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