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Early Intervention for Children with Language Difficulties: An Evaluation of Two School Based Interv

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Title: Early Intervention for Children with Language Difficulties: An Evaluation of Two School Based Interv


1
Early Intervention for Children with Language
Difficulties An Evaluation of Two School Based
Intervention Programmes
Claudine Crane, Margaret J. Snowling, Julia
Carroll, Fiona Duff, Elizabeth Fieldsend, Jeremy
Miles Charles HulmeUniversities of York and
Warwick, UK
2
Outline
  • Theoretical rationale
  • Design of study and overview of Programmes
  • Participant selection
  • Training of Teaching Assistants
  • Findings
  • Implications for theory and practice

3
Background
  • According to the simple model, Reading
    Comprehension depends on both decoding and
    listening comprehension
  • Muter et al (2004) different language subskills
    underpin different component reading skills
  • Phonological Awareness Letters -gt Decoding
  • Vocabulary Grammar -gt Read Comp
  • Children with speech-language impairments at
    high-risk of RD (e.g. Catts et al., 2005
    Snowling et al., 2000)

4
Intervention
  • Evidence that early intervention programmes that
    train phonemes and letters in context of reading
    can facilitate reading development (decoding) in
    at-risk children (Hatcher et al 2004 Hindson et
    al., 2005)
  • Less evidence regarding the role of vocabulary
    and grammatical instruction
  • Question addressed by this study
  • is it possible to improve the development of
    vocabulary and grammar skills in at-risk
    children?
  • how do such training programmes differ in their
    effects from phonological training programmes?

5
Design
  • Evaluation of two interventions designed for
    children with speech and language difficulties in
    mainstream schools to be delivered by trained
    teaching assistants (TAs)
  • Oral Language Programme and Reading with
    Phonology Programme
  • Randomised Controlled Trial (following the
    Consort guidelines)
  • 20-week programme
  • 4 test phases pre-test, mid-test, post-test and
    maintenance test
  • Investigators blind to group membership

6
3 schools excluded (n 100) performance too
high
n 4 children unavailable for testing
Allocation Feb 2005 n 160 children selected to
take part in the intervention programmes (n 8
from each school) and randomly allocated to one
arm of the intervention project.
1 school withdrawn from programme Total n 45
Selected n 8 (4 children from each arm) n 17
children replaced following discussion with
teacher
Mar 2005 152 children seen for
pre-testing. Intervention programmes begin.
Reading with Phonology N 76 allocated to
intervention N 75 received allocated
intervention N 1 did not receive allocated
intervention moved schools but maintained
follow-up
Oral Language N 76 allocated to intervention N
76 received allocated intervention
Oral Language Discontinued Intervention N 1
moved schools Lost to follow up N 1
Reading with Phonology Discontinued intervention
N 8 moved schools Lost to follow-up N 3
Analysed n 75
Analysed n 71 Excluded from analysis n 2 -
Incomplete dataset
7
Participant Recruitment and Attrition
December 2004 N 960 children in 23 schools
screened for participation in early intervention
project.
3 schools excluded (n 100) performance too
high
January 2005 n 200 children selected from
remaining 20 schools (n 860) for further testing
8
January 2005 n 200 children selected from
remaining 20 schools (n 860) for further testing
n 4 children unavailable for testing
Allocation Feb 2005 n 160 children selected to
take part in the intervention programmes (n 8
from each school) and randomly allocated to one
arm of the intervention project.
1 school withdrawn from programme Total n 45
Selected n 8 (4 children from each arm) n 17
children replaced following discussion with
teacher
Mar 2005 152 children seen for
pre-testing. Intervention programmes begin.
9
Mar 2005 152 children seen for
pre-testing. Intervention programmes begin.
Reading with Phonology N 76 allocated to
intervention N 75 received allocated
intervention N 1 did not receive allocated
intervention moved schools but maintained
follow-up
Oral Language N 76 allocated to intervention N
76 received allocated intervention
Reading with Phonology Discontinued intervention
N 8 moved schools Lost to follow-up N 3
Oral Language Discontinued Intervention N 1
moved schools Lost to follow up N 1
Analysed n 71 Excluded from analysis n 2 -
Incomplete dataset
Analysed n 75
10
Participants (N146)
11
Teaching Assistants
  • Teaching assistants selected by schools
  • Attended 4 day intensive training programme
  • 2 Refresher days
  • Fortnightly tutorials
  • On-site tutorials

12
Structure of the Programmes
  • Programmes conducted over 2 x 10 week periods
  • Following initial introduction week, teaching was
    broken into 3 week blocks consisting of two
    teaching weeks and one consolidation week
  • Each week consisted of alternating daily group
    sessions or individual sessions
  • Repetitive session structure familiar routine,
    positive reinforcement

13
Programmes
  • Reading with Phonology
  • Training in letter sound knowledge (Jolly
    Phonics)
  • Oral phonological awareness
  • Reading books at easy and instructional levels
  • Sight word vocabulary development
  • Letter formation
  • Oral Language
  • Vocabulary development
  • Speaking
  • Listening
  • Narrative production
  • Comprehension
  • Question generation

14
Programmes
  • Reading with Phonology
  • Training in letter sound knowledge (Jolly
    Phonics)
  • Oral phonological awareness
  • Reading books at easy and instructional levels
  • Sight word vocabulary development
  • Letter formation
  • Oral Language
  • Vocabulary development
  • Speaking
  • Listening
  • Narrative production
  • Comprehension
  • Question generation

15
Measures
  • Language Skills
  • Reading Comprehension
  • Listening Comprehension
  • Specific Vocabulary
  • Action Picture Test
  • Bus Story
  • WISC III Picture Arrangement
  • Information Carrying
  • Reading and Phonological Skills
  • Early Word Reading
  • Letter Knowledge
  • Spelling
  • Reading Accuracy
  • Segmenting and Blending
  • Sound Isolation
  • Articulation

16
Measures
  • Language Skills
  • Reading Comprehension
  • Listening Comprehension
  • Specific Vocabulary
  • Action Picture Test
  • Bus Story
  • WISC III Picture Arrangement
  • Information Carrying
  • Reading and Phonological Skills
  • Early Word Reading
  • Letter Knowledge
  • Spelling
  • Reading Accuracy
  • Segmenting and Blending
  • Sound Isolation

17
Mode of Analysis
  • Data are clustered 4 children per arm two arms
    delivered by each TA
  • Complex samples analyses giving robust estimates
    and CIs (SPSS14)
  • Primary outcomes
  • Vocabulary
  • Grammar
  • Phoneme Awareness
  • Letter Knowledge
  • Word Recognition
  • Reading Comprehension
  • Covariates age, gender, autoregressor (when
    available)

18
Relative Advantage of Language Gp in z-score
units (95 CIs)
19
Relative Advantage of Reading with Phonology Grp
in z-score units (95 CIs)
20
Summary
  • Both intervention programmes were effective in
    promoting basic skills that underlie reading
    comprehension
  • Vocabulary and grammatical skills fostered better
    by language program (effect sizes .25-1.02)
  • Word-level reading skills and phoneme awareness
    fostered better by early literacy program (effect
    sizes .21-.71)
  • Biggest effects of training on receptive
    vocabulary (1.02) and segmentation/blending (.71)
  • Neither program had significant effect on reading
    comprehension (effect size .19) at this early
    stage in development

21
Predictors of outcome
  • Explored two further predictors of childrens
    outcome
  • Behaviour (SDQ total deviance score)
  • Socio-economic circumstances
  • Post code index of dis/advantage
  • Free school meals
  • Controlling for behaviour had no effect on
    findings
  • Significant influence of ses on outcome

22
Effect of SES?
  • When SES controlled training effects remained
    significant for early literacy and phonological
    measures, and vocabulary
  • No longer significant effect of training on
    grammar (APT Bus story)nor sequencing picture
    arrangement

23
Conclusions
  • Focused intervention programs can be delivered
    successfully by teaching assistants to 5 and
    6-year-old at risk children
  • Such programmes can foster the basic skills that
    underpin word-level and text level reading skills
  • Programmes emphasizing early literacy versus oral
    language skills have differential effects

24
Conclusions 2
  • In terms of effect size, specific vocabulary and
    phoneme awareness skills appear to be the most
    trainable skills
  • Preliminary evidence that social class moderates
    gains in grammar but not in vocabulary

25
Thank You
  • Funders Nuffield Foundation, North Yorks County
    council
  • Sponsors Jolly Phonics Black Sheep
  • Schools Pupils, TAs and teachers
  • Assistants Naomi Meredith, Nicky Vowles, Rachel
    Harlow, Debbie Gooch, Ros Francis, Dimitra
    Ionnau, Lisa Henderson, Lizzie Bowen, Natalie
    Falkinder, Sarah Edwards, Emma Truelove, Kim
    Manderson, Jodie Unau, Michelle Cargan, Pam
    Baylis, Rachael McCool, Elisa Romeo, Meesha
    Warmington, Poppy Nash, Janet Hatcher
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