Social and Emergent Literacy
Outcomes Following Expressive
Grammar Intervention in
Preschool SLI
Karla N. Washington, PhD, CCC-SLP, S-LP(C)
Assistant Professor
1
Introduction
• Approximately 7% of young children are
identified with a specific language
impairment (SLI)
• SLI is defined as type of developmental
language impairment where the child fails
to acquire language skills at a normal
rate, despite typical development in other
areas
2
Introduction
• As a group, children with SLI are
considered to be heterogeneous in
nature, exhibiting varying degrees of
language skills
• Language intervention programs
designed to address deficits in oral
language skills development are
believed to be beneficial
3
Language Intervention
• Previous researchers have established the
worth of different types of language
interventions for the remediation of
receptive and expressive language deficits
• The “spreading effects” of language
intervention on other co-occurring areas of
development, however, requires further
exploration
4
a “post-hoc” investigation
of language intervention
for preschool SLI
5
Post-hoc Investigation
• The first author of a recently published
study on language intervention outcomes
for preschool SLI sought to establish the
broad-based effects of intervention
• Being a recipient of language intervention
could have provided added learning
benefits beyond the skills targeted
6
Washington et al., 2011
Journal of Communication Disorders, 44, 315-330.
• A language intervention program targeting
expressive grammar deficits in a sample of
34 preschoolers with SLI was completed
• Findings from that study demonstrated that
preschoolers receiving expressive grammar
intervention (n = 22) achieved greater
outcomes in a formal and informal context
compared to controls (n = 12)
7
Washington et al., 2011
• During the intervention,
preschoolers abilities to produce
grammatically-correct sentences
were targeted
–Present progressive tense
–Subject Verb Object
8
Washington et al., 2011
• Preschoolers had numerous opportunities for
repeated practice to be aware of and produce
sentence elements needed to create
grammatically correct target sentences
• Intervention features:
– A computer program, along with storybooks and toy objects
were used
– With SLP guidance, preschoolers had opportunities for
turning pages (in books and on the computer screen),
attending to print, learning to listen and take turns, and
engaging in appropriate social interactions with others
9
Washington et al., 2011
• While directly addressing expressive grammar
deficits, indirect benefits to preschoolers’
attention to print and knowledge of how to listen
and engage well with others could also have
been achieved
• Many learning benefits beyond the skills targeted
could therefore have occurred for specific social
and emergent literacy skills
10
Washington et al., 2011
• Preschoolers did not demonstrate inordinately
low abilities in either of these areas at preintervention and so may have more easily
responded to the non-specific and incidental
aspects of the expressive grammar
intervention
• Program could offer enrichment rather than
remediation of skills
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Social and Emergent Literacy Skills
• Social Skills
1. Interpersonal relationships (peer relations)
2. Play
3. Coping
• Emergent Literacy Skills
1. Print Concepts (under-researched area)
•
•
Print and word awareness
Book knowledge
12
Research Question
• Does language intervention for
expressive grammar have a
“broad-based” impact on social
skills and print concepts for
preschool SLI?
13
Method
• Participants:
1. All preschoolers (n = 34) from the original language
intervention study were included to address the research
question
2. Recruited from a government-funded preschool speech
and language initiative in Ontario, Canada
3. Met the criteria for SLI
4. Enrolled in Early Learning Environments
14
Method
• 22 of the 34 participants received
Expressive Grammar Intervention (EGI)
• 12 participants were randomly selected
from a waitlist for intervention, no
intervention (NI)
• Participants equivalent at pre-intervention
for social and print concept skills
15
Outcome Measures
• The Vineland Adaptive Behavior
Scales (VABS) was used to
evaluate social skills
• The Preschool Word and Print
Awareness (PWPA) Test was used
to evaluate print concepts
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Vineland Adaptive Behavior Scales
• This measure is an interview-based
standardized assessment of everyday
adaptations in four major domains,
including communication, daily living skills,
socialization, and motor skills for birth to 18years
• The Socialization Domain of the VABS was
used
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Vineland Adaptive Behavior Scales
• The VABS has established psychometric properties
and can be used for progress monitoring
• Individuals who know the client best complete the
interviews
• In this study, parents (32 mothers, 2 fathers)
completed 20- to 30-minute face-to-face interviews
about their children’s interpersonal relationships,
play & leisure, and coping skills
18
Preschool Word and Print Awareness
• The PWPA is an individuallyadministered measure of
children’s print and word
awareness and book
knowledge for 14 specific print
concepts
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The 14 print concepts evaluated on the Preschool Word and Print Awareness Test
Item
Print Concept
1
Front of the book
2
Title of the book
3
Role of the title
4
Identification of print versus picture
5
Directionality – left to right identification
6
Contextualized print – narrative text
7
Directionality of print – book organization
(left/right)
8
Directionality of print (top line)
9
Directionality of print (bottom line)
10
Print function – purpose of narrative text
11
Letter concept
11a
First letter
11b
Capital letter
12
Print function – narrative text meaning
Note. Items and print concepts as administered in the Print Concepts evaluation.
Information abstracted from the article by Justice & Ezell (2001).
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Preschool Word and Print Awareness
• Preschoolers’ knowledge of these concepts
were evaluated during a clinician-client shared
book-reading activity using the commercially
available book Nine Ducks Nine
• The procedure utilized in this study, adhered
to that previously established by Justice et al.
(2006) and Clay (1979)
– Embedding a series of Print Concepts tasks into
the shared book reading activity
21
Method
• Blind assessments of outcomes
using the VABS and the PWPA were
completed at:
1. Pre-intervention (week 1)
2. Post-intervention (week 12)
3. 3-months post-intervention (week 23)
22
Design & Data Analysis
• A pre-post-follow-up design was
employed
• Outcomes for EGI and NI
• Analyses of variance (ANOVA) tests
(p< .05) were used to evaluate social and
print concepts outcomes
– Planned follow-up tests (p<.017) were
completed for significant F values
23
Results
• A significant interaction effect was
found between intervention type (EGI or
NI) and time (assessment time point) for
both the VABS and the PWPA scores
• Simple main effect analyses for scores
at each time point were therefore
completed
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Results - VABS
• No statistically significant differences were
found at pre-intervention,
F(1,32) = 1.20, p = .281, η2 = .04
• Significant differences were found at postintervention,
F (1, 32) = 38.68, p < .001, η2 = .55
• Significant differences were found at 3months post-intervention
F (1, 32) = 47.95, p < .001, η2 = .60
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VABS–Pairwise Comparisons
• EGI participants had higher VABS
scores at post-intervention and 3months post-intervention compared to
NI participants
• Gains of at least one standard deviation
above the mean for EGI participants
only
26
VABS Performance
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Results - PWPA
• No statistically significant differences were
found at pre-intervention,
F (1, 32) = 1.54, p = .223, η2 = .05
• Significant differences were found at postintervention,
F (1, 32) = 10.12, p < .001, η2 = .24
• Significant differences were found at 3months post-intervention
F (1, 32) = 28.56, p < .001, η2 = .47
PWPA–Pairwise Comparisons
• EGI participants had higher PWPA
scores at post-intervention and 3months post-intervention compared to
NI participants
• Gains of at least one standard deviation
above the mean for EGI participants
only
29
PWPA Performance
30
Discussion
• Language intervention addressing
expressive grammar deficits in
preschool SLI facilitated greater
social and print concept gains
compared to no intervention
31
Discussion
• During the intervention, participants had
SLP guidance for learning how to
interact with peers, learning to listen and
take turns
• Thus, their social skills for interaction,
play, and coping may have indirectly
benefited from this guided exposure
32
Discussion
• For intervention participants, the
repeated opportunities for exposure to
print and print conventions while using a
book or while using the computer
program to learn the grammatical
targets may have also facilitated growth
in print concept skills
33
Discussion
• Since all preschoolers were given daily
exposure to building social skills and
print concepts in preschool, the added
benefits of language intervention
compared to no intervention for both
these skills are even more significant
34
Clinical Implications
• As SLPs, we need to know that the features of
language interventions we provide can result in
broader impacts on other areas of development
• The impact does not always have to be
remedial, but can offer enrichment as in the
current study
• The gains evident are beyond that attributed to
maturation alone
35
Limitations & Future Direction
• Direct examination of preschoolers’
social skills were not completed
• Sample of preschoolers not
representative of all preschoolers with
SLI
– Thus other preschoolers with low social and
print concept skills might not benefit from
the indirect facilitation provided
36
Limitations & Future Direction
• Expand research to preschoolers with SLI
with low functioning in both areas
• Conduct research with broader population
of children with language impairments
• Expand research to explore if gains in
language intervention predict social and
print concept skills
37
Conclusion
• The important benefits of language
intervention for expressive grammar
deficits in preschoolers with SLI has been
established
• A cascade of positive experiences for cooccurring areas of development, like social
and print concepts, following intervention is
possible for preschoolers with SLI
38
Questions?
Thank you!
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