Applying behaviour change theory to parent-led language interventions for children in the early years.

BACKGROUND: The aim of many interventions used by speech and language therapists (SLTs) is to change behaviours related to communication and interaction. Parent-led language interventions for children in the early years (0-5 years) rely on SLTs supporting parents to change their behaviour in child-focused interactions to effect a change in the child's communication. Therapeutic techniques used by SLTs in parent-led language interventions are largely underspecified, impacting on intervention reporting, replication, trialling and development. The Behaviour Change Technique Taxonomy Version 1 (BCTTv1) offers a method of describing intervention techniques developed for use in public health interventions, but with several examples of its application to speech and language interventions. AIMS: To identify behaviour change techniques (BCTs) from the BCTTv1 occurring in parent-led language interventions for children in the early years. METHODS & PROCEDURES: A literature search identified relevant descriptions of parent-led language interventions. These were coded using the BCTTv1. A reliability check was carried out on 10% of the descriptions. To confirm the use of identified BCTs in clinical practice, results of the literature search were triangulated with an online survey of SLTs, and observations of SLTs delivering parent-led language intervention. OUTCOMES & RESULTS: A total of 84 papers containing descriptions of 45 interventions were coded; 62 SLTs responded to the survey and three SLTs were observed delivering parent-led language intervention. A total of 24 BCTs were identified in the literature search, replicated in the observations and verified by SLTs in the survey. BCTs were identified at two levels: Level 1 SLT implemented to change parent interactive behaviour; and Level 2 parent implemented to change child communicative behaviour. CONCLUSIONS & IMPLICATIONS: The BCTTv1 is a useful starting place for describing parent-led language interventions. With some additions and adjustments, BCTs identified in this study were immediately recognized by practitioners and can easily be adopted into practice. WHAT THIS PAPER ADDS: What is already known on this subject Techniques used in SLT interventions are often not clearly described. The BCTTv1 has been used to clarify technique descriptions with success in a small number of SLT disciplines, but not yet in parent-led language interventions for preschoola children. What this paper adds to the existing knowledge This paper constitutes the first research into quantifying the techniques used in parent-led language interventions using the BCTTv1. What are the potential or actual clinical implications of this work? This paper provides a clear list of techniques used by SLTs implementing interventions for preschool children, which can be immediately adopted and used in practice. It also highlights potential adjustments and gaps in the BCTTv1 in relation to SLT which can contribute to future iterations.

Validation of a measure of parental responsiveness: Comparison of the brief Parental Responsiveness Rating Scale with a detailed measure of responsive parental behaviours.

Parental responsiveness is vital for child language development. Its accurate measurement in clinical settings could identify families who may benefit from preventative interventions; however, coding of responsiveness is time-consuming and expensive. This study investigates in a clinical context the validity of the Parental Responsiveness Rating Scale (PaRRiS): a time- and cost-effective global rating scale of parental responsiveness. Child health nurse (CHN) PaRRiS ratings are compared to a detailed coding of parental responsiveness. Thirty parent-child dyads completed an 8-min free-play session at their 27-month health review. CHNs rated the interaction live using PaRRiS. Videos of these interactions were then blindly coded using the more detailed coding system. PaRRiS ratings and detailed codings were compared using correlational analysis and the Bland-Altman method. PaRRiS and the detailed coding showed a moderate-strong correlation (rs (28) = 0.57, 95% CI [0.26, 0.77]) and high agreement (Bland-Altman). CHNs using PaRRiS can capture parental responsiveness as effectively as trained clinicians using detailed coding. This may allow (1) increased accuracy and efficiency in identifying toddlers at risk for long-term language difficulties; (2) more accurate allocation to speech and language therapy (SLT) services; (3) decreased burden on SLT resources by empowering CHNs to make more informed referral decisions.

Collocational knowledge in children: a comparison of English-speaking monolingual children, and children acquiring English as an Additional Language.

Collocations, e.g., apples and pears, hard worker, constitute an important avenue of linguistic enquiry straddling both grammar and the lexicon. They are sensitive to language experience, with adult L2 learners and children learning English as an Additional Language (EAL) exhibiting poor collocational knowledge. The current study piloted a novel collocational assessment with children (mean age 6;3, 40 monolingual, 32 EAL). It investigated (1) the feasibility of a collocational assessment at this age, (2) whether collocational knowledge is associated with other language domains (receptive grammar and vocabulary), and (3) whether collocational knowledge is more affected than other domains. The assessment demonstrated good psychometric properties and was highly correlated with performance in other domains, indicating shared psycholinguistic mechanisms. Unlike adult counterparts, the EAL children performed equally poorly across domains. Given the role played by collocations in vocabulary development and reading, a focus on this domain may be beneficial for EAL children.

Verb morphology in German-speaking children with developmental language disorder and phonological impairment.

The verb inflections of matched groups of German-speaking children with developmental language disorder (DLD) and phonological impairment (PI) were evaluated, and performance compared with age-matched and language-matched typically developing (TD) children (66 participants in total). An elicitation task for second- and third-person singular present tense inflections was used and spontaneous language samples were also analysed for present tense inflections. Errors resulting from the children's speech difficulties were excluded from the analysis. Evidence was found in the elicited data for delayed development in the DLD children, but no differences were found between this group and the TD group matched on language development. Both clinical groups made errors consistent with bare stem- and prosodic factors described in the literature. The children with PI, although scoring within normal limits on standardised tests of language, displayed difficulties with tense inflections that went beyond limitations imposed by their speech. This suggests there may be underlying difficulties in both phonological and grammatical domains for both clinical groups, and potential interaction between these domains. It is recommended that clinicians take account of this possibility when assessing and identifying children with DLD and with PI, and that they avoid reliance on standardised language tests or assessment of grammatical morphology alone when assessing for DLD.

Case marking in German-speaking children with specific language impairment and with phonological impairment.

Identification of children with specific language impairment (SLI, now known as Developmental Language Disorder) remains challenging. Morphosyntax difficulties have been proposed as potential linguistic 'markers' for SLI across a number of languages. This study investigates the existence of such a clinical marker in German-speaking children with SLI, looking in particular at German case marking, and makes comparisons with matched typically developing groups and a group with isolated phonological impairment (PI). A case-control study was completed with 66 pre-school children in four groups (1) SLI, (2) PI, (3) age-matched typically developing children (TD-A) (4) language-matched typically developing children (TD-L). Errors in nominative, accusative and dative marking were analysed from the production of articles in elicitation tasks and spontaneous language samples. The performance of the SLI group was poorer than the TD-A group across all three grammatical cases investigated, but there was little supportive evidence for this being a diagnostic marker. It is, however, suggested that poor case marking may alert clinicians to the need for further linguistic assessment. No significant differences were found between the SLI and PI groups; rather scores for the PI group suggested they fell on a gradient between the SLI TD-A groups. Findings are discussed in relation to the proposed new diagnostic category of developmental language disorder.

Triggering word learning in children with Language Impairment: the effect of phonotactic probability and neighbourhood density.

The effect of phonotactic probability (PP) and neighbourhood density (ND) on triggering word learning was examined in children with Language Impairment (3;04-6;09) and compared to Typically Developing children. Nonwords, varying PP and ND orthogonally, were presented in a story context and their learning tested using a referent identification task. Group comparisons with receptive vocabulary as a covariate found no group differences in overall scores or in the influence of PP or ND. Therefore, there was no evidence of atypical lexical or phonological processing. 'Convergent' PP/ND (High PP/High ND; Low PP/Low ND) was optimal for word learning in both groups. This bias interacted with vocabulary knowledge. 'Divergent' PP/ND word scores (High PP/Low ND; Low PP/High ND) were positively correlated with vocabulary so the 'divergence disadvantage' reduced as vocabulary knowledge grew; an interaction hypothesized to represent developmental changes in lexical-phonological processing linked to the emergence of phonological representations.

Developmental change is key to understanding primary language impairment: the case of phonotactic probability and nonword repetition.

PURPOSE: In this study, the authors aimed to explore the relationship between lexical and phonological knowledge in children with primary language impairment (PLI) through the application of a developmental methodology. Specifically, they tested whether there is evidence for an impairment in the process of phonological abstraction in this group of children over and above that which would be predicted by their vocabulary growth. METHOD: The authors measured developmental change in the abilities of typically developing (TD) children ( n = 38, chronological age [CA] = 3;0-5;6 [years;months]) and those with PLI ( n = 13, CA = 3;0-6;6 and 4;6-8;0) to repeat nonwords with high and low phonotactic probability (PP) to uncover group differences in the process of abstraction of phonological representations. RESULTS: Cross-sectional developmental trajectories of change in nonword repetition abilities were compared across CA and vocabulary growth. Unlike TD children, the children with PLI did not evince a narrowing gap in the influence of PP across development, and they reached a plateau in their development. CONCLUSION: These results suggest slowed emergence of phonological representations in PLI, with a plateau in the development of lexical-phonological representations. This plateau may represent entrenchment and "fixing" due to a missed critical period and/or atypical word learning biases in PLI.

Socio-economic status and language acquisition: children's performance on the new Reynell Developmental Language Scales.

BACKGROUND: Several studies in recent years have indicated a link between socio-economic status (SES) of families and children's language development, including studies that have measured children's language through formal standardized test procedures. High numbers of children with low performance have been found in lower socio-economic groups in some studies. This has proved a cause for concern for both clinicians and educationalists. AIMS: To investigate the relationship between maternal education and postcode-related indicators of SES, and children's performance on the New Reynell Developmental Scales (NRDLS). METHODS & PROCEDURES: Participants were 1266 children aged between 2;00 and 7;06 years who were recruited for the standardization of a new assessment procedure (NRDLS). Children were divided into four groups reflecting years of maternal education, and five groups reflecting SES Index of Multiple Deprivation (IMD) quintiles for the location of participating schools and nurseries. Groups were compared using analysis of covariance (ANCOVA), with age as a covariate, in order to identify which might be affected by the two SES variables. Where relationships were found between SES and performance on the scales, individual children's standard scores were looked at to determine numbers potentially at risk for language delay. OUTCOMES & RESULTS: An effect of years of maternal education on performance was found such that children whose mothers had minimum years performed less well than other children in the study, this effect being stronger for younger children. Children attending schools or nurseries in IMD quintile 1 areas performed less well in language production. Higher than expected numbers with language delay were found for younger children whose mothers had minimum years of education, and for children in quintile 1 schools and nurseries; however, numbers were not as high as noted in some other studies. CONCLUSIONS & IMPLICATIONS: Characteristics of the participant sample and measures used for language and SES may explain these results and are important considerations when interpreting results of studies or developing policies for intervention. The usefulness of commonly used categories of language delay is questioned.

Functional reorganization in the developing lexicon: separable and changing influences of lexical and phonological variables on children's fast-mapping.

Neighbourhood Density (ND) and Phonotactic Probability (PP) influence word learning in children. This influence appears to change over development but the separate developmental trajectories of influence of PP and ND on word learning have not previously been mapped. This study examined the cross-sectional developmental trajectories of influence of PP and ND on fast-mapping in thirty-eight English-speaking children aged 3 ; 01-5 ; 02, in a task varying PP and ND orthogonally. PP and ND exerted separable influences on fast-mapping. Overall, low ND supported better fast-mapping. The influence of PP changed across the developmental trajectory, 'switching' from a high to a low PP advantage. A potential explanation for this 'switch' is advanced, suggesting that it represents functional reorganization in the developing lexicon, which emerges from changes in the developing lexicon, as phonological knowledge is abstracted from lexical knowledge, over development.

Lexical mixing in the early productive vocabularies of Maltese children: implications for intervention.

Since norms for vocabulary acquisition in Maltese children do not yet exist, documentation of productive vocabulary acquisition may contribute to establishing a baseline of lexical development. Clinical implications may thus be derived. The current study is a small-scale investigation of the proportions of Maltese and English lexemes in the vocabularies of ten normally-developing Maltese children aged between 12 and 30 months. The participants were primarily exposed to Maltese within their immediate environments, while receiving indirect exposure to English. Outcomes of parental report and language sampling were analysed for evidence of a bilingual dimension in these children's productive vocabularies. Translation equivalents were reported on by parents, but negligible evidence of equivalents emerged in conversational language use. In contrast, lexical borrowings were both reported and sampled. A substantial proportion of English lexemes were reported by the parents in the absence of Maltese equivalents.