Treatment of Language Disorders in Children

Rebecca J. McCauley, Marc E. Fey, Ronald Gillam, Marc E. Fey, Alan Kamhi, Rebecca J. McCauley, Marc E. Fey, Ronald Gillam

• Publisher: Brookes Publishing
• Year: 2016
• ISBN:
  9781681250588
• Edition: 2
• Topic: Education
• Subtopic: Inclusive Education

Thoroughly updated to meet the needs of today's students in SLP courses, the second edition of this classic textbook prepares future professionals to evaluate, compare, select, and apply effective interventions for language disorders in children. Using realistic case studies and many new video clips that show each strategy in action, the expert contributors introduce your students to 14 current, research-based intervention models and examine practical ways to apply them in the field. The new edition covers interventions for both emerging communication and language and more advanced language and literacy, in a consistent chapter format that makes it easy for students to compare treatment approaches. A textbook SLPs will keep and reference often throughout their careers, this balanced, in-depth look at interventions will prepare professionals to choose and implement the best interventions for children with language disorders.

YOUR STUDENTS WILL LEARN ABOUT

• the theoretical and empirical basis of each intervention
• target populations for the intervention
• assessment and decision making
• practical requirements for implementation
• considerations for children from culturally and linguistically diverse backgrounds
• future directions

STUDENT-FRIENDLY MATERIALS: A video clip to illustrate each intervention (on the included DVD and available online); case studies; learning activities that challenge students to apply their new knowledge

WITH NEW CHAPTERS ON: Print-Referencing Interventions * Language Intervention for School-Age Bilingual Children * Comprehensive Reading Intervention in Augmentative Communication * Complex Sentence Intervention * Narrative Language Intervention * Social Communication Intervention for Children with Language Impairment * Strathclyde Language Intervention Program (SLIP)

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Introduction to Treatment of Language Disorders in Children, Second Edition

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Rebecca J. McCauley, Marc E. Fey, and Ronald B. Gillam

ABSTRACT

In this chapter, we introduce this book’s organization and the template used by contributing authors to structure the 14 chapters that address individual interventions. In addition to reviewing a model of intervention structure, we summarize trends in treatment development and implementation that serve as a backdrop for current and future actions by both researchers and clinicians. We also suggest ways that different audiences can take advantage of the book for their own purposes—placing greatest emphasis on how to use the intervention descriptions to inform decisions about whether and how to incorporate each intervention into plans for the management of language disorders in children.

THE PURPOSE OF THIS BOOK

The main purpose of this second edition of Treatment of Language Disorders in Children, as in the first edition, is to make it easier for readers to learn about and evaluate current treatments for children with language disorders. We introduce 14 evidence-based language interventions for children, and we provide specific information on how to conduct each treatment. Furthermore, we highlight claims of value associated with each treatment approach and facilitate readers’ evaluations and comparisons of the interventions in terms of their clinical procedures and the extent of their research base. We want to help readers develop strategies for accessing and interpreting the complex web of information that constitutes evidence that does and does not support the value of an intervention. We consequently have planned the book’s organization carefully, recruited outstanding researchers as chapter authors, and diligently edited what they produced with the intent of giving readers the information they need regarding when a decision to use an intervention may be judged “evidence based” and how the intervention can be successfully implemented.

Although beginning and seasoned speech-language pathologists (SLPs) form the principal audiences of this volume, we also hope this book serves professionals in other fields, such as education and psychology, who want to know more about interventions used with children with language problems whom they serve. Furthermore, families of affected children may find this a useful tool for investigating one or more interventions proposed for use with their child. To serve these broader purposes, we offer recommendations regarding how members of these differing audiences might select sections to read or ways to use and supplement the information they obtain.

THE BOOK’S ORGANIZATION

Although the major structure of the 14 treatment chapters in the book is very similar to that used in the first edition published in 2006, the organization of sections and the treatments included in them have changed, sometimes considerably. An entire section from the earlier edition that included nonlanguage interventions (e.g., sensory integration) has been omitted. This means that the book now contains just two sections, with one addressing language problems characteristic of infants, toddlers, and preschoolers and the other targeting problems found in school-age children.

We have made significant changes in the interventions included in each section as well. Seven of the original chapters have been updated to reflect ongoing developments as the interventions have continued to be studied and implemented (Chapters 2, 3, 4, 5, 6, 8, and 10). Eight of the interventions from the first edition were not carried over to this edition, for reasons including insufficient fit with the new sectional organization, a lack of new research exploring their use, or their recent description in related volumes. In their place, seven different interventions have been added. Three of these new chapters expand the book’s attention to literacy and its precursors, including chapters on print referencing (Chapter 7), word decoding, reading comprehension (Chapter 11), and narration (Chapter 13). In addition, two of the new chapters target more complex language (Chapter 12) and social communication skills (Chapter 14) and two others address bilingualism (Chapter 9) and service delivery models (Chapter 15).

As noted previously, we have included more interventions dealing with written language in this volume. In so doing, we have tried to maintain our focus on children who exhibit or have histories of spoken language disorders and the relationship between these early problems and reading disabilities. Though we have intentionally paid greater attention to interventions targeting skills associated with early reading development, this is not designed to be a book on intervention for children with reading disabilities, per se.

HOW TREATMENTS ARE DESCRIBED IN THIS BOOK

Table 1.1 describes the template adhered to by the authors of the intervention chapters. The template—a description of content areas and headings used to signal them—was devised to focus on theoretical and empirical information supporting an intervention’s use as well as practical and procedural information that can help clinicians determine the intervention’s feasibility for their setting and client population and, possibly, set the clinician on the path to learning and using it. Several relatively small adjustments to the earlier template version are noted in the description that follows.

Table 1.1. Content specifications of the template followed within each chapter

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Section	Content
Abstract and Introduction	Overview and broader introduction to the intervention and the chapter itself, including the specific individuals for whom the intervention is designed, the intervention’s basic focus, and its key methods
Target Populations	Description of populations for which empirical and/or theoretical support is available with regard to variables such as age, diagnosis, and prerequisite skills
Theoretical Basis	Outline of the dominant rationale for the intervention, including assumptions about the deficit, compensatory strategy or strength that is targeted and the nature of the desired outcomes (e.g., improvement in social participation, acquisition of specific morphosyntactic forms)
Empirical Basis	Detailed discussion of research studies supporting the treatment or components of it for use with target population, including as a new component, and a level of evidence table that provides a quick reference regarding the strength of designs and outcomes included in cited studies
Overview of Assessment and Decision Making	Description of the major assessments and assessment points used to reach decisions regarding 1) the appropriateness of the intervention, 2) initial and subsequent treatment targets, 3) advancement through treatment, and 4) treatment termination. New to this edition is the inclusion of a flowchart to illustrate these processes.
Practical Requirements	Time and personnel demands, including training for all intervention agents (e.g., clinicians, family members, aides), types of sessions (e.g., group/individual) and dosage information (e.g., number of teaching sessions, total intensity duration)
Key Components	A description of the approach that may include discussion of the type of goals targeted; strategy for addressing multiple goals (e.g., sequential, cyclic, simultaneous); procedures (therapeutic actions by the intervention agent); activities (interactional context in which procedures are embedded, e.g., conversation, storybook reading); materials and roles of secondary intervention agents
Considerations for Children from Culturally and Linguistically Diverse Backgrounds	Descriptions of the applicability of the treatment to children from linguistically or culturally diverse backgrounds and ways in which it might be modified to be more appropriate for such children
Application to an Individual Child	Description of one or more children for whom the intervention could be expected to be helpful, used to illustrate children’s responses to intervention and ongoing decision making
Future Directions	Description of research needed to support and extend existing claims of treatment effectiveness for the current population as well as those for whom it has suspected, but untried, value
Video Clip Description(s)	One or more video clips selected to illustrate components of the intervention, thus providing viewers with a richer understanding of the nature of the intervention and its demands
Recommended Readings	A small group of references directing readers to pertinent additional information about the intervention
Learning Activities	A set of questions or activities designed to help readers make the best use of the text or video content associated with the chapter

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Following a very brief Abstract, a longer Introduction section provides more extensive, but still concise background information. The next section, Target Populations, identifies the client populations for whom the intervention has been developed and child characteristics that might either enhance or detract from the intervention’s appropriateness. Whereas in the earlier edition, discussion of assessments used to identify candidates for an intervention was included in this section, that content has now been consolidated in a single later section related to the ongoing processes of assessment.

There are many terms that are used by the chapter authors to refer to children who experience significant difficulties learning and using language. The World Health Organization (2001) uses the word impairment to refer to any loss or abnormality of psychological, physiological, or anatomic structure or function. With respect to child language development, most authors have used the term language impairment to refer to describe children with significant delays in the development of language comprehension or use. The term specific language impairment (SLI) is often used to refer to delays or deficits in language that cannot be attributed to hearing, intellectual, emotional, or acquired neurological impairments (Bishop, 2014). There are two classification categories in the Individuals with Disabilities Education Improvement Act (IDEA) of 2004 (PL 108–446) that are used for children who present significant language learning difficulties (U.S. Department of Education, 2014). Children who present with developmental language difficulties that primarily affect communication and socialization are referred to as having language impairment (LI) during the preschool years or when they are in kindergarten or first grade. Over time, children with LI often demonstrate significant academic problems including poor reading comprehension and written composition skills (Catts, Bridges, Little, & Tomblin, 2008; Scott, 2011) that can continue into adulthood (Johnson, Beitchman, & Brownlie, 2010; Young et al., 2002). Children with a learning disability (LD) primarily present with academic problems that appear during the school-age years. Students with LD are characterized by persistent and intractable difficulties in academic areas, such as literacy, that are often associated with underlying language learning difficulties (Vaughn & Bos, 2014), making them an appropriate target population for study and treatment. Some authors have argued that LI and LD represent a continuum of deficits in language learning (Bashir, Kuban, Kleinman, & Scavuzzo, 1984; Sun & Wallach, 2014). However, most of the authors of the chapters in this volume have decided to refer to these groups separately because they are often treated that way by school assessment teams across the nation. The LI or SLI diagnosis is more commonly used for children in preschool, kindergarten, and first grade who are at the earliest stages of academic learning, whereas the LD diagnosis is more commonly used for children in second grade or beyond who have not profited from academic instruction after having sufficient educational opportunity to do so. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013) uses the term language disorder to refer to children whose language abilities (comprehension or production) are “substantially and quantifiably” below age expectations.

Careful readers will note that the terms language impairment, specific language impairment, primary language impairment, language disorder, and language learning disability are used by the authors of the chapters of this book. Rather than restrict all the authors to the use of one term and, more importantly, to assign meanings to these terms that are not well recognized in the field, we have allowed authors to use terms of their own preference and to define the terms explicitly when they have used them to refer to distinc...