past tense production for early school-aged children with developmental language disorder

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

The effectiveness of two grammar treatment procedures for children with SLI: A randomized clinical trial

Purpose: This study compared the effectiveness of two grammar treatment procedures for children with specific language impairment. Method: A double-blind superiority trial with cluster randomization was used to compare a cueing procedure, designed to elicit a correct production following an initial error, to a recasting procedure, which required no further production. Thirty-one 5-year-old children with specific language impairment participated in 8 small group, classroom-based treatment sessions. Fourteen children received the cueing approach and 17 received the recasting approach. Results: The cueing group made significantly more progress over the 8-week treatment period than the recasting group. There was a medium–large treatment effect in the cueing group and a negligible effect size in the recasting group. The groups did not differ in maintenance of treatment effects 8 weeks after treatment. In single-subject analyses, 50% of children in the cueing group and 12% in the recasting group showed a significant treatment effect. Half of these children maintained the treatment effect 8 weeks later. Conclusion: Treatment that used a structured cueing hierarchy designed to elicit a correct production following a child’s error resulted in significantly greater improvement in expressive grammar than treatment that provided a recast following an error

Correlates of externalising and internalising problems in children with dyslexia: An analysis of data from clinical casefiles

© 2019 The Australian Psychological Society Objective: Adopting a socio-ecological perspective, we used data extracted from clinical casefiles to investigate factors associated with externalising and internalising problems in a large, representative sample of children with a diagnosis of dyslexia. Method: This study is a secondary analysis of data collected by the Dyslexia-SPELD Foundation in Western Australia. Casefiles for school-aged children who had received a dyslexia diagnosis in 2014 and 2015 were identified (n = 1,235), and a subset of casefiles were randomly selected for data extraction (n = 454). Of the sample, 58% (n = 262) were male, 42% (n = 192) were female. Ages ranged between 6 and 17 years (M = 12.32, SD = 3.07). Casefiles include results from assessments of literacy-related achievement, as well as parent-reported information on behavioural and socio-emotional development. Results: After controlling for child age, gender, and reading ability, it was found that low self-esteem, difficulties in emotion regulation, and social skills difficulties were all associated with externalising problems. Additionally, low self-esteem, difficulties in emotion regulation, and bullying victimisation were all associated with internalising problems. Peer relationship difficulties were indirectly associated with both externalising and internalising problems through associations with low self-esteem and difficulties in emotion regulation. Conclusion: Self-esteem, bullying victimisation, emotion regulation, social skills, and peer problems are salient correlates of externalising and internalising problems in children with a diagnosis of dyslexia. Implications for intervention are discussed, both universal school-based mental health promotion programs, as well as more targeted programs for children with dyslexia

Fetal alcohol spectrum disorder and youth justice: a prevalence study among young people sentenced to detention in Western Australia

Objectives: To estimate the prevalence of fetal alcohol spectrum disorder (FASD) among young people in youth detention in Australia. Neurodevelopmental impairments due to FASD can predispose young people to engagement with the law. Canadian studies identified FASD in 11%–23% of young people in corrective services, but there are no data for Australia. Design: Multidisciplinary assessment of all young people aged 10–17 years 11 months and sentenced to detention in the only youth detention centre in Western Australia, from May 2015 to December 2016. FASD was diagnosed according to the Australian Guide to the Diagnosis of FASD. Participants: 99 young people completed a full assessment (88% of those consented; 60% of the 166 approached to participate); 93% were male and 74% were Aboriginal. Findings: 88 young people (89%) had at least one domain of severe neurodevelopmental impairment, and 36 were diagnosed with FASD, a prevalence of 36% (95% CI 27% to 46%). Conclusions: This study, in a representative sample of young people in detention in Western Australia, has documented a high prevalence of FASD and severe neurodevelopmental impairment, the majority of which had not been previously identified. These findings highlight the vulnerability of young people, particularly Aboriginal youth, within the justice system and their significant need for improved diagnosis to identify their strengths and difficulties, and to guide and improve their rehabilitation

Applying psycholinguistic principles to spelling and word learning

This article presents a case study to illustrate the application of theory and research to intervention for a child with dyslexia and auditory processing disorder (APD).The use of the speech processing profile developed by Joy Stackhouse and Bill Wells provided a framework for psycholinguistic based intervention for spelling and word learning. Strategies for addressing lexical retrieval/storage difficulties, word learning and spelling within this framework are discussed

The Epidemiology of Literacy Difficulties (Focusing on Children with Speech and Language Impairment)

Speech and language impairment in preschool children is frequently a precursor of language and literacy difficulties that persist throughout childhood into adolescence and beyond. For the majority, the surface level symptoms of speech and language impairment change over time, but the underlying difficulties persist with negative impact on both spoken and written language development. Children with literacy difficulties are a heterogeneous group. A classification of reading difficulties is presented which is based on a simple model of reading (reading comprehension can be seen as the product of skills in decoding and listening comprehension). Three distinct subgroups of individuals with reading difficulties arise; those with dyslexia, those with a specific comprehension deficit and those with a broader based reading disability (language-based). This paper aims to describe each of these three groups, and present worldwide and local prevalence data (where available)

The relationship between stored phonological representations and speech output

Low quality, imprecise phonological representations have been hypothesized as an underlying deficit in Specific Language Impairment (SLI). This research compared performance on a silent judgement task and a multisyllabic word naming task using the same 10 words, for 21 children with SLI (mean age 7;6), 21 age-matched (AM) (mean age 7;6) and 21 language-matched (LM) (mean age 5;6) peers. The children with SLI demonstrated significantly poorer performance on the judgement task than either AM or LM peers, while performance on the naming task followed a developmental sequence. There was no correlation between the ability to correctly reject inaccurate productions and the ability to correctly name the items. These results support the suggestion of separate input and output phonological representations and that speech output errors should not necessarily be interpreted as indicative of underlying weakness in phonological representations. The research also highlights the value of individually-designed tasks to measure the input phonological representations for specific words

Literacy outcomes for students with speech impairment: long-term follow up

Background: Theoretical and empirical support now exists for the finding that many children with expressive phonological impairment experience problems in acquiring phonological awareness and early literacy skills. Few studies, however, have examined the long-term academic and literacy outcomes for this population, in particular as the students leave the final stages of primary school. Aims: The reported study forms the final stage of a longitudinal research project that tracked the phonological processing and literacy skills of a group of children with specific speech impairment from their first year at school (aged 5–6 years). The earlier data provided evidence of a relationship between speech impairment characterized by the presence of non-developmental error processes and weaker phonological awareness and literacy skills in the first 2–3 years at school. It was hypothesized that the effect of this relationship would continue to be apparent as the students completed the final stages of primary school. Methods & Procedures: Fourteen of the original set of 36 students were available for reassessment of their phonological processing, reading and spelling skills at age 12–13 years.Outcomes & Results: Those children with an original classification of non-developmental speech errors performed significantly more poorly than those with an original classification of developmental errors on phonological awareness and reading comprehension measures. Reading accuracy and spelling scores also showing a similar trend. Conclusions: These findings provide further evidence for the long-term impact of speech impairment. The follow-up data demonstrated ongoing difficulties for students who entered school with expressive speech impairment, particularly those whose speech errors were characterized by non-developmental error processes. The impact was apparent on tasks measuring phonological awareness, reading accuracy and spelling (skills that depend on good phonological processing skills and clear underlying phonological representations). Weaknesses in reading comprehension were also found. These findings have implications for the early identification of those at risk. In addition, intervention approaches for young children with expressive speech difficulties demonstrating these patterns of error should address weak underlying phonological representations and develop phonological awareness skills

WordDriver-1: Evaluating the efficacy of an app-supported decoding intervention for children with reading impairment

© 2018 Royal College of Speech and Language Therapists. Background: Fluent word reading is a key characteristic of skilled reading, yet most children with reading disorders have impaired word-reading skills. Previous research has demonstrated that multi-component interventions targeting phonemic awareness and the alphabetic principle are effective for children with reading disorders. However, about 25% of children fail to respond to these interventions. While it has been difficult to isolate the active ingredient, the findings of some studies suggest that tasks targeting phonological recoding and orthographic processing are essential elements in improving decoding. Aims: To develop and evaluate an intervention that specifically targets phonological recoding and orthographic processing (a decoding intervention) for children with persistent word-reading impairment. Methods & Procedures: A single-subject crossover design with multiple treatments was used to examine the efficacy of the decoding intervention (15 × 20-min sessions) compared with a language intervention that controlled for individual therapy time. Eight children (aged 7:6-8:11 years) with persistent word-reading impairment were randomly assigned to one of two intervention sequences. The effect of the decoding intervention was evaluated by (1) changes in decoding accuracy measured by performance on researcher-developed non-word lists; and (2) generalization to other standardized measures of reading. Outcomes & Results: The results showed that all participants demonstrated significant gains in non-word reading on researcher-developed non-word lists and standardized measures of non-word-reading accuracy and efficiency. Trends for improvement on standardized measures of word-reading efficiency, text-reading accuracy and reading comprehension were observed. Conclusions & Implications: This decoding intervention significantly improved non-word decoding skills in all participants who had not responded to previous reading interventions. As such, it may be an efficient adjunct to the first stage of reading interventions for this population. The relative lack of generalization to other word-reading skills may have been due to the nature of the outcome measures, the short intervention time and/or additional delays in participant orthographic processing skills