NSDSK, Research & Development Department, Amsterdam, the Netherlands.
Royal Dutch Auris Group, Research Department, Rotterdam, the Netherlands.
Int J Lang Commun Disord. 2024 Nov-Dec;59(6):2580-2604. doi: 10.1111/1460-6984.13102. Epub 2024 Aug 16.
Morphosyntactic problems are a core symptom of Developmental Language Disorder (DLD). In the Netherlands, children with (presumed) DLD can receive special care in language-focused treatment groups. The focus of these groups mainly lies in improving communicative intentions, vocabulary and phonology. Morphosyntactic skills receive less attention.
The authors developed a scripted group-based intervention targeting morphosyntactic skills in young children with DLD. In this study, the effect of the intervention on the morphosyntactic skills of preschoolers with (presumed) DLD was tested and the usability for pedagogical practitioners (PPs) was evaluated.
METHODS & PROCEDURES: Twenty-seven preschoolers with DLD (aged 2;10-3;10 [years;months]) participated in an A-B group study in which the development of grammatical structures was monitored with a morphosyntactic task and language sample analyses (LSA). Progression during 8 weeks usual care (UC) and 8 weeks morphosyntactic intervention was examined using Bayesian mixed effects models. In LSA, structures that were targeted were compared to control structures. The intervention consisted of a weekly script-based group session in which morphosyntactic structures were targeted, and daily activities in which these target structures were repeated. The intervention was provided by trained PPs, who were coached by a speech-language therapist. An early indication of usability and feasibility was evaluated using an online questionnaire.
OUTCOMES & RESULTS: The analyses show that morphosyntactic skills improved during the intervention period, with strong evidence for growth in the production of target structures on the morphosyntactic task and target and control structures in LSA, while barely any evidence was found for growth in the use of these structures in UC. However, target structures and control structures seem to develop at the same rate. General measures of morphosyntactic ability showed improvement both during UC and the intervention phase. Evaluation among practitioners suggested that the intervention is regarded as usable and feasible.
CONCLUSIONS & IMPLICATIONS: Growth in morphosyntactic skills of children in the intervention period was demonstrated, but this could not be proven to be related to the intervention because both target and control structures improved during the intervention. This growth might be due to maturation instead of the intervention. Nevertheless, our study demonstrates that the morphosyntactic skills of preschoolers with DLD can show considerable improvement over a period of 8 weeks. Furthermore, our study underlines the importance of using LSA measures when monitoring the morphosyntactic development of children, as they might be more sensitive to change than standardised tests.
What is already known on the subject Most children with Developmental Language Disorder (DLD) experience difficulties in their morphosyntactic development. In the Netherlands, preschoolers with DLD can receive special care in language-focused treatment groups. These groups mainly focus on stimulating communicative intentions, vocabulary and phonology, but less so on stimulating morphosyntactic skills. What this study adds We designed a new group-based intervention targeting the expressive morphosyntactic skills of children with DLD, examined the effect and investigated the usability and feasibility. Although there is strong evidence for growth in morphological skills, intervention effects could not be demonstrated. Evaluations among practitioners suggested that the intervention is regarded as usable and feasible. Furthermore, this study shows that children's morphosyntactic skills can improve over relatively short periods of time and language sample analyses seem to be sensitive to detect these changes. What are the clinical implications of this work? Currently, very few group-based morphosyntactic interventions exist (in the Netherlands). Since practitioners were generally positive about the intervention and its usability and feasibility, the proposed intervention might benefit the treatment of morphosyntactic problems in children with DLD.
形态句法问题是发育性语言障碍（DLD）的核心症状。在荷兰，（疑似）患有 DLD 的儿童可以在以语言为重点的治疗小组中接受特殊护理。这些小组的重点主要在于提高交际意图、词汇和语音。形态句法技能得到的关注较少。
作者开发了一种脚本式基于小组的干预措施，针对患有 DLD 的幼儿的形态句法技能。在这项研究中，测试了干预对（疑似）患有 DLD 的学龄前儿童形态句法技能的影响，并评估了教学实践工作者（PPs）的可用性。
27 名（年龄 2；10-3；10[年；月]）患有 DLD 的学龄前儿童参加了 A-B 组研究，使用形态句法任务和语言样本分析（LSA）监测语法结构的发展。使用贝叶斯混合效应模型检查 8 周常规护理（UC）和 8 周形态句法干预期间的进展。在 LSA 中，比较了目标结构和对照结构。该干预由经过培训的 PPs 每周进行一次基于脚本的小组会议，其中目标是形态句法结构，并在日常生活中重复这些目标结构。该干预由言语治疗师进行指导。通过在线问卷评估了早期可用性和可行性的迹象。
分析表明，在干预期间，形态句法技能有所提高，在形态句法任务和 LSA 中的目标和对照结构中，目标结构的产生有很强的证据表明有所增长，而在 UC 中，几乎没有证据表明这些结构的使用有所增长。然而，目标结构和对照结构似乎以相同的速度发展。一般形态句法能力的衡量标准在 UC 和干预阶段都有所提高。实践工作者的评估表明，该干预措施被认为是可用的和可行的。
证明了干预期儿童形态句法技能的增长，但这不能证明与干预有关，因为在干预期间，目标和对照结构都有所改善。这种增长可能是由于成熟而不是干预。然而，我们的研究表明，患有 DLD 的学龄前儿童的形态句法技能可以在 8 周的时间内得到显著提高。此外，我们的研究强调了在监测儿童形态句法发展时使用 LSA 测量的重要性，因为它们可能比标准化测试更敏感。
主题已知内容：大多数患有发育性语言障碍（DLD）的儿童在形态句法发展方面都有困难。在荷兰，患有 DLD 的学龄前儿童可以在以语言为重点的治疗小组中接受特殊护理。这些小组主要侧重于激发交际意图、词汇和语音，但对激发形态句法技能的关注较少。
本文新增内容：我们设计了一种针对儿童 DLD 表达性形态句法技能的新的小组干预措施，考察了干预效果，并研究了可用性和可行性。虽然在形态技能方面有很强的增长证据，但无法证明干预的效果。实践工作者的评估表明，该干预措施被认为是可用的和可行的。此外，这项研究表明，儿童的形态句法技能可以在相对较短的时间内提高，语言样本分析似乎能够敏感地检测到这些变化。
临床意义：目前，基于小组的形态句法干预措施很少（在荷兰）。由于从业者对干预措施及其可用性和可行性普遍持积极态度，因此所提出的干预措施可能有益于治疗儿童 DLD 的形态句法问题。
