Purpose: Over 49,000 speech-language pathologists (SLPs) provide services for over one million elementary school pupils who have a primary speech and language impairment. Despite the prevalence and $36 billion annual expense of speech-language services, there is little research showing which characteristics of language intervention specifically lead to improved language outcomes for students. In order to identify "what works" in speech-language pathology, this study will identify characteristics of language intervention received by early elementary pupils with primary language impairment within public school programs. Specifically, this research will examine how dosage (e.g., how much and how often intervention is provided), techniques (e.g., what language targets are addressed and steps for doing so), and context (e.g., where intervention is provided and the size of student groupings) are associated with language outcomes, providing guidance for future speech-language pathology intervention development and efficacy studies.

Project Activities: This identification study will conduct primary data collection to carefully study dosage, technique, and context for kindergarteners and first graders with language impairment receiving treatment from 90 speech-language pathologists. Participating students will be screened to include only students with primary language impairment, and exclude students who exhibit language differences (e.g., English language learners) or language difficulties stemming from other primary origins (e.g., hearing loss). Participating students are tested on measures of language and reading in the fall and the spring of the academic year. Between these assessments, students are observed in six therapy sessions and characteristics of the therapy sessions are recorded. The SLPs will also maintain a log for each child that specifies dosage, technique, context, and any published intervention programs used.

Products: This research will identify associations between dosage, techniques, and context of language interventions and student language outcomes. The results of this research will provide guidance for future development (Goal Two) and efficacy projects (Goal Three) that develop and test specific approaches to language intervention in schools.

Structured Abstract

Setting: Public elementary schools across Ohio.

Population: The study will include 90 public school-based speech-language pathologists (SLPs) and 450 kindergarten and first grade students with primary language disorders, excluding those who exhibit language differences (i.e., English language learners) or language difficulties stemming from other primary origins (e.g., autism, hearing loss). A total of 5 students on the caseload of each SLP will be recruited.

Intervention: N/A

Research Design and Methods: This study uses a real-time prospective longitudinal research design. Participating students will complete a battery of language and reading measures in the fall and spring of the academic year with a nine-month interval between assessments. Between these assessments, students are observed in six therapy sessions and characteristics of the therapy sessions are recorded. The SLPs will also maintain a log for each child that specifies dosage, context, and any published intervention programs used. The primary question is to identify those characteristics of school-based language intervention that are uniquely associated with language growth for early elementary students with language impairment. Three specific questions guide the research: (1) To what extent is the dosage (e.g., length of therapy session) of language intervention associated with language growth for early elementary pupils with language impairment? (2) To what extent are the techniques (e.g., support, manipulatives) of language intervention associated with language growth for early elementary pupils with language impairment? (3) To what extent are the contexts of language intervention (e.g., physical location, number of session participants) associated with language growth for early elementary pupils with language impairment?

Control Condition: N/A

Key Measures: Screening measures will include a hearing assessment, a brief cognitive assessment, and language assessments. The battery of language and reading ability measures will include conversational samples and three subtests of the Woodcock-Johnson III Tests of Achievement. Measures of classroom quality and home experiences will also be collected for each child as potential. Characteristics of the language interventions will be measured with a coding scheme developed for the purpose of this study, the Language Intervention Observation Scale (LIOS).

Data Analytic Strategy: Hierarchical linear modeling will provide estimates of different intervention characteristics and children's spring language outcomes, considering both main effects when controlling for all other intervention characteristics as well as moderated effects (e.g., how one intervention characteristic influences another). The data structure used will be a two-level model that treats children as being nested within SLP, and potential school level predictors (e.g., percentage of children receiving free/reduced lunch, average kindergarten reading scores on state tests) as fixed effects. Because natural co-variation between dosage, techniques, and contexts are likely to occur, these three predictors will be considered simultaneously in the models.

Products and Publications

Journal article, monograph, or newsletter

Biancone, T.L., Farquharson, K., Justice, L.M., Schmitt, M.B., and Logan, J.A. (2014). Quality of Language Intervention Provided to Primary-Grade Students With Language Impairment. Journal of Communication Disorders, 49: 13–24. doi:10.1016/j.jcomdis.2014.03.001

Farquharson, K., Tambyraja, S. R., Justice, L. M., and Redle, E. E. (2014). IEP Goals for School-Age Children with Speech Sound Disorders. Journal of Communication Disorders, 52: 184–195. doi:10.1016/j.jcomdis.2014.09.005

Farquharson, K., Tambyraja, S. R., Logan, J., Justice, L. M., and Schmitt, M. B. (2015). Using Hierarchical Linear Modeling to Examine How Individual SLPs Differentially Contribute to Children's Language and Literacy Gains in Public Schools. American Journal of Speech-Language Pathology, 24(3): 504–516. doi:10.1044/2015_AJSLP-14–0055

Justice, L. M., Logan, J., Schmitt, M. B., and Jiang, H. (2016). Designing Effective Speech-Language Interventions for Children in the Public Schools Leverage the Spacing Effect. Policy Insights from the Behavioral and Brain Sciences, 3(1): 85–91. doi:10.1177/2372732215624705

Justice, L.M., Schmitt, M.B., Murphy, K.A., Pratt, A., and Biancone, T. (2014). The "Robustness" of Vocabulary Intervention in the Public Schools: Targets and Techniques Employed in Speech-Language Therapy. International Journal of Language and Communication Disorders, 49(3): 288–303. doi:10.1111/1460–6984.12072

Schmitt, M. B., Justice, L. M., and Logan, J. A. (2017). Intensity of Language Treatment: Contribution to Children's Language Outcomes. International Journal of Language & Communication Disorders, 52(2): 155–167. doi:10.1111/1460–6984.12254

Schmitt, M. B., Justice, L. M., Logan, J. A., Schatschneider, C., and Bartlett, C. W. (2014). Do the Symptoms of Language Disorder Align with Treatment Goals? An Exploratory Study of Primary-Grade Students' IEPs. Journal of Communication Disorders, 52: 99–110. doi:10.1016/j.jcomdis.2014.06.002

Schmitt, M.B., Justice, L.M., and O'Connell, A. (2014). Vocabulary Gain Among Children With Language Disorders: Contributions of Children's Behavior Regulation and Emotionally-Supportive Environments. American Journal of Speech-Language Pathology, 23(3): 373–384. doi:10.1044/2014_AJSLP-12–0148

Tambyraja, S. R., Farquharson, K., Logan, J. A., and Justice, L. M. (2015). Decoding Skills in Children with Language Impairment: Contributions of Phonological Processing and Classroom Experiences. American Journal of Speech-Language Pathology, 24(2): 177–188. doi:10.1044/2015_AJSLP-14–0054

Tambyraja, S. R., Schmitt, M. B., Farquharson, K., and Justice, L. M. (2015). Stability of Language and Literacy Profiles of Children with Language Impairment in the Public Schools. Journal of Speech, Language, and Hearing Research, 58(4): 1167–1181. doi:10.1044/2015_JSLHR-L-14–0197

Tambyraja, S. R., Schmitt, M. B., Farquharson, K., and Justice, L. M. (2017). Home Literacy Environment Profiles of Children with Language Impairment: Associations with Caregiver- and Child-Specific Factors. International Journal of Language & Communication Disorders, 52(2): 238–249. doi:10.1111/1460–6984.12269

Tambyraja, S.R., Schmitt, M.B., Justice, L.M., Logan, J.A., and Schwarz, S. (2014). Integration of Literacy into Speech-Language Therapy: A Descriptive Analysis of Treatment Practices. Journal of Communication Disorders, 47: 34–46. doi:10.1016/j.jcomdis.2014.01.004