Early Intervention for Children with Language Difficulties: An Evaluation of Two School Based Interv

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Early Intervention for Children with Language
Difficulties An Evaluation of Two School Based
Intervention Programmes
Claudine Crane, Margaret J. Snowling, Julia
Carroll, Fiona Duff, Elizabeth Fieldsend, Jeremy
Miles Charles HulmeUniversities of York and
Warwick, UK
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Outline

• Theoretical rationale
• Design of study and overview of Programmes
• Participant selection
• Training of Teaching Assistants
• Findings
• Implications for theory and practice

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Background

• According to the simple model, Reading
  Comprehension depends on both decoding and
  listening comprehension
• Muter et al (2004) different language subskills
  underpin different component reading skills
• Phonological Awareness Letters -gt Decoding
• Vocabulary Grammar -gt Read Comp
• Children with speech-language impairments at
  high-risk of RD (e.g. Catts et al., 2005
  Snowling et al., 2000)

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Intervention

• Evidence that early intervention programmes that
  train phonemes and letters in context of reading
  can facilitate reading development (decoding) in
  at-risk children (Hatcher et al 2004 Hindson et
  al., 2005)
• Less evidence regarding the role of vocabulary
  and grammatical instruction
• Question addressed by this study
• is it possible to improve the development of
  vocabulary and grammar skills in at-risk
  children?
• how do such training programmes differ in their
  effects from phonological training programmes?

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Design

• Evaluation of two interventions designed for
  children with speech and language difficulties in
  mainstream schools to be delivered by trained
  teaching assistants (TAs)
• Oral Language Programme and Reading with
  Phonology Programme
• Randomised Controlled Trial (following the
  Consort guidelines)
• 20-week programme
• 4 test phases pre-test, mid-test, post-test and
  maintenance test
• Investigators blind to group membership

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3 schools excluded (n 100) performance too
high
n 4 children unavailable for testing
Allocation Feb 2005 n 160 children selected to
take part in the intervention programmes (n 8
from each school) and randomly allocated to one
arm of the intervention project.
1 school withdrawn from programme Total n 45
Selected n 8 (4 children from each arm) n 17
children replaced following discussion with
teacher
Mar 2005 152 children seen for
pre-testing. Intervention programmes begin.
Reading with Phonology N 76 allocated to
intervention N 75 received allocated
intervention N 1 did not receive allocated
intervention moved schools but maintained
follow-up
Oral Language N 76 allocated to intervention N
76 received allocated intervention
Oral Language Discontinued Intervention N 1
moved schools Lost to follow up N 1
Reading with Phonology Discontinued intervention
N 8 moved schools Lost to follow-up N 3
Analysed n 75
Analysed n 71 Excluded from analysis n 2 -
Incomplete dataset
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Participant Recruitment and Attrition
December 2004 N 960 children in 23 schools
screened for participation in early intervention
project.
3 schools excluded (n 100) performance too
high
January 2005 n 200 children selected from
remaining 20 schools (n 860) for further testing
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January 2005 n 200 children selected from
remaining 20 schools (n 860) for further testing
n 4 children unavailable for testing
Allocation Feb 2005 n 160 children selected to
take part in the intervention programmes (n 8
from each school) and randomly allocated to one
arm of the intervention project.
1 school withdrawn from programme Total n 45
Selected n 8 (4 children from each arm) n 17
children replaced following discussion with
teacher
Mar 2005 152 children seen for
pre-testing. Intervention programmes begin.
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Mar 2005 152 children seen for
pre-testing. Intervention programmes begin.
Reading with Phonology N 76 allocated to
intervention N 75 received allocated
intervention N 1 did not receive allocated
intervention moved schools but maintained
follow-up
Oral Language N 76 allocated to intervention N
76 received allocated intervention
Reading with Phonology Discontinued intervention
N 8 moved schools Lost to follow-up N 3
Oral Language Discontinued Intervention N 1
moved schools Lost to follow up N 1
Analysed n 71 Excluded from analysis n 2 -
Incomplete dataset
Analysed n 75
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Participants (N146)
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Teaching Assistants

• Teaching assistants selected by schools
• Attended 4 day intensive training programme
• 2 Refresher days
• Fortnightly tutorials
• On-site tutorials

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Structure of the Programmes

• Programmes conducted over 2 x 10 week periods
• Following initial introduction week, teaching was
  broken into 3 week blocks consisting of two
  teaching weeks and one consolidation week
• Each week consisted of alternating daily group
  sessions or individual sessions
• Repetitive session structure familiar routine,
  positive reinforcement

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Programmes

• Reading with Phonology
• Training in letter sound knowledge (Jolly
  Phonics)
• Oral phonological awareness
• Reading books at easy and instructional levels
• Sight word vocabulary development
• Letter formation

• Oral Language
• Vocabulary development
• Speaking
• Listening
• Narrative production
• Comprehension
• Question generation

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Programmes

• Reading with Phonology
• Training in letter sound knowledge (Jolly
  Phonics)
• Oral phonological awareness
• Reading books at easy and instructional levels
• Sight word vocabulary development
• Letter formation

• Oral Language
• Vocabulary development
• Speaking
• Listening
• Narrative production
• Comprehension
• Question generation

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Measures

• Language Skills
• Reading Comprehension
• Listening Comprehension
• Specific Vocabulary
• Action Picture Test
• Bus Story
• WISC III Picture Arrangement
• Information Carrying

• Reading and Phonological Skills
• Early Word Reading
• Letter Knowledge
• Spelling
• Reading Accuracy
• Segmenting and Blending
• Sound Isolation
• Articulation

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Measures

• Language Skills
• Reading Comprehension
• Listening Comprehension
• Specific Vocabulary
• Action Picture Test
• Bus Story
• WISC III Picture Arrangement
• Information Carrying

• Reading and Phonological Skills
• Early Word Reading
• Letter Knowledge
• Spelling
• Reading Accuracy
• Segmenting and Blending
• Sound Isolation

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Mode of Analysis

• Data are clustered 4 children per arm two arms
  delivered by each TA
• Complex samples analyses giving robust estimates
  and CIs (SPSS14)
• Primary outcomes
• Vocabulary
• Grammar
• Phoneme Awareness
• Letter Knowledge
• Word Recognition
• Reading Comprehension
• Covariates age, gender, autoregressor (when
  available)

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Relative Advantage of Language Gp in z-score
units (95 CIs)
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Relative Advantage of Reading with Phonology Grp
in z-score units (95 CIs)
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Summary

• Both intervention programmes were effective in
  promoting basic skills that underlie reading
  comprehension
• Vocabulary and grammatical skills fostered better
  by language program (effect sizes .25-1.02)
• Word-level reading skills and phoneme awareness
  fostered better by early literacy program (effect
  sizes .21-.71)
• Biggest effects of training on receptive
  vocabulary (1.02) and segmentation/blending (.71)
  
• Neither program had significant effect on reading
  comprehension (effect size .19) at this early
  stage in development

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Predictors of outcome

• Explored two further predictors of childrens
  outcome
• Behaviour (SDQ total deviance score)
• Socio-economic circumstances
• Post code index of dis/advantage
• Free school meals
• Controlling for behaviour had no effect on
  findings
• Significant influence of ses on outcome

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Effect of SES?

• When SES controlled training effects remained
  significant for early literacy and phonological
  measures, and vocabulary
• No longer significant effect of training on
  grammar (APT Bus story)nor sequencing picture
  arrangement

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Conclusions

• Focused intervention programs can be delivered
  successfully by teaching assistants to 5 and
  6-year-old at risk children
• Such programmes can foster the basic skills that
  underpin word-level and text level reading skills
• Programmes emphasizing early literacy versus oral
  language skills have differential effects

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Conclusions 2

• In terms of effect size, specific vocabulary and
  phoneme awareness skills appear to be the most
  trainable skills
• Preliminary evidence that social class moderates
  gains in grammar but not in vocabulary

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Thank You

• Funders Nuffield Foundation, North Yorks County
  council
• Sponsors Jolly Phonics Black Sheep
• Schools Pupils, TAs and teachers
• Assistants Naomi Meredith, Nicky Vowles, Rachel
  Harlow, Debbie Gooch, Ros Francis, Dimitra
  Ionnau, Lisa Henderson, Lizzie Bowen, Natalie
  Falkinder, Sarah Edwards, Emma Truelove, Kim
  Manderson, Jodie Unau, Michelle Cargan, Pam
  Baylis, Rachael McCool, Elisa Romeo, Meesha
  Warmington, Poppy Nash, Janet Hatcher