Collaboration Between Child Play Therapy and Speech-Language Pathology: Case Reports of a Novel Language and Behavior Intervention.

Purpose It has been well documented that a significant number of children with developmental language disorders (DLDs) also exhibit challenging behaviors. In this study, a new intervention (Play and Language [PAL]) was developed through a research collaboration between a speech-language pathologist and a play therapist. The purpose of this clinical focus article is to describe child play therapy techniques and how these, along with early language intervention techniques, may positively impact preschool children's general communication and behavior. Method Students in a communication sciences and disorders program were trained to use a combination of child therapy techniques and language facilitation procedures in the PAL approach. Five preschool children, who displayed DLD and challenging behaviors, participated in a 2-week daily intensive intervention. Pre- and postintervention data for general communication and behavior skills were collected through parent report and language sample data. Student clinician and parent surveys were collected to assess the feasibility of conducting the new intervention and the parent-observed outcomes and satisfaction. Results A majority of the children who participated in the study increased their intelligibility and number of different words. Fewer than half increased their sentence length. These same children decreased their challenging behaviors, with 11 of 14 behaviors being reduced to normal levels. All parents reported satisfaction with their child's results. In addition, students trained to provide the intervention reported high levels of satisfaction with the training to implement PAL and that they were confident in providing the intervention techniques. Conclusion Together, our exploratory data provide preliminary and limited evidence that combining play therapy and language facilitation techniques may improve general communication skills and decrease challenging behaviors within the same intervention. Supplemental Material https://doi.org/10.23641/asha.16840459.

Language, Motor, and Cognitive Outcomes of Toddlers Who Were Born Preterm.

Purpose The purpose of this study was to examine the language, motor, and cognitive abilities of children born preterm in four categories: (a) healthy preterm infants, (b) infants of diabetic mothers, (c) infants with respiratory distress syndrome, and (d) infants with chronic lung disease when the children were 30 months, uncorrected age. Comorbidity of language, motor, and cognitive skills was examined, along with predictor variables. Method A total of 148 children who were born preterm participated and were assessed using bivariate tests and logistic regression on standardized assessment scores. Results Controlling for the children's gestational age (GA), overall language ability was significantly lower in the infants of diabetic mothers group compared to the healthy preterm infant group, and expressive language skills were significantly lower for the chronic lung disease group than the respiratory distress syndrome group. The children with language delays on at least one measure were significantly more likely to have cognitive, motor, or both delays. Lower maternal education was a significant predictor for language and cognitive delays, and younger GA was a significant predictor for language, motor, and cognitive delays. Conclusion Assessment of the preterm infant from a biosystems approach allows the speech-language pathologist to take into consideration maternal education, diagnosis at preterm birth, and GA, which were found to impact the language, motor, and cognitive outcomes of children born preterm. Our findings further reinforce the concept of the whole child in that children born preterm who display language delays should be screened for co-occurring motor and/or cognitive delays.

Preterm Neurodevelopmental Outcomes Following Orosensory Entrainment Intervention.

Previous research indicates that the NTrainer, a pressurized pacifier programmed to produce pulsed pneumotactile stimulation during gavage feeds, has been found to facilitate non-nutritive suck development and shorten the length of hospital stay when used in the Neonatal Intensive Care Unit (NICU). Four groups of children, including infants of diabetic mothers (IDM), healthy controls (HI), and those with respiratory distress syndrome (RDS), or chronic lung disease (CLD), were randomly assigned to an NTrainer therapy or sham 'control' condition when in the NICU. At 30 months of age, 113/223 study participants were assessed using standardized language, motor, and cognitive assessments. No significant group differences were evident between the NTrainer and sham groups in language, motor, or cognitive functioning. The NTrainer did not improve nor adversely impact language, cognition, or motor outcomes.

Concurrent and construct validity of oral language measures with school-age children with specific language impairment.

PURPOSE: This study investigated the psychometric properties of 2 oral language measures that are commonly used for diagnostic purposes with school-age children who have language impairments. METHOD: Two hundred sixteen children with specific language impairment were assessed with the Test of Language Development-Primary, Third Edition (TOLD-P:3; Newcomer & Hammill, 1997) and the Comprehensive Assessment of Spoken Language (CASL; Carrow-Woolfolk, 1999) within a 3-month period. The concurrent and construct validities of these 2 published tests were explored through correlation analysis and principle-component factor analysis. RESULTS: The TOLD-P:3 Spoken Language Quotient and CASL Core Composite scores were found to have an intertest correlation value of r = .596 within this sample, and a paired samples t test revealed a statistically significant difference between these scores. Principle-component factor analyses revealed a 2-factor structure solution for the TOLD-P:3, whereas data from the CASL supported a single-factor model. CONCLUSIONS: Analyses of assessment measure performance data from a sample of school-age children with specific language impairment revealed concurrent validity values and construct validity patterns that differed from those found in the norming samples as cited in examiner manuals. Implications for practice patterns and future research are discussed.

The effects of Fast ForWord Language on the phonemic awareness and reading skills of school-age children with language impairments and poor reading skills.

PURPOSE: To examine the efficacy of Fast ForWord Language (FFW-L) and 2 other interventions for improving the phonemic awareness and reading skills of children with specific language impairment with concurrent poor reading skills. METHOD: A total of 103 children (age 6;0 to 8;11 [years;months]) with language impairment and poor reading skills participated. The children received either FFW-L computerized intervention, a computer-assisted language intervention (CALI), an individualized language intervention (ILI), or an attention control (AC) computer program. RESULTS: The children in the FFW-L, CALI, and ILI conditions made significantly greater gains in blending sounds in words compared with the AC group at immediate posttest. Long-term gains 6 months after treatment were not significant but yielded a medium effect size for blending sounds in words. None of the interventions led to significant changes in reading skills. CONCLUSION: The improvement in phonemic awareness, but not reading, in the FFW-L, CALI, and ILI interventions limits their use with children who have language impairment and poor reading skills. Similar results across treatment conditions suggest that acoustically modified speech was not a necessary component for improving phonemic awareness.

The efficacy of Fast ForWord Language intervention in school-age children with language impairment: a randomized controlled trial.

PURPOSE: A randomized controlled trial was conducted to compare the language and auditory processing outcomes of children assigned to receive the Fast ForWord Language intervention (FFW-L) with the outcomes of children assigned to nonspecific or specific language intervention comparison treatments that did not contain modified speech. METHOD: Two hundred sixteen children between the ages of 6 and 9 years with language impairments were randomly assigned to 1 of 4 conditions: (a) Fast ForWord Language (FFW-L), (b) academic enrichment (AE), (c) computer-assisted language intervention (CALI), or (d) individualized language intervention (ILI) provided by a speech-language pathologist. All children received 1 hr and 40 min of treatment, 5 days per week, for 6 weeks. Language and auditory processing measures were administered to the children by blinded examiners before treatment, immediately after treatment, 3 months after treatment, and 6 months after treatment. RESULTS: The children in all 4 conditions improved significantly on a global language test and a test of backward masking. Children with poor backward masking scores who were randomized to the FFW-L condition did not present greater improvement on the language measures than children with poor backward masking scores who were randomized to the other 3 conditions. Effect sizes, analyses of standard error of measurement, and normalization percentages supported the clinical significance of the improvements on the Comprehensive Assessment of Spoken Language (E. Carrow-Woolfolk, 1999). There was a treatment effect for the Blending Words subtest of the Comprehensive Test of Phonological Processing (R. K. Wagner, J. K. Torgesen, & C. A. Rashotte, 1999). Participants in the FFW-L and CALI conditions earned higher phonological awareness scores than children in the ILI and AE conditions at the 6-month follow-up testing. CONCLUSION: Fast ForWord Language, the intervention that provided modified speech to address a hypothesized underlying auditory processing deficit, was not more effective at improving general language skills or temporal processing skills than a nonspecific comparison treatment (AE) or specific language intervention comparison treatments (CALI and ILI) that did not contain modified speech stimuli. These findings call into question the temporal processing hypothesis of language impairment and the hypothesized benefits of using acoustically modified speech to improve language skills. The finding that children in the 3 treatment conditions and the active comparison condition made clinically relevant gains on measures of language and temporal auditory processing informs our understanding of the variety of intervention activities that can facilitate development.

Imitative production of regular past tense -ed by English-speaking children with specific language impairment.

BACKGROUND: Language intervention procedures often involve the speech-language pathologist highlighting or making more salient forms that are problematic for the child with a language impairment. According to limited processing accounts of specific language impairment (SLI), one way to increase the saliency of a form is to manipulate its sentence position. AIMS: The placement of verbs with past tense regular -ed, a morpheme documented to be significantly difficult to acquire for English-speaking children with SLI, was manipulated. Specifically, the accurate production of verbs with regular past tense -ed in the final position of sentences was evaluated in comparison with verbs with regular past tense -ed in the internal sentence position. METHODS & PROCEDURES: Ten English-speaking children with SLI (mean age 5;2) who were variable in the production of the regular past tense -ed morpheme participated in the study. A sentence imitation task that consisted of sentences with the past tense -ed in the sentence internal position, the sentence final position and foil sentences was presented. OUTCOMES & RESULTS: Overall, the data suggest that in an imitative context, errors of omission occurred only when regular past tense -ed occurred in the sentence internal position compared with the sentence final position. CONCLUSIONS: The results are consistent with the SA explanation for omitted tense marking in children with SLI and do not support the Extended Optional Infinitive Account. Assessment and intervention of past tense -ed may be improved by manipulating the sentence position of this morpheme.

An evaluation of the facilitative effects of inverted yes-no questions on the acquisition of auxiliary verbs.

According to the Auxiliary Clarification Hypothesis (ACH), yes-no questions with sentence-initial auxiliaries (i.e., inverted questions) facilitate children's initial acquisition of auxiliary verbs. Sixteen 3-year-old children with specific language impairment (SLI) and 18 2-year-olds with typical language (TL) participated in an experiment to evaluate the ACH. The children were not yet making use of auxiliaries. Half of the children participated in twenty 30-min "enrichment" sessions over a 2-month period, during which an assistant produced 30 inverted question recasts in response to the child's own utterances. Fifteen question recasts contained the auxiliary is, and 15 contained the modal will. The other half of the children participated in play sessions but were not exposed to inverted is and will questions. Contrary to predictions based on the ACH, the results revealed no positive effects of the enrichment for is, for will, or for the broader BE and Modal auxiliary categories for either group of children. The children with TL demonstrated advantages over the children with SLI for the general category of BE forms but not for the category of Modals. Inverted questions may be too complex to foster the initial acquisition of auxiliaries in children not already using them productively.