Speech and Language Difficulties: Practical Suggestions for Intervention and Inclusion

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Speech and Language Difficulties Practical
Suggestions for Intervention and Inclusion

• SEN Conference 2008
• Claudine Crane
• University of York, University of Hull

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Outline

• Systems of Language
• Patterns of Language Impairment
• Simple View of Reading
• Research Findings

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Systems of Language
Phonology
Semantics
Syntax
Pragmatics
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Systems of Language

• Phonology
• Output (articulation)
• Abstract system (contrastive)
• Syntax
• Word order
• Inflectional morphology

• Semantics
• Meaning
• Morphology
• Pragmatics
• Use of language for communication
• Relevance and explicitness

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Systems of Language
Phonology
Semantics
Syntax
Pragmatics
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Patterns of Language ImpairmentRapin Allen
(1987)

• Word deafness
• Verbal dyspraxia (SSD)
• Phonologic programming deficit syndrome (SSD)
• Phonologic-syntactic deficit syndrome
• Lexical-syntactic deficit syndrome
• Semantic-pragmatic deficit syndrome

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Causes?

• Genetic Basis
• Perceptual Difficulties
• Cognitive Difficulties
• But what about?
• Role of IQ
• What tests included in diagnosis
• How to take account of age-related changes
• Issue of selective vs. widespread impairments
• Overlap with other disorders eg ASD

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Classroom Context

• How can children with speech and language
  difficulties be identified?
• How will their difficulties affect their
  performance in the classroom?
• How we can best support children with speech and
  language difficulties?

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Primary Framework for Literacy

• Rose Review emphasises importance of language
  to literacy development
• Move towards Simple View of Reading
• Two components of reading
• Decoding
• Language Comprehension
• Both skills are necessary. Neither skill is
  sufficient for reading

The simple Model R D x C
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Simple View of Reading
Language Comprehension
Word Recognition
- Word Recognition
- Language Comprehension
Taken from Primary National Strategy (2006)
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Implications and Recommendations

• More emphasis on oral language activities in
  classroom
• High quality systematic phonic work
• Includes training in phoneme awareness
• Speaking and listening
• Vocabulary
• Language comprehension
• Balance will shift with development from word
  recognition processes to comprehension processes
• Oral language fundamental to literacy development

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Intervention Research

• Evidence that early intervention programmes
  training 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
• Nuffield Language 4 Reading
• 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?

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Nuffield Language for Reading

• Evaluation of two intervention programmes oral
  language and reading with phonology
• RCT
• 19 schools
• n 152 (mean age 48 ) 8 children in each school
• n 4 in each arm
• n76 oral language
• n 76 phonology with reading
• Weak verbal skills (WPPSI NWd Rep)
• 20 weeks of daily intervention (group and
  individual)
• Teaching assistant delivered

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Intervention Programmes

• Reading with Phonology
• Training in letter-sound knowledge
• Oral Phonological Awareness
• Reading books
• Sight word vocabulary
• Letter formation

• Oral Language Programme
• Vocabulary Development
• Speaking
• Listening
• Narrative Production
• Comprehension
• Question Generation

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Relative Advantage of Reading with Phonology Grp
in z-score units (95 CIs)







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Relative Advantage of Language Gp in z-score
units (95 CIs)




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Language for Reading Summary

• Both intervention programmes were effective in
  promoting basic skills that underlie reading
  comprehension
• Oral Language programme facilitated vocabulary
  and grammatical skills
• Reading with Phonology programme supported
  word-level reading skills and phoneme awareness

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Reading with Vocabulary Intervention

• Not all children respond to intervention10 46
  of children fail to respond (Torgesen, 2000).
• Profile of non-responders
• poor phonological skills (Nelson et al., 2003
  Torgesen et al., 1999 Vellutino et al., 1996)
• weak oral language (Al Otaiba Fuchs, 2006
  Vadasay, Sanders Abbott, 2008 Whiteley,
  Smith, Connors, 2007 Duff et al., 2008)
• ReVI - 12 children in Year 3 (8 years old)
• Poor response to reading intervention
• non-responder profile

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Reading with Vocabulary Intervention

• 9 weeks approx. 20 hours
• 2 x 15 minute daily individual sessions
• Reading Intervention
• Hatcher, Hulme, and Ellis (1994)
• Vocabulary Instruction
• Beck, McKeown, and Kucan (2002)
• Delivered by Trained TAs

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Reading with Vocabulary Intervention

• REVI improved 3 target areas
• reading
• phonological awareness
• oral language
• Gains maintained 6 months later
• Most children remained outside the average range
  in reading
• mean BAS SS 78
• REVI more effective for these treatment
  nonresponders than RI
• 0.13 SS gained per hour vs. 0.02

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The York READing for MEaning Project

• The project has both practical and research aims
• . To compare three approaches to improving the
  reading comprehension skills of poor
  comprehenders.
• . To address the objectives of the primary
  framework (NLS) and equip teaching assistants
  with a wide range of skills and materials, useful
  in supporting children with reading comprehension
  and oral language difficulties.

• 168 poor comprehenders in 20 schools in York and
  N.Yorks
• Selected using a discrepancy based criteria
• Average discrepancy at pre test between reading
  efficiency (TOWRE)
• and reading comprehension (NARAII) of 15 std
  score points

• Design
• Randomised Controlled Trial
• Random allocation within school to four
  conditions
• Intervention groups compared to a waiting
  control group

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The York READing for MEaning Project

• Intervention Delivery
• A trained teaching assistant in each school
  delivered all three programmes over 20 weeks.
• Children in each of the programmes received
  three ½ hour sessions of intervention each week
  (2 in pairs and 1 individually)
• Children received two ten-week blocks of
  teaching (block 1 in the summer term of Y4 and
  block 2 in the autumn term of Y5)
• The control group will be receiving their
  intervention when they will be in Y6.

• The Interventions
• The Oral Language (OL) Programme
• Vocabulary
• Listening Comprehension
• Figurative Language
• Spoken Narrative
• The Text Comprehension (TC) Programme
• Metacognitive Strategies
• Reading Comprehension
• Inferencing from Text
• Written Narrative
• The Combined (COM) Programme
• The COM Programme combined all OL and TC
  components, connecting the activities using an
  integrated approach.

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The York READing for MEaning Project

• 20-week intervention programmes can produce
  significant gains in both expressive vocabulary
  and reading comprehension in poor comprehenders.
• Importantly these gains are relative to an
  untreated waiting control group.
• As yet we do not know the extent to which these
  gains are maintained over time.

Preliminary Results
plt0.001
plt0.05
plt0.01
WIAT II

• Whats next?
• Further data collection to examine maintenance
  effects.
• Statistical analyses to examine subgroups
  response to intervention.
• Investigate whether expressive vocabulary
  improvement is a mediating factor in reading
  comprehension gains.

plt0.05
WASI Verbal IQ
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Future Directions

• Nuffield Language4Reading Jan 2009
• Oral language training beginning in nursery and
  continuing into reception.
• Vocabulary, narrative, listening and speaking
• Complementing classroom activities including oral
  phonological awareness
• Impact on response to reading instruction?

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Acknowledgements

• University of York
• Centre for Reading and Language
• Margaret Snowling,
• Charles Hulme
• Paula Clarke
• Emma Truelove
• Fiona Duff
• Elizabeth Fieldsend
• Kristina Gotz
• Emma Hayiou-Thomas
• Dept of Health Sciences
• Jeremy Miles
• University of Warwick
• Julia Carroll

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, Goran Lukic, Angela
Harrington, Pam Baylis
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Thank You

• Funders Nuffield Foundation, North Yorks County
  Council, ESRC
• Sponsors Jolly Phonics Black Sheep
• Schools Pupils, TAs and teachers