Julie E. Dockrell

CATALISE: A multinational and multidisciplinary Delphi consensus study. Identifying language impairments in children

Delayed or impaired language development is a common developmental concern, yet there is little agreement about the criteria used to identify and classify language impairments in children. Childrens language difficulties are at the interface between education, medicine and the allied professions, who may all adopt different approaches to conceptualising them. Our goal in this study was to use an online Delphi technique to see whether it was possible to achieve consensus among professionals on appropriate criteria for identifying children who might benefit from specialist services. We recruited a panel of 59 experts representing ten disciplines (including education, psychology, speech-language therapy/pathology, paediatrics and child psychiatry) from English-speaking countries (Australia, Canada, Ireland, New Zealand, United Kingdom and USA). The starting point for round 1 was a set of 46 statements based on articles and commentaries in a special issue of a journal focusing on this topic. Panel members rated each statement for both relevance and validity on a seven-point scale, and added free text comments. These responses were synthesised by the first two authors, who then removed, combined or modified items with a view to improving consensus. The resulting set of statements was returned to the panel for a second evaluation (round 2). Consensus (percentage reporting agree or strongly agree) was at least 80 percent for 24 of 27 round 2 statements, though many respondents qualified their response with written comments. These were again synthesised by the first two authors. The resulting consensus statement is reported here, with additional summary of relevant evidence, and a concluding commentary on residual disagreements and gaps in the evidence base.

Teachers’ reported practices for teaching writing in England

To date there have been no systematic studies examining the ways in which teachers in England focus and adapt their teaching of writing. The current study addresses this gap by investigating the nature and frequency of teachers’ approaches to the teaching of writing in a sample of English primary schools, using the ‘simple view of writing’ as a framework to examine the extent to which different aspects of the writing process are addressed. One hundred and eighty-eight staff from ten different schools responded to an online questionnaire. Only the data from class teachers (nxa0=xa088) who responded to all items on the questionnaire were included in the final analyses. Respondents enjoyed teaching writing and felt prepared to teach it. However, despite feeling that they were effective in identifying approaches to support students’ writing, nearly half reported that supporting struggling writers was problematic for them. Overall teachers reported more work at word level, occurring several times a week, than with transcription, sentence or text levels, which were reported to occur weekly. Planning, reviewing and revising occurred least often, only monthly. For these variables no differences were found between teachers of younger (age 4–7) and older students (age 8–11). By contrast, an examination of specific aspects of each component revealed differences between the teachers of the two age groups. Teachers of younger students focused more frequently on phonic activities related to spelling, whereas teachers of older students focussed more on word roots, punctuation, word classes and the grammatical function of words, sentence-level work, and paragraph construction.

Identifying the Challenges and Opportunities to Meet the Needs of Children with Speech, Language and Communication Difficulties.

The views of experienced educational practitioners were examined with respect to the terminology used to describe children with speech, language and communication needs (SLCN), associated problems and the impact of speech and language difficulties in the classroom. Results showed that education staff continue to experience challenges with the range of terminology used to refer to the childrens needs. Terms used to refer to difficulties with speech were least familiar to the respondents. Difficulties were noted in distinguishing between children with SLCN and children where English was an additional language. Respondents indicated a variety of additional difficulties experienced by the children. Literacy difficulties were reported to be more prevalent in children with language difficulties, while levels of bullying and anxiety were reported to be higher in children with speech problems. Respondents reported that tools for identifying speech and language difficulties and procedures for accessing effective resources are required.

Evidence-based pathways to intervention for children with language disorders (Forthcoming/Available Online)

BACKGROUNDnPaediatric speech and language therapist (SLT) roles often involve planning individualized intervention for specific children, working collaboratively with families and education staff, providing advice, training and coaching and raising awareness. A tiered approach to service delivery is currently recommended whereby services become increasingly specialized and individualized for children with greater needs.nnnAIMSnTo stimulate discussion regarding delivery of SLT services by examining evidence regarding the effectiveness of (1) intervention for children with language disorders at different tiers and (2) SLT roles within these tiers; and to propose an evidence-based model of SLT service delivery and a flowchart to aid clinical decision-making.nnnMETHODS & PROCEDURESnMeta-analyses and systematic reviews, together with controlled, peer-reviewed group studies where recent systematic reviews were not available, of interventions for children with language disorders are discussed, alongside the differing roles SLTs play in these interventions. Gaps in the evidence base are highlighted.nnnMAIN CONTRIBUTIONnThe service-delivery model presented resembles the tiered model commonly used in education services, but divides individualized (Tier 3) services into Tier 3A: indirect intervention delivered by non-SLTs, and Tier 3B: direct intervention by an SLT. We report evidence for intervention effectiveness, which children might best be served by each tier, the role SLTs could take within each tier and the effectiveness of these roles. Regarding universal interventions provided to all children (Tier 1) and those targeted at children with language weaknesses or vulnerabilities (Tier 2), there is growing evidence that approaches led by education services can be effective when staff are highly trained and well supported. There is currently limited evidence regarding additional benefit of SLT-specific roles at Tiers 1 and 2. With regard to individualized intervention (Tier 3), children with complex or pervasive language disorders can progress following direct individualized intervention (Tier 3B), whereas children with milder or less pervasive difficulties can make progress when intervention is managed by an SLT, but delivered indirectly by others (Tier 3A), provided they are well trained and supported, and closely monitored.nnnCONCLUSIONS & IMPLICATIONSnSLTs have a contribution to make at all tiers, but where prioritization for clinical services is a necessity, we need to establish the relative benefits and cost-effectiveness at each tier. Good evidence exists for SLTs delivering direct individualized intervention and we should ensure that this is available to children with pervasive and/or complex language disorders. In cases where service models are being provided which lack evidence, we strongly recommend that SLTs investigate the effectiveness of their approaches.

Analysis of cognitive and attentional profiles in children with and without ADHD using an innovative virtual reality tool

In previous studies, children with Attention-Deficit Hyperactivity Disorder (ADHD) have been found to have more difficulties with processing speed, working memory, and attentional tasks. The present study aimed to compare the cognitive variables (working memory and processing speed) and the attentional profiles of a sample of students with and without ADHD, using scales from the WISC-IV, and the virtual reality-based attentional test known as ‘Aula Nesplora’; and determine the extent to which the aforementioned variables may predict student group membership. A total of 88 students took part in this study (66 males and 22 females), aged from 6 to 16 years (M = 10.20; SD = 2.79). The sample was divided into two groups: an ADHD group (n = 50) and a Control group (n = 38). Students in the ADHD group obtained lower scores in working memory and in processing speed, as well as demonstrating poorer performance in Aula Nesplora than did their peers. Working memory, and the number of omissions, were both shown to be reliable predictors of group membership. This study revealed the importance of obtaining data from attentional variables differentiated by modality when considering cognitive variables, in order to better characterize the difficulties experienced by individuals diagnosed with ADHD.

Victimization, Bullying, and Emotional Competence: Longitudinal Associations in (Pre)Adolescents With and Without Developmental Language Disorder

PurposenVictimization is a common problem for many children but is exacerbated for children with a developmental language disorder (DLD). However, the severity of communication problems does not explain their victimization rates. In children without DLD, difficulties with emotional competence are a risk factor for victimization and also increase the risk of bullying. In this longitudinal study, we examined the extent to which the level and development of emotional competence (understanding of ones own emotions and levels of anger, sadness, and fear) contributed to the prediction of victimization and bullying in children with and without DLD, over and above the type and severity of communication problems of children with DLD.nnnMethodnClinically referred youngsters (8-16 years old) with (n = 112; 48% girls, 52% boys) and without (n = 233; 58% girls, 42% boys) DLD completed self-reports 3 times over an 18-month period. Parents of children with DLD reported on their childrens communication problems.nnnResultsnParticipants with DLD reported more victimization but comparable levels of bullying behavior compared with peers without DLD. Higher levels of sadness and fear were risk factors for more victimization in both groups. Better understanding of ones own emotions had a larger effect on less victimization in children with DLD, independent of their communication problems. In addition, increased levels of anger and lower levels of understanding of ones own emotions explained more bullying in both groups.nnnConclusionnOutcomes indicate that secondary difficulties in emotional competence in children with DLD make these children more vulnerable to victimization and warrant specific support and interventions.

Depressive symptoms and emotion regulation strategies in children with and without developmental language disorder: a longitudinal study: Depressive symptoms and emotion regulation in DLD

Abstract Background Depressive symptoms are common in children with developmental language disorder (DLD). However, risk and protective factors contributing to these problems are currently underspecified. Aims The current longitudinal study examined the role of emotion‐regulation (ER) strategies in the severity of depressive symptoms in children with and without DLD, taking into account the severity of communication problems of children with DLD. Methods & Procedures We followed clinically referred children with DLD (n = 114, 49% girls) and without DLD (n = 214, 58% girls) between the ages of 8 and 16 years across an 18‐month period. Participants completed self‐report questionnaires at three time points. Parents of children with DLD reported on their childs communication problems. Outcomes & Results Multilevel analyses confirmed higher levels of depressive symptoms in youngsters with DLD compared with peers without DLD, with a decrease across time in the DLD group. In both groups, higher levels of approach and increasing avoidant strategies aimed at distraction or trivializing a problem explained lower depressive symptoms, whereas more worry and externalizing strategies contributed to more depressive symptoms. Within the DLD group, semantic language problems were associated with higher depressive symptoms. However, this relation was mediated by the tendency to worry or use externalizing strategies. Conclusions & Implications Results suggest that interventions for children with DLD should focus on enhancing their adaptive ER strategies to help them cope with daily stressors just as in the general population.