Wednesday, May 25, 2022

The use of questions to scaffold narrative coherence and cohesion: Use of questions to scaffold narrative

Silva, & Cain, K. (2019). The use of questions to scaffold narrative coherence and cohesion: Use of questions to scaffold narrative. Journal of Research in Reading, 42(1), 1–17. https://doi.org/10.1111/1467-9817.12129

    Narrative abilities refer to the telling of a story. Narrative skills require complex language skills including being able to tell a story that makes sense (also known as coherence) and is grammatically correct (also known as cohesion). Coherence refers to how story elements (e.g., character, settings, problem, solution) are included in the story, whereas cohesion refers to how one sentence is related to another by using causal (because) and temporal terms (before). 

    One potential way to improve the quality of narratives is through the use of questions. Some reasons why questions are beneficial include highlighting important aspects of the story, helping children elaborate, and guiding children’s attention to relevant information to include in narratives. However, the timing of the question may be an important factor to consider. Therefore, the goal of this study was to examine whether questions asked before or after narrative production affected the coherence and cohesion of the story. Further, the researchers examined whether cognitive or linguistic abilities were related to narrative skills.

    In this study, 81 4-to 6-year-olds told two stories, one before answering story questions and one after answering story questions. They also completed an assessment battery to measure their cognitive abilities, working memory skills, receptive vocabulary, and grammar knowledge. Results revealed that older children performed better than younger children. More interestingly, answering questions before narrative production improved coherence but not cohesion. Working memory was also related to the narrative coherence benefit. 

    The results are encouraging inasmuch as they suggest that exposure to questions before story telling benefited narrative coherence. Future work in our lab aims to look at how to improve narrative cohesion through the use of questions as well. The results of this work will be clinically important for findings ways to support children’s narrative skills.


Blogger: Theresa Pham is a Postdoctoral Associate working with Drs. Lisa Archibald and Janis Cardy.


Tuesday, April 26, 2022

Governing the voice: A critical history of speech-language pathology

St. Pierre, J., & St. Pierre, C. (2018). Governing the voice: A critical history of speech-language pathology. Foucault Studies, 24, 151-184.

This essay examines the history of the profession of speech-language pathology in the United States. The argument is made that at the beginning of the 20th century, speech became more central to civic and capitalist operations in the U.S. There came to be dominant norms of communication, which could be quantified especially as many children began attending school allowing for the calculation of ‘deviance’ across the population. These differences were considered medical and scientific, not political. The goal of correction was to ‘normalize speech’ (according to norms of civility, class, and whiteness). The question arises as to whether speech correction is a rational social response to non-normative forms of communication? A critical history allows us to question why we hold certain views about speech, and imagine a less ableist view.

This challenging essay provides an important viewpoint for examining the historical basis of practices in speech-language pathology. It points to important racist and ableist influences that continue to shape practice. 


Blogger: Lisa Archibald

Thursday, March 31, 2022

Building Sustainable Models of Research-Practice Partnerships Within Educational Systems

Alonzo, C. N., Komesidou, R., Wolter, J. A., Curran, M., Ricketts, J., & Hogan, T. P. (2022). Building Sustainable Models of Research-Practice Partnerships Within Educational Systems. American Journal of Speech-Language Pathology, 1-13.

    The research-practice gap refers to a disconnect between the latest evidence regarding practice in a field and the practices used in clinical settings. In speech-language pathology there is a current and ongoing movement for the use of implementation science to minimize the research-practice gap. Implementation science studies strategies that facilitate the movement of evidence-based practices into clinical settings. Central to implementation science are sustainable collaborations between researchers and those who use the research or knowledge, called knowledge users. Given the importance of partnerships, researchers have begun to look at how to build partnerships. Henrick and colleagues (2017) propose five critical dimensions for successful partnerships that include: (1) building trust and cultivating partnership relationships, (2) conducting research to inform action, (3) supporting the partner organization in achieving their goals, (4) producing knowledge to inform educational efforts, and (5) building capacity of participating researchers, knowledge users, and the organization.

    In the current article, the authors apply this partnership framework to their own partnerships in elementary schools. They outline three different ongoing partnerships in which they have been involved and describe the characteristics of the three schools, and the researchers and knowledge users included in each partnership. Each partnership also included the use of a knowledge broker who worked with the knowledge users and researchers to support the partnership and its success. The authors then mapped their own experiences onto the five dimensions proposed by Henrick et al., (2017). These authors report that their collaborative projects improved clinical knowledge for both the researchers and knowledge users.

    By sharing their experiences of working in partnerships, the authors provide an example of successful partnerships and how their partnership activities map onto an established framework in the field. Since there is a lot of momentum in communication sciences and disorders to use knowledge translation approaches such as implementation science, examples demonstrating experiences and outcomes support others looking to use similar approaches.

                 

         

Blogger: Meghan Vollebregt is a student in the combined SLP MClSc/PhD program working under the supervision of Dr. Lisa Archibald.

Monday, March 28, 2022

The duality of patterning in language and its relationship to reading in children with hearing loss

Nittrouer, S., (2020). The duality of patterning in language and its relationship to reading in children with hearing loss. Perspectives of the ASHA Special Interest Groups, 5, pp. 1400-1409.

    By the time we reach adulthood, reading is something we do without thinking about it. However, reading is a task that we spend years of our lives learning to do and practicing as children. It involves coordinating multiple skills, from recognizing the letters on a page to understanding the meaning behind what is written. Nittrouer (2020) discusses the concept of duality of patterning in which two different levels of structure are involved in reading: the semantic level, referring to the words that make up speech and their meanings, and the phonological level, referring to the sounds that make up words. These two levels work together in language, but develop somewhat separately. When learning a new language, development begins with the semantic level (or meaning) followed by the phonological level (or sounds).

    For children with hearing loss, some of the auditory information they hear will be degraded (even with hearing aids), which causes more problems for learning phonological than semantic information. To look at how this impacts the learning to read in children, Nittrouer (2020) followed a group of 122 US children: 49 with normal hearing (NH), 19 with moderate hearing loss and using a hearing aid (HA), and 54 with moderate-to-profound hearing loss and using a cochlear implant (CI) from infancy to grade 8. The researchers found that those with hearing loss had lower vocabulary skills than those with normal hearing, with the CI group showing lower performance than the HA group. On measures of phonological structure, children with normal hearing had higher scores than their peers with hearing loss, and again, those with CIs scored lower than those with HAs. Although these skills improved for everyone, by grade 8, the CI group had reached a level equivalent to that of the normal hearing group in grade 2, suggesting significant difficulty for the CI group in phonological structure. In reading, the normal group used phonological processes for phonological tasks and semantic processes for semantic tasks. In contrast, however, the groups with hearing loss used both phonological and semantic processes for phonological and semantic tasks, suggesting that they relied on a combination of both, especially for the phonological tasks.

    The authors suggest that intervention for children with hearing loss should include the use of meaningful structures, visual speech signals, and target both the semantic and phonological levels of structure throughout childhood.


Blogger: Rachel Benninger is a combined MClSc/PhD student working under the supervision of Dr. Lisa Archibald



Tuesday, February 15, 2022

Are Individual Differences in Response to Intervention Influenced by the Methods and Measures Used to Define Response? Implications for Identifying Children With Learning Disabilities.

Hendricks, & Fuchs, D. (2020). Are Individual Differences in Response to Intervention Influenced by the Methods and Measures Used to Define Response? Implications for Identifying Children With Learning Disabilities. Journal of Learning Disabilities, 53(6), 428–443. https://doi.org/10.1177/0022219420920379

Measuring response to intervention is important for capturing change in a student’s progress over time. However, there are numerous ways to measure change, highlighting a need to understand how different methods and measures are used to claim that a student has indeed changed as a result of the intervention. In this study, the authors compared three measures (near-transfer vs. mid-transfer vs. far-transfer) and two methods (final status vs. growth method) to evaluate response to their reading intervention:

Briefly, in their reading intervention, students who had poor reading skills were tutored 3x/week for 14-15 weeks. In each 45-minute session, students were taught strategies for understanding texts related to social studies or science topics. Students were then tested on their knowledge by answering multiple choice questions related to the passage they read.

Measures:

1. Near-transfer: Near-transfer refers to applying the knowledge learned from the intervention to a very closely related task. Near-transfer passages used the same social studies or science topics, but different passages than those used in the intervention.  After reading the passage, students answered multiple-choice questions, similar to the structure of the intervention.

2. Mid-transfer: Mid-transfer passages were about topics not addressed in the program (e.g., geography), but following the same format. Students were assessed with both multiple-choice questions and fill-in-the-blank questions. 

3. Far-transfer: Far-transfer would indicate that learning applied beyond the trained tasks. In this study, standardized reading comprehension tests were used as a measure of far-transfer. This included the Wechsler Individual Achievement Test and Gates-MacGinitie Reading Test.

Methods: 

1. Final status: The final status (also called “normalization method”) was captured in two ways for the standardized vs. experimental tasks. On the far-transfer tests, students were identified as having changed if they received a final, post-treatment score above a standard score of 100 (50th percentile). On the near- and mid-transfer tests, students were classified as having changed if they had final scores of 75% and 87.5% correct on these experimental tasks. 

2. Growth method: The growth method was also captured in two ways. The authors were able to calculate the reliable change index (RCI) for the standardized tests. RCI compares pre- and post-treatment outcomes; students who changed would have an RCI of greater than 1.96 (corresponding to a cut off on the standardized normal curve indicating the 5% tail of the distribution) . A “limited norm criterion” was used to capture change in the experimental tasks. Here, the authors determined the average change score for the group and students who made a reliable change improved their post-treatment score at/above that value. For example, students would have to improve their score by 3.5 on the near-transfer task to be classified as having changed. 

The results revealed that different measure-method combinations captured change differently. Rates of change ranged from 19% (far-transfer using RCI) to 80% (near-transfer using final status) depending on the method being used. Accordingly, there was low and inconsistent agreement on who improved across the methods of identifying change. On most measures, it was revealed that students with higher pretreatment scores were more likely to be classified as changed. However, on some growth measures, a slightly different pattern emerged: children with lower pretreatment scores (e.g., on all transfer-related measures) were more likely to have improvements following the intervention. 

The authors conclude that while capturing change is important to evaluate the effectiveness of intervention more broadly, the methods for doing so are currently arbitrary. Having benchmarks to compare responsiveness among measures would be useful for clinical decision making and we await future research to come to a consensus on how we should define change.


Blogger: Theresa Pham is a Postdoctoral Associate working with Drs. Lisa Archibald and Janis Cardy.


Wednesday, January 12, 2022

‘Making the Most of Together-Time’: Development of a Health Visitor Led Intervention to Support Children’s Early Language and Communication Development at the 2-2½ Year-Old Review

McKean, C., Watson, R., Charlton, J., Roulstone, S., Holme, C., Gilroy, V., & Law, J., (preprint). ‘Making the Most of Together-Time’: Development of a Health Visitor Led Intervention to Support Children’s Early Language and Communication Development at the 2-2½ Year-Old Review. Research Square.

    Poor language development may negatively affect many areas of an individual’s life including education and literacy, mental health and social-emotional well-being, and even employment. Early intervention is important, but challenging. This study reported on a process of developing an evidence-based intervention program for healthcare visitors in The Healthy Child Programme (UK) to implement to improve the health of babies, children, and their families in the UK. The goal was to develop the intervention by working together with practitioners and the parents of children currently receiving speech and language services. The paper reports the intervention design process.

    The development process included 5 stages made up of a series of reviews of literature, study team workshops, the development of workshop materials, the development of material and intervention prototypes, and multiple rounds of co-design workshops held with parents and practitioners. Following each stage, the research team used what they had learned to help prepare for the next stage of development. The involvement of the parents and practitioners allowed the research team to gather other perspectives and input from those individuals who would be directly involved in using the intervention.

    Briefly, the final intervention model consists of having the Health Care Visitors show parents how to use a specific behaviour for just 10-15 minutes per day to target a specific language goal for their child. Depending on the needs of the specific child/family, the Health Care Visitor would provide support at one of three levels. For example, if the child was at a low risk for poor language development, the family would be provided with resources to help them create an environment that would support language development (these same resources were provided to all families). If the child was identified as being at risk of poor language development and the family had access to resources and support, the Health Care Visitor would use a self-directed approach, meaning they would show parents/caregivers how to use various strategies to support their child’s language development. Finally, if the child was at risk of poor language development, but the family had barriers in accessing resources or supports (for example, financial barriers, geographic barriers, physical barriers), the Health Care Visitor used a coaching approach, where additional face-to-face support and additional resources (such as books or social supports) were provided.

    This study provides an excellent road map for how a team of researchers, clinicians, and end-users can partner together to design a feasible intervention system that fits a service context and provides a model for early intervention more broadly.


Blogger: Rachel Benninger is a combined MClSc/PhD student working under the supervision of Dr. Lisa Archibald



Thursday, December 2, 2021

The Girl Was Watered by the Flower: Effects of Working Memory Loads on Syntactic Production in Young Children

Adams, & Cowan, N. (2021). The Girl Was Watered by the Flower: Effects of Working Memory Loads on Syntactic Production in Young Children. Journal of Cognition and Development, 22(1), 125–148. https://doi.org/10.1080/15248372.2020.1844710

Working memory is the ability to maintain information in mind while manipulating that (or other) material in some way. Working memory is important for language production and comprehension tasks such as sentence repetition. Sentence repetition draws on language and working memory skills in order to hear and understand the sentence, retain the meaning of the sentence in mind, and then formulate and produce the sentence for recall. Working memory resources may be needed differently for different types of sentences, however. For instance, after hearing a passive sentence (the flower was watered by the girl), less working memory resources might be needed to use the more familiar active form (the flower was watered by the girl). On the other hand, it could be that verbatim repetition of passive sentences is easier than transforming the passive sentence into an active form. The aim of the current study was to understand how working memory loads affect recall of passive sentences.

Across two studies, children ages 4-6 completed a sentence repetition task with and without a memory load. An auditory-verbal memory load was imposed by having children store a list of spoken digits in mind. A visuo-spatial memory load was imposed by having children store a series of spatial locations in mind. Experiment 1 unfolded as follows: (1) children listened to passive sentences, (2) retained the memory load, (3) described the same pictures as shown in (1) (children were not explicitly told to use a passive voice), and (4) recalled the memory load by saying the digits or drawing the location. In Experiment 2, children were explicitly instructed to use the passive voice in step (3) of the procedure.

The results of Experiment 1 suggested that children were likely to use passive sentences with and without a memory load. In Experiment 2, children were more likely to use the passive voice with a visual-spatial load and active sentences without a memory load. Because passive sentences were retained even with reduced working memory resources, the authors suggested that children were simply repeating sentences verbatim. Additional support for simple repetitions came from the types of errors children made. Although children were using the passive voice, they made semantic errors such as switching the roles of the nouns (the girl was watered by the flower).

The results suggest that children can repeat sentences verbatim without understanding them, whereas working memory resources are required to make more semantically accurate responses. Given that immediate sentence recall tasks are used as part of language assessment in speech-language pathology, it is important for clinicians to understand the influence of language and memory on performance. As well, it is important to consider going beyond scoring number of errors to potentially understanding the types of errors being made.


Theresa Pham completed the combined SLP MClSc/PhD program under the supervision of Dr. Lisa Archibald.

Tuesday, October 5, 2021

The Effects of Different Sources of Stuttering Disclosure on the Perceptions of a Child Who Stutters

Snyder, G., Williams, M. G., Adams, C., & Blanchet, P. (2020). The Effects of Different Sources of Stuttering Disclosure on the Perceptions of a Child Who Stutters. Language, Speech & Hearing Services in Schools, 51(3), 745–760. https://doi.org/10.1044/2020_LSHSS-19-00059

 

Stuttering is a speech disorder involving disruptions, or ‘disfluencies’ in a person’s speech. People who stutter are often subject unfounded prejudice and negative stereotypes. People who stutter are often perceived to be quiet, guarded, anxious, and poor communicators. There is growing recognition of the therapeutic role of self-advocacy in stuttering treatment. One such strategy is stuttering self-disclosure, the act of telling someone else that you stutter. Self-disclosure has been found to have positive effects on a stutterer’s quality of life. Telling someone you stutter can be very challenging for a stutterer. Positive impacts have also been reported when a mother or teacher provides the stuttering disclosure on a child’s behalf. Past research has specifically addressed oral stuttering disclosure, but the current study focused on written disclosure.

There were 4 groups in this study: (1) Control participants viewed a 55 second video speech sample of a child who stuttered; the remaining participants view a written statement prior to the video either from the (2) child, (3) mother, or (4) teacher. Participants were then asked to rate the child’s speech skills and personality characteristics. Overall, few effects were found. Ease of listening was rated ‘easier’ when mothers or teachers disclosed. As well, ratings of more ‘calmness’ were found in the case of child or mother disclosure; and ratings of more ‘relaxed’ were found in the case of mother disclosure.

In this study, there was no direct comparison to an oral disclosure condition. As well, the disclosure statement did not provide any information other than stating the person in the video was a stutterer and stuttering might be observed in the video. It is possible that the disclosure statement may not have appeared authentic as something a child would say.

The authors suggest that a written disclosure statement may be used in stuttering treatment as a ‘stepping stone’ towards oral disclosure. For example, a child might write the statement, share it with advocates, practice reciting the statement orally, and then begin sharing it with others orally.



                          


Blogger: This article was reviewed by David Liu, a first year student at Western and a volunteer in the Language and Working Memory Lab. You can read more about David’s journey navigating stuttering on the Canadian Stuttering Association website: https://stutter.ca/articles/personal-stories/708-breaking-free-one-word-at-a-time.html

Thursday, September 23, 2021

The Contribution of Vocabulary, Grammar, and Phonological Awareness Across a Continuum of Narrative Ability Levels in Young Children

Khan, K. S., Logan, J., Justice, L. M., Bowles, R. P., & Piasta, S. B. (2021). The Contribution of Vocabulary, Grammar, and Phonological Awareness Across a Continuum of Narrative Ability Levels in Young Children. Journal of Speech, Language, and Hearing Research, 1-15.

 

Storytelling, or narrative ability, is a complex task that relies on many linguistic and cognitive skills. Oral language skills such as vocabulary, grammar, and phonological awareness support a child’s ability to both construct a story and retell a story. As these lower-level language components (i.e., vocabulary, grammar, phonological awareness) develop, increases are seen in the complexity of a child’s narrative language skills. Prior research has demonstrated strong associations between vocabulary, grammar, phonological awareness, and narrative skills. However, what is less known about the relationship is what unique contribution to narrative ability comes from each vocabulary, grammar, and phonological awareness and if specific associations among these lower-level skills vary at different points along the range of narrative ability.

 

In this study, 336 preschool and school age children completed an assessment battery to evaluate narrative ability, vocabulary, grammar, and phonological awareness. A narrative index was derived to reflect narrative skill while controlling for differences in age. Results demonstrated that combined vocabulary, grammar, and phonological awareness contributed to 13% of the variance in the narrative index. To understand any specific associations between the lower-level skills and the range of narrative ability, the authors looked at these associations for children preforming below average, at average, and above average on the narrative index. They found interesting differences across profile. For below average profiles, phonological awareness and vocabulary accounted for significant variance in narrative scores. For average profiles, grammar and vocabulary accounted for significant variance, and for above average profiles, only vocabulary accounted for a significant amount of the variance in narrative scores.

 

Clinically, it is interesting to note that different lower-level language skills accounted for a significant amount of the variance in narrative ability at differing skill levels. Further research has the potential to enhance our understanding for identifying specific targets in therapy depending on skill level. These findings also highlight the importance of vocabulary knowledge at any skill level. This research increases our understanding of the relationship between lower-level language skills and narrative ability.



                          

Blogger: Meghan Vollebregt is a student in the combined SLP MClSc/PhD program working under the supervision of Dr. Lisa Archibald.

Thursday, July 8, 2021

Tiered Approaches to Rehabilitation Services in Education Settings: Towards Developing an Explanatory Programme Theory

VanderKaay, S., Dix, L., Rivard, L., Missiuna, C., Ng, S., Pollock, N., Whalen, S. S., Eisen, I., Kyte, C., Phoenix, M., Bennett, S., Specht, J., Kennedy, J., McCauley, D., & Campbell, W. (2021). Tiered Approaches to Rehabilitation Services in Education Settings: Towards Developing an Explanatory Programme Theory. International Journal of Disability, Development and Education, 1-22.

Rehabilitation disciplines (i.e., speech-language pathology, occupational therapy, physiotherapy) often use a range of approaches with increasing support as required (called tiered approaches) to provide interventions in education settings. In a Response to Intervention (RTI) or tiered approach, tier 1 services are provided at a classroom-wide level, tier 2 services are provided to students who require some additional support, and tier 3 services are provided to students who require individualized and more intensive services. There are several benefits to using a tiered approach to services including early identification of difficulties, reduction in waitlist times, etc. Some barriers include insufficient resources and lack of clarity regarding professional roles at different tiers. Although much is known about the outcomes of using a tiered approach to intervention services, there is a lack of specific explanatory theories related to tiered rehabilitation service delivery in education.

One way to develop a theory is to use Realist Evaluation. Using realist evaluation allows for the development of a theory that answers “how, why, for whom, to what extent and in what context”. Realist Evaluation allows for the identification and examination of variables that impact the outcome of a program. Realist Evaluation outlines that the outcomes of the program are impacted by both mechanisms (i.e., how individuals in the program respond to the program) and contexts (i.e., setting, structure, environments).

In this study, the authors identified that their main goal was to develop the first theory for tiered rehabilitation services in education settings. As a first step in achieving this goal, the authors completed a realist synthesis of the literature to identify the relevant contexts, mechanisms, and outcomes from articles collected in their literature review. The realist synthesis identified 52 articles that reported on tiered rehabilitation services in education. From these articles the authors summarized the findings relating to outcomes, context, and mechanisms. Within outcomes three factors were identified and themes were included within each category: children and youth (e.g., greater sense of inclusion), parents and professionals (e.g., increase knowledge and skill), and systems (e.g., timely intervention). Three different contexts were identified including the macro-level (e.g., high-quality, universal curriculum), meso-level (e.g., clear guidelines for tiered approaches), and micro-level (e.g., rehabilitation professionals with relevant skills). Three different categories were identified in mechanism including collaborative relationships (e.g., common frameworks), authentic services (e.g., services are fluid and flexible), and building capacity (e.g., give and take of ideas).

These results are a first step in building a theory for tiered rehabilitation services in education. Future work from these authors will look at the relationship between the contexts and mechanisms and the influence on the outcomes of a program. The results of this work will be useful for reflecting on the current use of tiered services and future application of this approach to service.



                          

Blogger: Meghan Vollebregt is a student in the combined SLP MClSc/PhD program working under the supervision of Dr. Lisa Archibald.