Collaborative working with parents of children with DLD in speech and language therapy: Identifying Dutch speech and language therapists’ barriers to enhancing practice

Klatte et al. (2025). Collaborative working with parents of children with DLD in speech and language therapy: Identifying Dutch speech and language therapists’ barriers to enhancing practice. Research in Developmental Disabilities, 156, 104882. https://doi.org/10.1016/j.ridd.2024.104882

It is generally accepted that it is important to involve families in decision-making in the context of health and wellbeing interventions for young children. Such family-centred care requires collaboration between families and the professionals providing the services. This collaboration involves joint input on goals, planning, implementation and evaluation. In some contexts, a move to family-centred care requires practice change. Past studies by this author group have focused on identifying collaboration in behavioural terms, choosing select behaviours to target for change, and how to implement the behaviour for change. The current study focused on what needed to change in order to adopt the target behaviours.

In this study, focus groups were conducted with speech-language therapists (SLTs) in the Netherlands. Either in preparation for or during the focus groups, participants completed three assignments focused on (1) describing a challenging collaboration, (2) identifying parent priorities, or (3) establishing goals. Participants placed figures to position the parent, child and themselves for collaboration. They also wrote down their thoughts, feelings and actions. Participants then discussed their responses as a group. Results revealed two types of beliefs: beliefs about how SLTs can be supported in collaborating with parents (i.e., need for confidence, knowledge, skills) and (2) beliefs that are in conflict with collaborative working with parents (i.e., related to professional identity, consequences, emotion, environmental context and resources, social influences). More specifically, SLTs reported feeling pressure from parents, society and health insurances to spend their time on working directly with children, which hinders collaborating with parents.

It can be challenging for speech-language pathologists (SLPs) and SLTs to work collaboratively with parents in the context of high service demands. One important goal in this area would be to increase SLP/SLTs confidence in collaboration skills. 

Blogger: Lisa Archibald

Quantity and Complexity of Speech-Language Pathologists’ Talk During School-Based Therapy

Sun, J., Justice, L. M., Jhuo, R.-A., & Jiang, H. (2025). Quantity and Complexity of Speech-Language Pathologists’ Talk During School-Based Therapy. American Journal of Speech-Language Pathology, 1–15. https://doi.org/10.1044/2024_AJSLP-24-00303

Children with developmental language disorder (DLD) have difficulties learning language for no obvious reasons. Speech and language therapy is critical in helping children with DLD develop their language skills. One way speech-language pathologists (SLPs) can promote language growth is by using child-directed speech (e.g., how SLPs talk to children) to create a language rich-environment. We know from previous work that how parents and teachers talk to children influences children’s language growth, but this has not yet been studied in SLPs. Based on a previous study from this same research group (Sun et al., 2023), SLP talk was measured in the following ways: 1) Quantity – the volume of talk was characterized by number of utterances and number of words; 2) Grammatical complexity – based on auxiliary verbs/copulas, conjunctions; and 3) Lexical complexity – based on verbs, adjectives, and different words used. 

There are also SLP-specific and session-specific factors that may contribute to language growth. The current study focuses on 5 SLP characteristics: years of experience, caseload size, job satisfaction, self-efficacy, and time pressure; and 9 session characteristics: number of children in session, session duration, child’s age, grade, gender, family income, and measures on language, phonological awareness, and intelligence. The aim was to determine these factors predicted SLPs’ talk (e.g., quantity, grammatical complexity, lexical complexity).

The study involved observing 75 SLPs and 281 children (kindergarten to grade 2) across 209 business-as-usual therapy sessions. The findings showed wide variability in SLP talk. For example, number of words used (indexing quantity) ranged from 167-4000 per session. Further, some characteristics studied were related to SLPs’ quantity and complexity of talk, but not others. In terms of SLP characteristics: 1) SLPs with more years of experience produced less quantity of talk; 2) higher time pressure was positively linked to all dimensions (e.g., more quantity, greater lexical and grammatical complexity). In terms of session characteristics: 1) longer sessions led to more talk and more complex talk; 2) the older the child, the more complex the SLP’s talk; 3) lower phonological awareness score was linked to greater quantity and complexity too.  

Overall, the findings serve as a starting point for understanding how SLP talk can serve as a source of rich language input during therapy sessions, and what factors potentially influence the quantity and quality of talk. More research is needed to understand how we can leverage on SLPs’ and other professionals’ (e.g., educators) talk as a means to improve language outcomes for children with DLD.

 Blogger: Theresa Pham is a Postdoctoral Associate.

Sharing stories versus explaining facts: Comparing African American children’s microstructure performance across fictional narrative, informational, and procedural discourse

Gardner-Neblett, N., & Alvarez, D. L. (2024). Sharing stories versus explaining facts: Comparing African American children’s microstructure performance across fictional narrative, informational, and procedural discourse. Journal of Speech, Language, and Hearing Research, 67(11), 4431–4445. https://doi.org/10.1044/2024_JSLHR-23-00579

Discourse refers to the ability to put spoken (or written) utterances / statements together in communicative tasks. Fictional stories (or narratives) are one type of discourse. Young children often hear and are encouraged to tell stories. Other types of discourse involve explanations or descriptions. For example, information discourse refers to telling factual information about something (e.g., dinosaurs) and procedural discourse is when the steps of a task are described. A key feature of effective discourse is microstructure, or the sentence level grammatical features. Microstructure can be measured in terms of how many words or different words are produced (i.e., productivity) or the grammatical structure of sentences (i.e., complex sentence structures).

In this study, 130 African American kindergarten through second-grade students were shown wordless picture books to elicit three types of spoken discourse: narrative, procedural, informational. The findings showed that children produced longer and more diverse language in fictional narratives compared to informational and procedural discourse. Fictional narratives and procedural discourse also demonstrated more complex sentence structures than informational discourse. Additionally, older children generally outperformed younger ones in productivity and complexity, particularly in fictional and informational discourse.

The findings suggests that educators and speech-language pathologists should consider different discourse types when assessing and supporting children’s language development. Expository discourse is often used in teaching, so children may benefit from targeted strategies to develop their expository language skills.

Blogger: Diya Nair is a first year PhD student under the supervision of Dr Lisa Archibald

Oral and written discourse skills in deaf and hard of hearing children: The role of reading and verbal working memory

Arfé, B. (2015). Oral and written discourse skills in deaf and hard of hearing children: The role of reading and verbal working memory. Topics in Language Disorders, 35(2), 180-197. https://doi.org/10.1097/TLD.0000000000000054

Discourse skills include a person’s ability to organize and communicate information, such as a narrative or story. Storytelling requires one to use linguistic skills (e.g., knowledge of what words mean and how to combine them into a sentence) and cognitive-linguistic skills (e.g., using word knowledge to make connections between different parts of a story). How one uses these storytelling skills can look different depending on whether they tell the story aloud (orally) or in writing. For example, a written story can be revised, allowing for more control of the story being told. However, written storytelling also requires that attention is given to the writing process, which uses greater cognitive resources. Both written and oral storytelling requires holding information in one’s memory, which can challenge one’s working memory as well (e.g., with the need to hold onto information, and/or the need to hold information while performing other tasks). One important discourse skill for storytelling is the ability to tie together pieces of a story, or to generate coherence relations – meaningful links between parts of a story. These storytelling skills are difficult for children who are deaf and hard of hearing (DHH). DHH children have varied language backgrounds but often have limited access to spoken language and limited experience with storytelling in sign language. 

In a study addressing the discourse skills of DHH children, Arfé compared the written and oral narrative skills of DHH children (aged 7-15) to a group of school-age matched hearing peers (aged 7-13). Children were asked to tell a story (both orally and in writing) based on the wordless picture storybook. A standardized reading comprehension task and measures of working memory (forward and backward digit span tasks) were also used. Researchers considered the productivity (the number of words and clauses produced), story structure (the number of story grammar elements included; e.g., setting, initiating event, two or more episodes, and conclusion), and coherence (the meaningful relations between clauses within the story) as measures of discourse.

Arfé found that the hearing children scored higher than the DHH children on reading skills and measures of working memory. For oral stories, hearing and DHH children produced stories of similar number of words and used the same number of story structure elements. DHH children produced more clauses than hearing children, while hearing children produced more coherence relations than DHH children. For written stories, hearing and DHH children produced an equivalent number of clauses, but hearing children outperformed DHH children on measures of number of words, story structure elements included, and coherence relations.

Overall, the discourse skills of DHH children were poorer than those of their hearing peers, but this difference was more pronounced in written storytelling. DHH children need support in the classroom for the development of both oral and written discourse skills, and may benefit from addressing poor working memory skills as well. Exposing DHH children to narratives or teaching them how to construct stories may not be enough to help develop these skills. Additional support will likely be needed, for example, through scaffolding and collaborative writing, story elaboration, and story retelling, both in oral and written language.

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

Internal state terms in the narratives of bilingual children with developmental language disorder: The role of microstructure and macrostructure

Altman, C., Fichman, S., Perry, N., Osher, P., & Walters, J. (2024). Internal state terms in the narratives of bilingual children with developmental language disorder: The role of microstructure and macrostructure. Language, Speech, and Hearing Services in Schools, 55(4), 1039–1053. https://doi.org/10.1044/2024_LSHSS-23-00170

"Internal state terms" or ISTs are words and phrases that describe thoughts, emotions, perceptions, and physiological states, such as "think," "happy," or "see." These terms are crucial in storytelling as they help explain characters' motivations, feelings, and reactions, making narratives richer and more coherent. Stories also have a macrostructure and microstructure. Microstructure refers to the use of language at the word and sentence level, including grammar. Macrostructure, on the other hand, involves the overall organization of the story, including key narrative elements like setting, character goals, and emotional responses. The ability to tell a story is important as it supports the development of vocabulary, complex language, and later academic skills.  Children’s narrative ability or the ability to tell a story develops as early as 2 years and is refined by the age of 8. Children with a persistent difficulty learning language known as developmental language disorder (DLD) have been found to tell stories with fewer macro- and microstructure elements than their typically developing peers. Much of the research on narratives focuses on monolingual speakers. Research with bilingual speakers is very much needed. 

This study explored how bilingual children with DLD use language in storytelling. Russian-Hebrew bilingual preschoolers (n=58) with and without DLD were asked to create stories using a wordless picture book, and ISTs, microstructure and macrostructure were analyzed. Results revealed that children with DLD produced fewer ISTs and showed limited diversity in the types of ISTs used. Their narratives were often shorter, with less variation in vocabulary and simpler sentence structures, reflecting weaker microstructure skills. On the macrostructure level, they also struggled to include essential storytelling elements such as describing characters' goals, emotional reactions, and outcomes, leading to less coherent stories overall.

These findings suggest that bilingual children with DLD face challenges at the level of ISTs, microstructure and macrostructure. The study highlights the importance of language intervention strategies that target macrostructure, microstructure, and use of ISTs to help children build stronger narrative skills. 

Blogger: Diya Nair is a first year PhD student under the supervision of Dr Lisa Archibald

Measuring the Effects of Cognitive Capacity on Sentence Comprehension: Evidence From Elementary School-Age Children

Magimairaj, B.M., Nagaraj, N.K., & Gillam, R.B. (2024). Measuring the effects of cognitive capacity on sentence comprehension: Evidence from elementary school-age children. Journal of Speech, Language, and Hearing Research, 67(10), 3778-3793.

Sentence comprehension in children is a complex process involving various cognitive mechanisms beyond vocabulary and syntax. One critical aspect of this process is working memory (WM) capacity, which refers to the ability to hold and manipulate information in the mind over short periods. Additionally, retrieval from long-term memory (LTM) plays a significant role in how children understand sentences. This study aimed to explore these cognitive predictors of sentence comprehension in elementary school-age children, focusing on how WM and LTM interact during comprehension tasks.

In this study, children with typical development or Developmental Language Disorder (DLD) completed a sentence comprehension task by choosing a picture corresponding to a spoken sentence. Comprehension of adjectives included in the sentences either was or was not required to choose the right picture creating sentences of high or low cognitive load, respectively. Children also completed working memory tasks involving digit recall and a long-term memory task requiring categorizing or judgement of meaning relationships. The DLD group had lower comprehension accuracy, particularly when processing sentences requiring higher cognitive effort. As well, working memory was found to be a stronger predictor of comprehension accuracy than long-term memory. 

The findings suggest that children with DLD may struggle more with the demands placed on their WM capacity when interpreting complex sentences.

Blogger: Niloufar Ansari Dezfuly is a PhD Candidate working under the supervision of Dr. Lisa Archibald.

Supporting literacy development in kindergarten through teacher-facilitated play

Pyle, A., Wickstrom, H., Gross, O., & Kraszewski, E. (2024). Supporting literacy development in kindergarten through teacher-facilitated play. Journal of Early Childhood Research, 22(3), 428–441. https://doi.org/10.1177/1476718X231221363

Play-based learning is essential for supporting children’s learning during the early years. In fact, playful pedagogy is mandated as part of the current Ontario kindergarten curriculum. While it may sound simple to teach language and literacy skills in play, educators have expressed challenges related to (lack of) knowledge and confidence in knowing how and when to teach goals during play in a balanced way. The current study seeks to understand how different types of play may support different types of literacy skills. 

This study involved observing 30 kindergarten classrooms in Ontario. Observations were coded for the type of play observed and literacy skills targeted during play.

Play was defined as:

• Free play – Child-directed play with minimal educator involvement
• Teacher-direct play – Teacher-led activities with direct instruction and explicit steps that children follow
• Guided play – Educators create a context to focus on specific learning goals, while children direct play. Guided play is a combination of free play and teacher-directed play

Literacy skills were defined as:

• Alphabetics – Alphabet knowledge and decoding skills
• Fluency – Reading with speed and accuracy
• Comprehension – Understanding text and vocabulary
• Text conventions – Playing with books; book handling 
• Writing – Games with writing
• Oral language – Form (e.g., structure, grammar) and use (non-literal language) of language as well as storytelling skills

Results found that different types of play lend themselves well to targeting different types of literacy skills. Free play was the most common type of play in Ontario kindergarten classrooms. Free play targeted skills like text conventions and oral language. Teacher-directed play was the second most common form of play, targeting alphabetics, fluency, and writing skills. While guided play was the least common, all literacy skills were targeted during guided play. The authors advocate for enhancing guided play practice to support literacy skills in a more comprehensive way. 

We are also interested in the potential of guided play to support the full spectrum of oral language skills including grammar, vocabulary, sentence structure and length, and verbal reasoning. Another consideration is that talk during play may be good for good talkers, but those with weak oral language skills (English language learners, developmental language disorders) would require intentional instruction. 

 Blogger: Theresa Pham is a Postdoctoral Associate.

A meta-analytic review of the relations between motivation and reading achievement for K–12 students

Toste, J. R., Didion, L., Peng, P., Filderman, M. J., & McClelland, A. M. (2020). A meta-analytic review of the relations between motivation and reading achievement for K–12 students. Review of Educational Research, 90(3), 420-456.

Developing proficiency in reading is crucial to success for students at school and beyond. Growing evidence indicates that motivation plays a significant role in predicting reading performance over and above what is explained by cognitive and academic skills. Consequently, increasing knowledge on the relations between motivation constructs and reading has the potential to improve understanding of reading development and achievement. It can also inform investigations into how motivation might be applied to reading intervention.

In this meta-analysis, the authors sought to build on the previous literature by investigating the relations between motivational processes and reading in students across the school years (kindergarten through to grade 12). One of the issues identified was that motivation is complex and multidimensional, and research has been based on a range of theories which can be overlapping. This has led to inconsistency in the terminology and definitions used by researchers, creating challenges in understanding in the area. The authors used Conradi et al.’s (2014) hierarchy for categorizing and defining motivation constructs to, firstly, investigate the relationship between ‘a broad construct’ of motivation and reading in the literature. This hierarchy defines three constructs (goal orientation, beliefs, and disposition), with subconstructs under each of these. Intrinsic motivation was also included in the analysis. The authors then explored other potential moderators of interest -

(a) reading domain (code vs meaning focused)

(b) reading ability (typically developing vs students with learning disabilities or at risk)

(c) grade (elementary vs secondary)

Interactions between these moderators was examined, along with the influence of year of publication and motivation measure type (domain specific vs general). Directionality between motivation and reading in longitudinal investigations was also examined.

The search of the literature identified 132 peer-reviewed articles with 185 independent samples. Results indicated a significant, moderate relation between motivation and reading (r= .22, p< .001) with beliefs and disposition showing a stronger relation to reading than goal orientation. The authors propose that this suggests that motivation constructs can be different for different students, rather than a simple dichotomy of students being motivated or unmotivated.

No other significant interactions were found between the three motivation constructs, nor with the other moderating factors (reading domain, reading ability, grade) or between the moderating factors themselves. The authors found it surprising that the findings of the meta-analysis did not support the literature or the authors’ hypotheses that (a) struggling readers would have lower motivation than typically developing students, and (b) motivation decreases as students get older. The possible reasons for this are discussed. The longitudinal studies identified in the sample, all with typically developing students, suggested earlier reading is a stronger predictor of later motivation than motivation is of reading, reinforcing the importance of early reading instruction and intervention.

Reference:

Conradi, K., Jang, B. G., & McKenna, M. C. (2014). Motivation terminology in reading research: A conceptual review. Educational Psychology Review, 26, 127-164.

Blogger: Katrina Kelso is a Postdoctoral Associate working with Dr. Lisa Archibald.

Lexical-semantic organization as measured by repeated word association in children who are deaf and hard of hearing who use spoken language

Rush et al. (2023). Lexical-semantic organization as measured by repeated word association in children who are deaf and hard of hearing who use spoken language. JSLHR, 66, 3925-39.

Word knowledge is usually measured in terms of quantity, that is, the number of words a child knows. However, the way a child links and stores words for retrieval is another important component of word knowledge called lexical-semantic organization. There are 3 subprocesses involved in word learning: (1) Triggering – recognition that a word is new and must be learned, (2) configuration – recognizing and mapping a phonological (speech sound) and semantic (meaning-based) representation of a new word to what it refers to, and (3) engagement – the necessary interaction between a new word and the child’s existing word knowledge to facilitate organization of stored words. Perhaps unsurprisingly, children who are deaf and hard of hearing (DHH) tend to know fewer words than their hearing peers. Available research suggests that children who are DHH may have difficulty with the triggering and engagement subprocesses of word learning, although research addressing configuration is limited. One task used to study lexical-semantic organization is a repeated word association task. In this task, an individual prompt (e.g., the word turtle) is repeated multiple times and an individual is expected to provide a different single word response each time. Responses can be analyzed in terms of their relation to the target, for example, whether responses are semantically related, clang (share sounds or rhyme with the target word), or error responses. With development, hearing children typically provide more semantically related response.

In this study, kindergarten and grade 1 children who were typical hearing, wearing hearing aids, or with cochlear implants completed a repeated word association measure including 24 stimuli words (12 nouns, 12 verbs, included in text). Each word was presented 3 different times and the child was asked to verbally respond with the first word that comes to mind but to tell a new word each time they heard the same word. No differences in responses were noted between the hearing aid and cochlear implant groups, and so these groups were collapsed for further analysis. Results indicated a developmental increase in semantically related responses to target words regardless of hearing status. The younger DHH group produced more errors and when those errors were not semantically related, they produced more errors that were not clearly in the semantic network of the target word. The authors argued that this result could suggest that young children who are DHH may not organize their words using the most efficient strategies when learning new words. Over time, however, children with DHH showed similar lexical-semantic organization as typically hearing peers.

Measuring lexical-semantic organization may provide important information about a child’s lexical organization and flexible use of words. This information could help to understand a child’s word knowledge in more depth.

Blogger: Lisa Archibald

Dynamic Assessment of Narrative Skills for Identifying Developmental Language Disorder in Monolingual and Bilingual French-Speaking Children

Hadjadj, O., Kehoe, M., & Delage, H. (2024). Dynamic assessment of narrative skills for identifying developmental language disorder in monolingual and bilingual French-speaking children. Language, Speech & Hearing Services in Schools, 55(1), 130–151. https://doi.org/10.1044/2023_LSHSS-23-00054

Narratives are useful for assessing language skills in children, covering various domains like vocabulary and grammar. Typically, kids start storytelling with basic plots by age 5 and progress to more complex narratives by age 9. Children with language disorders struggle with both the structure (macrostructure) and details of stories (microstructure). While it is simpler to assess monolingual children for language disorders, bilingual children often are misdiagnosed due to less accurate assessment tools. In bilingual children, exposure time to each language along with age of learning second language are crucial when determining the storytelling abilities, with those exposed to a language later showing weaker language skills, resembling monolingual children with language disorders. Assessing bilingual children in all their languages is crucial to avoid misdiagnosis, but it's often challenging due to language diversity. Various tools, like parental questionnaires and language samples, can help evaluate bilingual children's language skills effectively. Dynamic assessment evaluates children's learning potential rather than static knowledge. It's suggested that children with language disorders have lower learning potential. DA involves teaching phases to improve performance between pre-and post-tests, aiding diagnosis accuracy. Because of its unbiased nature, this study used DA to assess various linguistic skills, including narratives, especially beneficial for diagnosing language disorders in bilingual children.

The main goal of this study was to investigate the effectiveness of Dynamic Assessment in distinguishing DLD and typical language development in French-speaking monolingual and bilingual children. Children (6-11 years old) were given a storytelling task before learning about story elements, then tested again. The test involved 12 questions: 8 focused on story grammar elements (macro-structure) and 4 focused on connectors (microstructure). Results showed no differences in storytelling ability between monolingual and bilingual children on macrostructure or microstructure elements. Children with (DLD) had lower scores than typically developing (TD) children, especially in microstructure elements.

This study provides further evidence that dynamic assessment can be useful in assessing the language abilities of bilingual children. The greater difficulty with story microstructure for children with DLD may indicate the need for tailored teaching methods.

Blogger: Diya Nair is a second year MSc student under the supervision of Dr Lisa Archibald.