Group Emergent Literacy Intervention for children

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Presented at the ASHA Convention November 2007, Boston, MA Group Emergent Literacy Intervention for Preschool Children with Language Disabilities Patricia L. Cleave1, Luigi Girolametto2, Carla J. Johnson2, Xi Chen2, Stephen Cohen3, 1Dalhousie University, 2University of Toronto, 3Toronto Preschool Speech and Language Services Introduction INTRODUCTION 5% – 10% of preschool children have language impairments. These can have a serious impact on future academic achievement and social-emotional development (e.g., Beitchman, et al., 2001). Group intervention models for preschool language intervention are frequently used clinically. This practice is based on estimates of cost-effectiveness and the assumption that group intervention provides the opportunity for learning from peers. However, there is little evidence on the effectiveness of group intervention with preschool children with language impairments. Children with oral language impairments are at high risk for reading and writing disorders They have significant weaknesses in narrative skills (e.g., Catts et al., 2001) and phonological awareness skills (e.g., Briscoe et al., 2001). Narrative development has been found to impact literacy development and academic achievement (e.g., Dickinson & Tabors, 2001). Narrative skill is an area of oral language in which delays are less likely to resolve over time (e.g., Girolametto et al., 2001; Manhardt & Rescorla, 2002). Phonological awareness skills are related to decoding and training phonological awareness skills impacts reading skills (e.g., Ehri et al., 2001 ) The intervention program reported here targets important emergent literacy skills: phonological awareness, alphabet knowledge, and print referencing skills (e.g., Kaderavek & Justice, 2004) and narrative skills. PRELIMINARY RESULTS Data are currently being coded and analysed. Only preliminary results are available at this time. Repeated Measures ANOVA group (2) by time (Time 1 to Time 2) were conducted on one print concept, one PA measure and one narrative measure. Print Concepts – TOPEL There was a significant effect of time (p = .001) but no significant group by time interaction. At Time 1, all children scored within normal limits on this test. Initial Sound Matching There were no significant effects for either time or group by time interaction. Narrative - Bus Story There was a significant effect of time on both Bus Story measures (Information: p = .004, Sentence Length p = .003) but no significant group by time interaction on either measure. METHODS Participants 22 children with specific language impairments (SLI) participated in the first year of the program. Speaking in least 2- and 3- word utterances. at least 1 sd below the mean on 2/3 core language subtests from the CELF-P2, a standardized language test. Nonverbal intelligence within normal limits. No sensory disabilities, oral motor problems, or frank neurological problems and normal socio-emotional development. English as the dominant language. Subject Characteristics *Columbia Mental Maturity Scales ** Clinical Evaluation of Language Fundamentals – Preschool 2 *** Structured Photographic Expressive Language Test – Preschool 2 Design Pretest-posttest delayed treatment control group design. 22 children randomly assigned to treatment and control groups. 3 Assessment periods. Assessment battery contains measures of oral language, parent-child book reading, print concepts, phonological awareness and narrative skills. Only narrative, print concepts, and phonological awareness measures are reported here. Analysis of language samples, parent-child book reading are ongoing. 9-week intervention program. Targets include phonological awareness, print concepts and narrative development. 1 parent training session 8 Weekly 75 minute sessions - 60 minutes with 2-3 children, 15 minute consult with parents. Daily home program of book reading and phonological awareness games. Measures Preliminary Analyses of 3 measures are reported here. Narrative Measures Renfrew Bus Story – A picture supported story re-tell task. Information score – number of story elements (max 52) Length – mean length in words of 5 longest utterances Print Concepts Test of Preschool Early Literacy (TOPEL) Print Knowledge Subtest – alphabet knowledge, written language conventions (max 36) Phonological Awareness An initial Sound Matching task In addition to these measures, a second narrative task (Edmonton Narrative Norms Instrument - ENNI) and two additional phonological awareness measures were administered and play and book reading samples were collected with the parent. REFERENCES Beitchman, J., Wilson, B., Johnson, C., Atkinson, L., Young, A., Adlaf, E., et al. (2001). Fourteen-year follow-up of speech/language impaired and control children: Psychiatric outcome. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 75-82. Catts, H., Fey, M., Zhang, X., & Tomblin, J.(2001). Estimating the risk of future reading difficulties in kindergarten children: A research—based model and its clinical implementation. Language, Speech and Hearing Services in the Schools, 32I, 38-50. Dickinson, D., & Tabors, P. (2001). Beginning literacy with language. Baltimore, MD: Brookes Ehri, L., Nunes, S., Willows, D., Schuster, B., Yaghoub-Zadeh, Z., & Shanahan, T. (2001). Phonemic awareness instruction helps children learn to read: Evidence from the National Reading Panel’s meta-analysis. Reading Research Quarterly, 36, 250-287. Gillon, G. (2005). Facilitating phoneme awareness development n 3- and 4- year old children with speech impairment. Language, Speech and hearing Services in Schools, 36, 308-324. Girolametto, L., Wiigs, M.,, Smyth, R., Weitzman, E., Pearce, P. (2001). Children with a history of expressive language delay: Outcomes at 5 years of age. American Journal of Speech-Language Pathology, 10, 358-369. Kaderavek, J., & Justice, L. (2004). Embedded-explicit emergent literacy intervention II: Goal selection and implementation in the early childhood classroom. Language, Speech, and Hearing Services in the Schools, 35, 212-228. Law, J., Garrett, Z., & Nye, C. (2004). The efficacy of treatment for children with developmental speech and language delay/disorder: A meta-analysis. Journal of Speech, Language and Hearing Research, 47, 924-943. Manhardt, J., & Rescorla, L. (2002). Oral narrative skills of late talkers at ages 8 and 9. Applied Psycholinguistics, 23, 1-21. DISCUSSION This poster describes an intervention program targeting emergent literacy skills in preschool children with SLI and presents preliminary analyses of the first year data. Although there was an effect of time, there was no evidence of treatment effects on the TOPEL: Print Concepts measure. The majority of the children (n = 17) were within normal limits at Time 1 which may account for why there were no treatment effects. However, there was room for improvement as no child reached ceiling on this subtest. Similarly, on the Bus Story Narrative measures, there was an effect of time but no evidence of treatment effects. There are plans to apply a coding system by McKeough to the narrative samples. This system examines such things as the identification of characters, number of events, and use of connectives and mental state words. As such, it may be a more sensitive measure of change. In addition, the second unanalysed narrative task (the ENNI) requires the children to tell a story to a set of pictures without first hearing the examiner tell the story, as is done in the Bus Story. Thus, it may be a more sensitive measure of treatment effects. On the PA measure – an initial sound matching task, there was no evidence of either time or treatment effects. This suggests that this skill is a challenging one for children with SLI. In the second year of the study, we have added two PA measures which are designed to be easier. Next Steps Additional narrative analyses are being conducted on the Bus Story and ENNI narratives. Analyses are currently underway on the parent-child language and book-reading samples. A second cohort of children are currently enrolled in the program. ABSTRACT This poster presents the results from the first year of a randomized control trial of a group intervention program targeting emergent literacy skills in children with Specific Language Impairment (SLI). Twenty-two 4-year old children with SLI were randomly assigned to immediate treatment or a delayed-treatment control group. The intervention program included a parent training session and 8 intervention sessions. The intervention sessions were 75 minutes long and involved a small group of 3 children. Goals included narrative skills, phonological awareness, alphabet knowledge, and print referencing skills. The treatment program is described and the first year results for some measures are presented. PROGRAM DESCRIPTION Group Sessions Each group session includes: Warm-up Alphabet Activity (5 min) Children learn letter names and visually match letters from key words (e.g., child’s name) and sing the alphabet song Storybook Reading (20 min) Clinician reads the story and asks planned questions to focus on print referencing, decontextualized language, and narrative structure. A storyboard is used to review the story, highlighting four early developing narrative elements – setting, problem, action, direct consequence. Focused stimulation techniques are used to facilitate language skills Post-Story Activity (20 min) Children reenact the story in a variety of ways using props, pictures, puppets, etc. The story board and the book are used to help the children remember the story. The 4 narrative elements are discussed as the story is reenacted. Focused stimulation techniques and scaffolding are used to respond to the children. Phonological Awareness Activities (15 min) Initial sound identification and matching are targeted. Games such as fishing, sorting, and search pictures are used. Two sounds are targeted each week. There are 4 pairs of sounds which are targeted twice over the program. t/ and /l/ in Sessions 1 and 4 /p/ and /f/ in Sessions 2 and 5 /k/ and /s/ in Sessions 3 and 6 /m/ and /d/ in Sessions 4 and 8 A sound blending activity is added in Sessions 4-8. Parent Training (15 min) (see below) Parent Involvement Parents are expected to read an assigned storybook and conduct at least one PA activity daily. Parents attend Session 1, which teaches them: How to read the story and ask story questions How to distinguish letter names from sounds and conduct the PA activities. How to complete observation and home practice sheets Scheduling, rules of participation, who to call for missed sessions Parents observe all sessions through a one-way mirror. They use an observation sheet to help them focus on activities that they will conduct at home (storybook reading & the PA activity). At the end of each session, the clinician meets with parents for 15 minutes as a group while the children interact with session materials. The clinician assigns three home practice activities: read the same storybook and ask questions that are indicated in the text conduct the phonological awareness activity that was conducted during the session or conduct the alternative phonological awareness activity. Each parent has one individual consultation session in which the parent demonstrates activities with the child. The clinician provides the parent with feedback on the use of questions in the storybook reading and general language stimulation strategies and strategies for teaching PA.