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Med Travelers - December 2019

Research Watch Report, Issue 5

Research Watch Report, Issue 5
Meredith Poore Harold, PhD, CCC-SLP
November 13, 2017

The following is the August 2017 issue of research reviews for pediatric and school-based SLPs, written by Meredith Harold, PhD, CCC-SLP. Each month, Dr. Harold accesses 34 journals with the highest impact ratings for the area (Thompson-Reuters, SCImago, and h5-index). Articles that are (a) relevant to pediatric and school-based SLPs' daily practice, and (b) draw from strong evidence, are included in the monthly review. The research reviews highlight the most important clinical findings, then indicate additional resources to be found in the full article. These reviews are meant to be brief, informative, and—most importantly—keep you up-to-date on evidence-based practice. 


Learning Outcomes

After this course readers will be able to: 

  1. Describe the impact of medium (video storybooks vs. live reading) on preschool literacy outcomes.
  2. Describe evidence-based instructional strategies for children with vocabulary and word-finding difficulties.
  3. Describe the potential impact of client characteristics and communication partners on client outcomes.

Digital vs. Live Book Reading:
Does it matter for preschoolers?

Young children using storybook apps instead of having the book read live to them—what do we think about this?

The impact of digital media on child learning has received quite a bit of attention of the past couple decades. This study not only reviews much of that literature, but adds some relevant data. 

The researchers recruited 3- and 4-year-old children enrolled in a Head Start program. The resultant preschool group had a range of language skills, from significantly delayed to above average, but with the average child in their group falling in the low-average range (as measured by the Peabody Picture Vocabulary Test-4). A within-subject design, the kids all received readings from several age-appropriate stories, with comprehension measures following. However, some were read live, and others were via video. The stories were pulled from Speakaboos*, which is an app designed to read stories to 2–6-year-old kids, with video animation and interactive literacy-supportive features. The researchers removed the interactive component from both the live and video conditions, though—so these Speakaboos stories were video-only for the “digital” condition, then they used screenshots of the storybook pages and printed them to create books for the “live” condition. So truly the only difference was whether someone was reading the kids stories live vs. via video. 

Are there differences in reading comprehension, word learning, or enjoyment of reading
when the book is read live vs. read digitally?

They found that the medium did NOT have an impact on: words learned, comprehension, or motivation to read more. The thing that DID impact all of these (words learned, comprehension, motivation to read more) was the story itself. Certain stories gained better child outcomes, simply based on their content (e.g. those that were easier for the kids to understand).

Though “…certainly not a substitute for parent­–child interactive reading…” (the live condition wasn’t dialogic at all), digital stories may certainly have their place in literacy support.

Neuman, S.B., Wong, K.M., & Kaefer, T. (2017). Content not form predicts oral language comprehension: the influence of medium on preschoolers’ story understanding. Reading and Writing. Advance online publication. doi:10.1007/s11145-017-9750-4.

*Speakaboos is an app that you can download for free. 

Predicting Which Children Will Make Progress with Language Goals

This study examined 294 Kindergarten and 1st grade children, identified with a primary language disorder, spread across 75 SLPs and multiple states, and tracked business-as-usual therapy provision. The purpose of this study wasn’t to provide a new or different type of therapy, but to simply measure what normally happens with language therapy. The analyses of this paper focus on which child characteristics best predict gains while receiving language therapy, from the beginning to end of the school year.

The SLPs kept weekly data logs and videotaped a handful of therapy sessions. The researchers ran the children through a battery of tests to measure various skills. The child characteristics that most predicted language gains were: phonological awareness and vocabulary. The authors state, “Children with higher levels of phonological awareness and vocabulary at the start of the academic year exhibited the greatest gains in language skill over time…” and that these two skills “…together accounted for nearly 70% of the explained variance in children’s language gains over an academic year…”

So, basically, kids who start with relatively “higher” (but still disordered) oral language skills are more likely to make greater gains from language therapy? Makes sense… starting with some good skills makes it easier to gain skills. But! These data are correlational. So we actually can’t say why this trend is observed—it could be child factors (e.g. these kids are more capable of making language gains because of skills they start with) OR it could be something else entirely, like SLP or therapy factors (e.g. SLPs are more likely to teach to these kids’ level, or our current therapy practices better “fit” these kids). Could be many things…

So, what else? Also predictive of gains from language therapy, but less-so: externalizing behavior and nonverbal cognition. So, “… children with lower levels of problem behavior and higher levels of nonverbal cognition exhibited greater gains in language skill…” Surprise, surprise—behavior and cognition impact the ability to make progress in language therapy!? ;)

On the one hand, none of this is particularly shocking to the SLP—kids with better language, lower problem behaviors, and higher cognitive skills make more progress in language therapy. Makes sense. But we also need to consider, now, what wasn’t found to be predictive in their study. This included: working memory, internalizing behavior (negative behaviors focused inward, like fear or anxiety), self-regulation, maternal education, and family income, among others (see article for full list). Looking back at that list of what doesn’t predict gains from language therapy, and trying to make sense of it all can kind of make your head spin. I’d recommend going back to what is predictive and sitting with that for a bit.

The authors importantly state, “…the results of this study do not speak to what the clinician should do…” So this data doesn’t change our practice, really (I almost didn’t include this study in the newsletter for this reason). Instead, it allows us to predict, prepare for, or perhaps better understand the kids on our caseload who may be less likely to make progress in their language goals over the course of the year.

Justice, L.M., Jiang, H., Logan, J.A., & Schmitt, M.B. (2017). Predictors of language gains among school-age children with language impairment in the public schools. Journal of Speech, Language, and Hearing Research, 60, 1590–1605.

Word Webs for Treatment of Word-Finding Difficulty

This article examines a treatment strategy for children with word-finding difficulties, which may or may not co-occur with developmental language disorder. For children with word-finding difficulties, having receptive knowledge of a word, but being unable to retrieve and produce it can be quite frustrating.

Overall, this study of 20 children ages 6–8 years old provides evidence that word webs can be a useful tool for elementary-aged children with word-finding difficulties (looking for more? Try this study, too). Results show significant effects for both treated words and words than children chose as personally relevant to them (hobby interests, things they’re doing in the classroom, etc.). Further research needs done to get a better picture of how the WORD treatment generalizes.

What did they do? Well, good news—the researchers have provided materials and in-depth description of the intervention procedures on a website! See here to download the therapy materials, and here for additional information about the treatment methods. But basically what they did in this study is had the children construct word webs—one phonological (with things like what the word rhymes with, starts with, etc.) and one semantic (with meaning category, linked things, etc.). Research on the WORD program is ongoing; for example, they haven’t yet analyzed whether phonological or semantic word webs (or which components of each) are most beneficial. So, for now, results considered the use of both. Notable components of the intervention include the child’s active participation in generation of the maps plus reflection on what cues most helped them recall words.

Best, W., Hughes, L.M., Masterson, J., Thomas, M., Fedor, A., Roncoli, S., … & Kapikian, A. (2017). Intervention for children with word-finding difficulties: a parallel group randomised control trial. International Journal of Speech–Language Pathology. Advance online publication. doi:10.1080/17549507.2017.1348541.

Vocabulary Intervention for At-Risk Adolescents

So much of our attention to word-learning is on young children. However, vocabulary is pivotal for adolescents, too. Across age ranges, there is “… evidence for an association between vocabulary knowledge and academic attainment…”.

In this treatment study, thirty-five 12–14-years-old kids, all in low-ability classes and not making expected progress, were enrolled for intervention. None were receiving SLP services at the time. However, when you examine the group’s standardized language scores, they overall had low-average/borderline language skills, with some higher and some lower than this.

Intervention consisted of 10 weeks of once-weekly, one-hour, small group sessions. The students were taught one targeted word per week. The targeted words were Tier 2—so abstract words that occur in multiple contexts, across the curriculum, and are thus have potential to be quite impactful. One word per week may not seem like much, but “…while the sessions targeted one word (e.g. evaluate), the session included information on related words (e.g. positive and negative) as well as derivatives (e.g. evaluation, evaluated)…” So there was a high level of intensity on one targeted word (previous research has shown this is necessary), but with extra vocabulary and morphological instruction, as well.

To teach the target words, intervention tasks included things like defining, using the words in sentences, concept mapping, experimental activities, and challenges to use the words in real life. And—GOOD NEWS!—all their session descriptions and activities are freely available online. No joke; you can go download and use all of them. See here. (Psst—there are also some great links out from this website, too, to other research-based resources, like this. It’s great stuff.)

So how did the researchers measure if the students had learned a word? Post-intervention vocabulary knowledge was measured using their Word Knowledge Profile (takes 10–20 minutes to complete, also available on their website, with scoring examples). Do note that, though their study showed correlation between the Word Knowledge Profile and the standardized language measures, the Word Knowledge Profile is not itself standardized.

Results showed that, “…participants significantly improved their knowledge of target words, as indicated by their increased ability to describe the targeted words’ meaning…”. The authors highlight the “…potential consequences of poor vocabulary skills for literacy skills and educational attainment,” and that, “…explicit teaching of such vocabulary is needed…”

Spencer, S., Clegg, J., Lowe, H., & Stackhouse, J. (2017). Increasing adolescents’ depth of understanding of cross-curriculum words: an intervention study. Advance online publication. doi: 10.1111/1460-6984.12309.

And More...

Douglas et al. (2017) takes communication partner training strategies that already have a good evidence base (see Kent-Walsh & McNaughton, 2005 and Douglas et al., 2014), and hosted them online for parents of young children with autism. Results indicate “increased communication by the child”; however, note that this study is small, and “…further replication is necessary before generalizing results.”

Hughes et al. (2017) provides evidence that having a positive, meaningful relationships with a person who stutters (friend, family member, role model) is, “…associated with high ratings of an average person who stutters as being trustworthy and reliable.” The authors suggest that, “… simply knowing a person who stutters may not improve attitudes toward stuttering,” but that having a bit more meaningful relationship with a person who stutters, may. This prediction requires further investigation, as the study is correlational not experimental.

Douglas, S.N., Kammes, R., & Nordquist, E. (2017). Online Communication Training for Parents of Children With Autism Spectrum Disorder. Communication Disorders Quarterly. Advance online publication. doi: 10.1177/1525740117727491.

Hughes, C.D., Gabel, R.M., & Palasik, S.T. (2017). Examining the relationship between perceptions of a known person who stutters and attitudes toward stuttering. Canadian Journal of Speech–Lanugage Pathology and Audiology, 41(3), 237–252.

meredith poore harold

Meredith Poore Harold, PhD, CCC-SLP

Dr. Harold, author of  The Informed SLP, is a Speech–Language Pathologist and Assistant Professor of Communication Sciences and Disorders at Rockhurst University. Her clinical work and scholarship focus on pediatric speech–language development and disorders. 

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