Introduction to the Forum: Intervention With Children With Developmental Language Disorder

You have accessAmerican Journal of Speech-Language PathologyIntroduction21 Feb 2024Introduction to the Forum: Intervention With Children With Developmental Language Disorder James W. Montgomery, and Ronald B. Gillam James W. Montgomery Hearing, Speech, and Language Sciences, Ohio University, Athens Google Scholar and Ronald B. Gillam https://orcid.org/0000-0003-0106-1908 Communication Disorders and Deaf Education, Utah State University, Logan Google Scholar https://doi.org/10.1044/2024_AJSLP-24-00046 SectionsAboutAbstractPDF ToolsAdd to favoritesDownload CitationTrack Citations ShareFacebookTwitterLinked In Welcome to this forum, where we explore the intricacies of language intervention with children with developmental language disorder (DLD). DLD is one of the most common childhood developmental disorders (McGregor, 2020), representing about 7–13% of the population. During the preschool years, children with DLD present difficulties with lexical, morphological, and grammatical development that primarily impact their socialization skills. These language challenges often continue into the school-age years, negatively impacting the language of instruction, reading comprehension, and written composition. While the DLD literature is quite robust, treatment research remains very scarce (~4% of all articles published in the last 5 years in ASHAWire and PsycInfo), which represents a serious gap in our field (Bishop, 2010; Kulkarni et al., 2022; McGregor, 2020). In response to this gap, the development of effective treatments has been identified as one of the top research priorities by key stakeholders (parents, speech-language clinicians, teachers) who support these children (Kulkarni et al., 2022). In this forum, we have brought together a number of experts to provide their ideas and insights on best practices for treating the language difficulties of young and school-age children, as well as ideas on how to expand the preparation of graduate clinicians for intervention. Language intervention approaches fall along a continuum from explicit to implicit (Baron & Arbel, 2022). In explicit teaching intervention approaches, clinicians provide children with explanations of rules that govern language structure (e.g., "When there are two of something, we put an [s] on the end. One book. Two books."), employ explicit feedback after child responses, and often use drill-like formats. In explicit instruction, clinicians often use graphic organizers to represent the components of a sentence or story. In implicit approaches, clinicians optimize the nature of the input they provide in ways that make language targets easier for children to discover. Implicit treatments typically employ modeling, priming, and recasting intervention strategies. The articles in this forum are excellent representations of ways to combine these approaches to facilitate learning in children with DLD. In each article, the authors acknowledge the theoretical framework underlying the intervention practices they implement. Doing so provides clinicians with a meaningful way to think about the links between learning mechanisms and behavioral changes that underlie their choice of treatment approach and its methodological details (Plante, 2020). Three articles focus on the teaching of vocabulary. Camarata et al. (2024) describe a single-subject design study employing an implicit-oriented naturalistic developmental behavioral intervention to teach young children new vocabulary. The treatment method combines storytelling and recasting. Gordon et al. (2023) examine the effects of combining retrieval-based training and criterion-based training strategies. In their retrieval-based training, they present target vocabulary words and then ask learners to actively retrieve that information during subsequent training trials. In their criterion-based training, they teach individual word forms and meanings repeatedly until children successfully retrieve the form and the meaning at the beginning of two sessions. Their intervention also incorporates principles of robust vocabulary instruction, emphasizing the acquisition of words through diverse contexts, embedding them within meaningful narratives, and encouraging children to engage in comparing and contrasting word meanings. Finally, Bedore et al. (2023) examine the impact of a Spanish-language intervention on vocabulary usage in narratives. Like Gordon et al., they use implicit and explicit principles of robust vocabulary instruction to strengthen the connections between language and literacy skills in bilingual children. In their intervention, expository and narrative texts serve as contexts for children to learn word meanings and to practice incorporating words into sentences that convey events and details. Two of the articles center on the grammatical morphology deficits of children with DLD. Finestack et al. (2023), in their clinical focus article, provide a comprehensive set of evidence-based principles to guide clinicians' development of intervention activities to facilitate children's learning of grammatical morphology. The principles embrace implicit, explicit, and hybrid treatment approaches. In their review article, Leonard et al. (2023) offer a novel explanation for the difficulties children with DLD have learning tense and agreement. Based on an examination of the natural input children receive and the results of computational modeling, the authors argue that the combination of the occurrence of subject + nonfinite verb strings in auxiliary-fronted questions (e.g., "Is [the baby crying]?") and bare-stem verbs (e.g., "Does he run fast?") makes it hard for the children to learn and consistently use these grammatical forms (e.g., "the baby (is) crying," "he run(s) fast"). They conclude by offering treatment ideas that encompass a combination of implicit and explicit approaches to render the grammatical forms more discoverable in the input. The treatment of the syntactic deficits of DLD is addressed in two articles, an area of research that, relative to other deficit areas, is underrepresented in the field (Tarvainen et al., 2021). In their clinical focus article, Balthazar and Scott (2023) provide an excellent description of the nature of the wide range of complex structures school-age children and adolescents encounter in their academic studies and a powerful rationale for why complex syntax is such a critically important intervention target. The authors review the evidence for the use of available implicit, explicit, and implicit–explicit hybrid approaches to treat the grammar deficits of the children. In a second clinical focus article, Montgomery et al. (2023) offer a different framework of syntactic development based on the view of syntactic development as a chunk-based, statistically driven learning activity. The authors briefly review the evidence of currently available explicit approaches to grammar teaching and discuss the clinical implications for using what is known about implicit statistical learning in typical learners to fashion an implicit intervention approach (Plante & Gómez, 2018) that leverages the natural phenomenon of syntactic priming as a form of implicit learning. In the final article on syntax, a tutorial, Wang et al. (2023) report the results of a training program designed to prepare graduate clinicians to use the recast method to treat the syntactic deficits of young children with DLD. Speech-language pathologists (SLPs) in school settings play an important role in enhancing the academic skills of students with DLD. Specifically, these children need to learn how to understand and produce expository discourse across various subject areas. Ukrainetz (2023) provides a tutorial on the nature and development of expository discourse and summarizes expository text intervention methods that combine explicit and implicit strategies for teaching text organization, as well as strategies for learning from expository texts. In closing, this forum has provided an insightful exploration of the challenges and opportunities in language intervention for children with DLD. Our forum has assembled experts who have shared their valuable insights and best practices in treating language difficulties among young and school-age children with DLD. Language intervention strategies, ranging from explicit to implicit, have been extensively explored. These strategies encompass explanations of language rules, explicit feedback, and drill-like formats, as well as implicit techniques such as modeling, priming, and recasting. Each article within this forum offers a thoughtful consideration of the theoretical frameworks underpinning their chosen intervention practices. This approach equips clinicians with a deeper understanding of the learning mechanisms and behavioral changes that drive their treatment decisions. Furthermore, our forum acknowledges the crucial role of SLPs in school settings, where they play a pivotal role in enhancing the academic skills of students with DLD. As SLPs, we need to empower children with DLD to overcome linguistic challenges, achieve academic success, and unlock their full potential. By leveraging the insights shared within this forum, we hope clinicians will be better equipped to provide effective interventions that create brighter social and academic futures for children with DLD. Finally, we would like to thank everyone associated with making this forum possible. We are grateful to all the authors for their thoughtful and kind contributions. Special thanks to Erinn Finke, AJSLP editor-in-chief, for her strong support of the forum and her guidance and help with the setup logistics and all the manuscript processing. Special thanks also to Elaine Niefeld, ASHA director of content development, for all her assistance during the review process and post-review process. Thank you to the entire production team. Finally, we thank the many reviewers for their evaluations. References Balthazar, C. H., & Scott, C. M. (2023). Sentences are key: Helping school-age children and adolescents build sentence skills needed for real language.American Journal of Speech-Language Pathology. Advance online publication. https://doi.org/10.1044/2023_AJSLP-23-00038 ASHAWireGoogle Scholar Baron, L. S., & Arbel, Y. (2022). An implicit–explicit framework for intervention methods in developmental language disorder.American Journal of Speech-Language Pathology, 31(4), 1557–1573. https://doi.org/10.1044/2022_AJSLP-21-00172 ASHAWireGoogle Scholar Bedore, L. M., Peña, E. D., Shivabasappa, P., Perez, C., Vargas, A. G., Leachman, M., & Wang, J. (2023). An exploration of the nature of vocabulary change following Language and Literacy Together intervention.American Journal of Speech-Language Pathology. Advance online publication. https://doi.org/10.1044/2023_AJSLP-23-00042 ASHAWireGoogle Scholar Bishop, D. V. M. (2010). Which neurodevelopmental disorders get researched and why?.PLOS ONE, 5(11), Article e15112. https://doi.org/10.1371/journal.pone.0015112 CrossrefGoogle Scholar Camarata, S., Stiles, S., & Birer, S. (2024). Naturalistic developmental behavioral interventions for developmental language disorder.American Journal of Speech-Language Pathology. Advance online publication. https://doi.org/10.1044/2023_AJSLP-23-00116 ASHAWireGoogle Scholar Finestack, L. H., Ancel, E., Lee, H., Kuchler, K., & Kornelis, M. (2023). Five additional evidence-based principles to facilitate grammar development for children with developmental language disorder.American Journal of Speech-Language Pathology. Advance online publication. https://doi.org/10.1044/2023_AJSLP-23-00049 ASHAWireGoogle Scholar Gordon, K. R., Storkel, H. L., Lowry, S. L., & Sultani, M. J. (2023). A word-learning intervention pilot study utilizing principles of retrieval- and criterion-based learning for children with developmental language disorder.American Journal of Speech-Language Pathology. Advance online publication. https://doi.org/10.1044/2023_AJSLP-23-00037 ASHAWireGoogle Scholar Kulkarni, A., Chadd, K., Lambert, S., Earl, G., Longhurst, L., McKean, C., Hulme, C., McGregor, K., Cunniff, A., Pagnamenta, E., Joffe, V., Ebbels, S., Bangera, S., Wallinger, J., & Norbury, C. (2022). Editorial perspective: Speaking up for developmental language disorder – The top 10 priorities for research.The Journal of Child Psychology and Psychiatry, 63(8), 957–960. https://doi.org/10.1111/jcpp.13592 CrossrefMedlineGoogle Scholar Leonard, L. B., Deevy, P., Bredin-Oja, S. L., & Schroeder, M. L. (2023). Sources of misinterpretation in the input and their implications for language intervention with English-speaking children.American Journal of Speech-Language Pathology. Advance online publication. https://doi.org/10.1044/2023_AJSLP-23-00016 ASHAWireGoogle Scholar McGregor, K. K. (2020). How we fail children with developmental language disorder.Language, Speech, and Hearing Services in Schools, 51(4), 981–992. https://doi.org/10.1044/2020_LSHSS-20-00003 ASHAWireGoogle Scholar Montgomery, J. W., Gillam, R. B., & Plante, E. (2023). Enhancing syntactic knowledge in school-age children with developmental language disorder: The promise of syntactic priming.American Journal of Speech-Language Pathology. Advance online publication. https://doi.org/10.1044/2023_AJSLP-23-00079 ASHAWireGoogle Scholar Plante, E. (2020). A neural perspective on implicit learning: A reply to Kamhi (2019).Journal of Communication Disorders, 83, Article 105948. https://doi.org/10.1016/j.jcomdis.2019.105948 CrossrefMedlineGoogle Scholar Plante, E., & Gómez, R. L. (2018). Learning without trying: The clinical relevance of statistical learning.Language, Speech, and Hearing Services in Schools, 49(3S), 710–722. https://doi.org/10.1044/2018_LSHSS-STLT1-17-0131 ASHAWireGoogle Scholar Tarvainen, S., Launonen, K., & Stolt, S. (2021). Oral language comprehension interventions in school-age children and adolescents with developmental language disorder: A systematic scoping review.Autism & Developmental Language Impairments, 6. https://doi.org/10.1177/23969415211010423 CrossrefMedlineGoogle Scholar Ukrainetz, T. A. (2023). Evidence-based expository intervention: A tutorial for speech-language pathologists.American Journal of Speech-Language Pathology. Advance online publication. https://doi.org/10.1044/2023_AJSLP-23-00036 ASHAWireGoogle Scholar Wang, D., Curran, M., McGregor, K., & Owen Van Horne, A. (2023). Preparing student clinicians to provide recast therapy on complement clauses: A training program.American Journal of Speech-Language Pathology. Advance online publication. https://doi.org/10.1044/2023_AJSLP-23-00244 ASHAWireGoogle Scholar Author Notes Disclosure: The authors have declared that no competing financial or nonfinancial interests existed at the time of publication. Correspondence to James W. Montgomery: [email protected] Editor-in-Chief: Erinn H. Finke Publisher Note: This article is part of the Forum: Intervention With Children With Developmental Language Disorder. Additional Resources FiguresReferencesRelatedDetails Newly PublishedePub Ahead of IssuePages: 1-3 HistoryReceived: Feb 2, 2024Accepted: Feb 5, 2024 Published online: Feb 21, 2024PubMed ID: 38381489 Get Permissions Add to your Mendeley library Metrics Topicsasha-topicsasha-article-typesCopyright & PermissionsCopyright © 2024 American Speech-Language-Hearing AssociationPDF downloadLoading ...