Barbara A. Bain

The Notion of Clinically Significant Change

Determining if treatment results in a significant change in a client’s communication ability can be a difficult task for clinicians. We addressed this issue by proposing a definition of clinically significant change that contains three dimensions. A clinically significant change is a change in client performance that (a) can be shown to result from treatment rather than from maturation or other uncontrolled factors, (b) can be shown to be real rather than random, and (c) can be shown to be important rather than trivial. Additionally, some methods are described for evaluating the clinical significance of improvements in client performance during treatment.

Examining Readiness for Learning Two-Word Utterances by Children With Specific Expressive Language ImpairmentDynamic Assessment Validation

Dynamic assessment examines how children respond to cues presented hierarchically from least to most supportive. The hypothesis is that childrens responsiveness reflects readiness to learn a new behavior; that is, responsiveness to the least supportive cuing indicates a readiness for immediate learning (Vygotsky, 1978). A dynamic assessment procedure was employed with 15 preschool children with specific expressive language impairment to determine their readiness for producing two-word utterances. Three types of validation were examined for the dynamic assessment procedure: construct, predictive, and concurrent. The results supported construct validity in that the subjects were able to produce more two-word utterances correctly with the more supportive cuing than they produced with the least supportive cuing. The results also supported predictive validity in that subjects who demonstrated responsiveness to the cuing hierarchy generally demonstrated greater language change during the 9-week study period th...

Data CollectionMonitoring Children’s Treatment Progress

For many of us, not having data concerning a client’s progress during treatment is tantamount to being unprepared for a lecture, or showing up at a birthday party without a present—totally unthinkable. This zealous position is based on the assumption that clinical decisions regarding treatment efficacy should be based on data. Data, in this case, refers to both quantitative and qualitative information that provides evidence for deciding the course of treatment. This is not to say that

When to Recommend Intervention

The first treatment efficacy decision that faces the clinician is deciding when a child with language impairments can benefit from intervention. This article reviews the critical issues that influence this decision and recommends a data-based approach to answering the question. Three procedures (profiling, dynamic assessment, and tracking/monitoring) are recommended as the tools for helping speech-language pathologists make informed decisions about when children might best benefit from intervention.

The influence of adaptive seating devices on vocalization

This study examined the relationship between receipt of adaptive seating devices (ASD) and sophistication of early vocalizations/verbalizations. Eight nonverbal children with cerebral palsy were studied prior to and following receipt of an ASD. Total speech tokens increased for 7 of the 8 subjects and diversity of speech sounds increased for 6 subjects. A concomitant improvement in feeding independence was observed for those subjects who demonstrated the greatest increase in speech sound diversity.

Language learning: moving performance from a context-dependent to -i ndependent state

Static and dynamic assessment procedures were used to determine actual and potential levels of functioning for two preschool language-impaired children at the single-word stage of development. The information obtained from both types of assessment was used to predict the childrens onset and rate of correct performance in a context-dependent situation (i.e. treatment) and a context-independent situation (i. e. generalization). Results of this study provide preliminary direction to clinicians as they decide who should receive direct treatment and how best to monitor learning during the therapy process.

The Natural Occurrence of Generalization during Articulation Treatment.

This study examined the extent to which generalization of correct phoneme production occurred in various speaking environments and across word positions without direct training. Three preschool children with articulation disorders received treatment in a clinic setting. Treatment targets consisted of specific phonemes restricted to particular word positions. Data were collected on the childrens productions of the target phonemes in treated and untreated word positions. In addition, the childrens productions were monitored with different adults in the clinic and at home. The results indicated that generalization occurred in the two speaking environments without direct training. The extent to which generalization occurred across word position varied and seemed to be related to specific phonemes. The practical implications of the results and methodology are discussed.

How Long To TreatA Multiple Outcome Approach

When should a child be discharged from language intervention? We address this issue by integrating the concept of multiple treatment outcomes into existing frameworks of treatment dismissal. Rosen and Proctor (1978) define three dimensions of treatment outcome: ultimate, intermediate, and instrumental. This article provides definitions of each of these and offers techniques for evaluating a child’s progress toward their attainment.

Assessment of Language in Developmentally Disabled Infants and Preschoolers

The language assessment of infants and developmentally delayed preschoolers requires a usable definition of language and a comprehensive understanding of language development. Language is a complex skill that has traditionally been viewed as consisting of four basic parts: phonology, semantics, syntax, and pragmatics. Phonology refers to the sound system of our language; semantics, to the meaning of words and word relations; syntax, to the grammatical rules for ordering words; and pragmatics, to communication, or the use of language in social contexts. Although language must always be viewed as an interactive system in which the whole is greater than the sum of the parts, the assessment process requires that the major components be examined separately. This approach is necessary for evaluating language development and for identifying specific deficit areas.