Purpose: Proficient language is necessary for young children to communicate their needs. It also facilitates their social interactions. However, many young children with significant developmental disabilities are unable to acquire and use language to interact with their surroundings due to their overwhelming inability to produce or comprehend speech. Severe spoken language impairment, coupled with developmental disabilities, has profound consequences for a child's long-term development and success in school. In order to ameliorate these developmental and educational consequences, young children with language impairment need valid, specialized interventions that specifically address the scope and severity of their needs.

To address this problem, researchers at Georgia State University are developing a parent-implemented augmented language intervention. The intervention is intended for young children with a range of developmental disabilities who encounter significant difficulty with speech and language. The researchers are also conducting an initial evaluation of whether the intervention improves these children's communication and school outcomes.

Project Activities: Two studies will be conducted. The first study will follow up with children from a previous intervention study. The previous study compared three language interventions implemented by parents when their children were toddlers. Follow up will occur with these children who are now 6 to 9 years old to examine their progress since receiving the intervention as toddlers. In the second study, children will be given either a parent-implemented intervention that focuses on language comprehension and production or a parent-implemented intervention that focuses on only language production. Data on communication skills at three, six, and twelve months after the intervention will be collected and analyzed to determine the potential effects that the two interventions have on communication and school outcomes.

Products: Expected outcomes include a parent-implemented language intervention and accompanying training materials designed to improve children's language skills; publications; and presentations.

Structured Abstract

Purpose: Proficient language is necessary for young children to communicate their needs. It also facilitates their social interactions. However, many young children with significant developmental disabilities are unable to acquire and use language to interact with their surroundings due to their overwhelming inability to produce or comprehend speech. Severe spoken language impairment, coupled with developmental disabilities, has profound consequences for a child's long-term development and success in school. In order to ameliorate these developmental and educational consequences, young children with language impairment need valid, specialized interventions that specifically address the scope and severity of their needs.

To address this problem, researchers at Georgia State University are developing a parent-implemented augmented language intervention. The intervention is intended for young children with a range of developmental disabilities who encounter significant difficulty with speech and language. The researchers are also conducting an initial evaluation of whether the intervention improves these children's communication and school outcomes.

Setting: The research will be conducted at Georgia State University and in the homes of young children with disabilities in Georgia.

Population: There are two samples of children. The first sample includes 60 children who are six to nine years old, have developmental disabilities, and have previously participated in a longitudinal study of parent-implemented language interventions during their toddler years. Approximately 50 toddlers will comprise the second sample. The toddlers are 24 to 36 months old; are not speaking; and have significant developmental delays, primitive intentional communication abilities, upper extremity gross motor skills that permit them to touch symbols on a speech-generating communication device, and a primary disability other than delayed speech and language impairment, deafness/hearing impairment, or autism.

Intervention: A parent-implemented augmented language intervention that focuses on language comprehension and production will be developed. The interventionist and parents will use a speech-generating device to provide communication input to the child, and the child will use it to produce communication. The intervention will take place over 12 weeks with two sessions per week. For 9 weeks, sessions will occur in a laboratory setting, and for three weeks, sessions will take place in the child's home. Each session will last for 30 minutes and consist of three 10-minute blocks of play, book reading, and snack time in that order. A set of targeted vocabulary words will be chosen for each child by the parent and project staff. Parents will receive an intervention protocol manual with weekly materials that include goals for the parent, interventionist, and child. For the first 4 weeks (8 sessions), the parents and a speech-language pathologist will observe the interventionist implementing the intervention with the child. During the observations, the speech language pathologist will highlight strategies used by the interventionist. Beginning in the fifth week, the parent will join intervention sessions on a limited basis. Parents will lead entire 30 minute sessions, including the intervention sessions conducted in the child's home, beginning in the eighth week.

Research Design and Methods: Two studies are being conducted. The first study is a continuation of a previous intervention study comparing three types of parent-implemented language interventions during the toddler years. Follow up will occur with children who participated in the original longitudinal study and are now 6 to 9 years old. This study will investigate the course a child takes given his or her unique early communication experiences.

In the second study, approximately 50 children will participate over three years. Half of the children will be randomly assigned to the newly developed intervention that focuses on language comprehension and production and half to a language production control condition. Within each intervention group, half of the children will be randomly assigned to receive the intervention immediately and half to receive the intervention in three months. Communication skills at three, six, and twelve months after the intervention will be assessed.

Control Condition: The comparison intervention will focus on only language production. Children in the comparison condition will use a speech-generating device to communicate. The device will not be used for language comprehension.

Key Measures: Outcome measures for both studies include measures of general development, and communication, language, and literacy development. In addition, data on parent perceptions of child experiences and development and information related to the child's medical, assessment, and intervention histories will be gathered. Finally, for the first study, a copy of the child's Individualized Education Program (IEP) will be obtained.

Data Analytic Strategy: Multiple statistical analysis techniques will be used to analyze the data from the first study to illustrate how children's development, particularly communication skills, changed based on the type of intervention received. In addition, multiple regression techniques, analysis of variance, and analysis of covariance will be used in the second study to determine the (a) the potential efficacy of the speech comprehension and production intervention as compared to the language production control condition; (b) differences on outcomes between children who received the intervention immediately and those who received the intervention in three months (within each condition); and (c) children's growth in communication skills over time.