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Understanding differing outcomes from semantic and phonological interventions with children with word-finding difficulties: A group and case series study

Lookup NU author(s): Professor David Howard

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Abstract

© 2020 Elsevier Ltd. Developmental Language Disorder occurs in up to 10% of children and many of these children have difficulty retrieving words in their receptive vocabulary. Such word-finding difficulties (WFD) can impact social development and educational outcomes. This research aims to develop the evidence-base for supporting children with WFD and inform the design and analysis of intervention studies. We included 20 children (age 6 to 8) with WFD each of whom participated in two interventions one targeting semantic attributes and the other phonological attributes of target words. The interventions, employing word-webs, were carefully constructed to facilitate direct comparison of outcome which was analysed at both group and case-series level. The study used a robust crossover design with pre-intervention baseline, between–intervention wash-out and post-intervention follow-up testing. We incorporated: matching of item sets on individual performance at baseline, independent randomisation of order of intervention and items to condition, blinding of assessor, evaluation of fidelity and control items. The interventions were clinically feasible, with weekly sessions over six weeks. Intervention improved children's word-finding abilities with statistically significant change only during treatment phases of the study and not over baseline, wash-out or follow-up phases. For the group the semantic intervention resulted in a gain of almost twice as many items as the phonological intervention, a significant difference. However, children differed in their response to intervention. Importantly, case-series analysis revealed outcomes predictable on the basis of children's theoretically driven language profiles. Taking account of individual profiles in determining choice of intervention would enable more children to benefit. The study provides new evidence to inform and refine clinical practice with this population. Future studies should be designed such that results can be analysed at both group and case series levels to extend theoretical understanding and optimise use of appropriate interventions.

Publication metadata

Author(s): Best W, Hughes L, Masterson J, Thomas MSC, Howard D, Kapikian A, Shobbrook K

Publication type: Article

Publication status: Published

Journal: Cortex

Year: 2021

Volume: 134

Pages: 145-161

Print publication date: 01/01/2021

Online publication date: 17/11/2020

Acceptance date: 22/09/2020

ISSN (print): 0010-9452

ISSN (electronic): 1973-8102

Publisher: Masson SpA

URL: https://doi.org/10.1016/j.cortex.2020.09.030

DOI: 10.1016/j.cortex.2020.09.030

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