Center for Childhood Deafness, Language and Learning, Boys Town National Research Hospital, Omaha, NE.
Department of Communication Sciences and Disorders, The University of Iowa, Iowa City.
Lang Speech Hear Serv Sch. 2021 Apr 20;52(2):467-484. doi: 10.1044/2020_LSHSS-20-00110. Epub 2021 Feb 9.
Purpose The aims of the study were to explore responses of children with developmental language disorder (DLD) to rich vocabulary instruction and to identify potential factors that contribute to outcomes. Method Children with DLD participated in a language intervention embedded within a science camp. Using parent and clinician reports, standardized tests, probes, notes, and video, we derived descriptions of seven of the campers who received a vocabulary intervention that incorporated principles of rich instruction. We present them here as a case series. Results Five cases responded to the intervention with modest gains in Tier 2 science vocabulary and science knowledge. One case demonstrated no response, and another was unable to complete the intervention. The latter two cases presented with triple risks: DLD, executive function deficits, and stressors associated with poverty. In comparison, the best responder also lived in poverty and had DLD, but he had intact executive function, strengths in extant vocabulary, stronger knowledge of science, better engagement in the science and language intervention activities, and was older. Other factors that seemed to contribute to outcomes included the complexity of the word forms and dosage. Conclusions Translating research on rich instruction to clinical practice is challenging. This case series motivated hypotheses about the nature of the challenge and what to do about it, the primary one being that the modest success of rich vocabulary instruction for children with DLD is not a limitation of the approach itself but rather a reflection of the difficulty of delivering the intervention while tailoring the targets, approach, and dosage to the needs of individual children with DLD. Supplemental Material https://doi.org/10.23641/asha.13667699.
目的 本研究旨在探索语言发育迟缓(DLD)儿童对丰富词汇教学的反应,并确定有助于结果的潜在因素。
方法 语言发育迟缓儿童参加了一个嵌入科学营地的语言干预项目。我们使用家长和临床医生报告、标准化测试、探针、笔记和视频,从参加了包含丰富教学原则的词汇干预的 7 名营员中得出描述。我们在这里将他们作为一个病例系列呈现。
结果 5 个病例对干预有适度反应,在二级科学词汇和科学知识方面有了提高。一个病例没有反应,另一个病例无法完成干预。后两个病例存在三重风险:DLD、执行功能缺陷以及与贫困相关的压力。相比之下,最佳反应者也生活在贫困中,并有 DLD,但他的执行功能完好,现有的词汇量较强,对科学的了解更好,更积极地参与科学和语言干预活动,年龄也更大。其他似乎有助于结果的因素包括单词形式和剂量的复杂性。
结论 将丰富教学的研究转化为临床实践具有挑战性。本病例系列激发了关于挑战性质和应对方法的假设,主要假设是,丰富词汇教学对 DLD 儿童的适度成功不是该方法本身的局限性,而是反映了在为个别 DLD 儿童量身定制目标、方法和剂量的同时提供干预的困难。