Oral Language Intervention Research Articles

Intervention studies with group design targeting expressive phonology for children with developmental speech and language disorder: A systematic review and meta-analysis.

Phonological difficulties are prevalent in children with speech and/or language disorders and may hamper their later language outcomes and academic achievements. These children often form a significant proportion of speech and language therapists' caseloads. There is a shortage of information on evidence-based interventions for improving phonological skills in children and adolescents with speech and language disorder. The aim of this systematic literature review and meta-analysis was to systematically examine the effects of different intervention approaches on speech production accuracy and phonological representation skills in children with speech and language disorders. A preregistered systematic review (International Prospective Register of Systematic Reviews ID: CRD42017076075) adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was completed. Seven electronic databases (PubMed, Web of Science, ERIC, PsychINFO, Cochrane Library, SCOPUS and Linguistics & Language Behavior Abstracts) were searched for studies related to oral language interventions with children with developmental speech and/or language disorder (mean age ranging from 3-18 years) published between January 2006 and August 2022. The included articles reported intervention studies with a group design in which speech production accuracy was the outcome measure. Studies were appraised using the Cochrane risk of bias tool, and individual effect sizes were calculated using standardised means differences when enough data was available. A meta-analysis was conducted obtaining the average standardised mean difference d. Heterogeneity, influence of possible moderator variables and publication bias were explored. The 23 studies that met the inclusion criteria presented low-medium risk of bias. Nine effect sizes were obtained from seven of these studies that presented a pre-post-test with a control group design. Medium-high average effect sizes were found in phonological accuracy. Heterogeneity was found between individual effect sizes. Significant moderator variables and publication bias were not detected. The results of this meta-analysis indicate positive effects on speech production accuracy. Based on this review, further improvements in the quality of reporting for intervention research are required in developing the evidence base for practice. What is already known on the subject An increasing number of interventions is available for children and adolescents with developmental speech and/or language disorders. Previous reviews suggest relatively low levels of evidence of interventions having phonology as an outcome measure. What this paper adds to the existing knowledge This review and meta-analysis summarise the intervention evidence from a substantial body of group design studies, indicating positive results from a range of interventions with phonological outcomes. It highlights the need to systematically implement and replicate different intervention procedures to understand factors that will maximise positive outcomes and to grow the evidence base for best practice. What are the potential or actual clinical implications of this study? Tentative evidence is emerging for the effectiveness of various approaches in enhancing speech production accuracy skills of children and adolescents with developmental speech and/or language disorder.

Synthesis and Meta-Analysis of Oral Language Interventions on the Vocabulary and Listening Comprehension Development of Young Children

ABSTRACT The purpose of this study was to systematically review the components of oral language (OL) instruction and meta-analyze the effects of OL instruction on vocabulary and listening comprehension (LC) skills. We included experimental and quasi-experimental studies with 3- to 6-year-old children at risk for reading difficulties based on economic disadvantage or poor performance on OL assessments. Additionally, included studies had to report using at least one vocabulary or LC outcome measure. From the 16 eligible studies, we computed 80 standardized mean differences (SMDs), ranging from 2 to 14 SMDs per study (Mdn = 4). The multivariate weighted average SMD with robust variance yielded a positive effect of 0.52 (95% CI = 0.29 – 0.76), indicating OL instruction significantly improved children’s vocabulary and LC. Although measure type, intervention session length and frequency, and publication type were explored as moderators, only outcome skill and measure type were significant. Findings suggest it is feasible for classroom teachers to implement effective OL practices.

Plano de intervenção em vocabulário, memória de trabalho e consciência sintática para adolescentes e jovens adultos com trissomia do 21: desenvolvimento e validação do conteúdo

ABSTRACT Purpose: to develop and validate the content of an intervention plan for adolescents and young adults with Trisomy 21, focusing on vocabulary, working memory, and syntactic awareness. Methods: a methodological study with validation stages for the proposed intervention, which was assessed by ten judges. The content validity index was used to evaluate the content, quantitatively. Results: most judges had a doctoral degree. All propositions reached the minimum score. The oral language intervention plan focusing on vocabulary, working memory, and syntactic awareness was designed for adolescents and young adults aged 13 to 25 years and 11 months. The proposal included fifteen 40-minute weekly sessions. Conclusion: the study presented the process of developing and validating the Oral Language Therapy Plan, focusing on vocabulary, working memory, and syntactic awareness for people presented with trisomy 21, with the judges’ agreement.

Oral language interventions can improve language outcomes in children with neurodevelopmental disorders: A systematic review and meta-analysis.

Young people who fail to develop language as expected face significant challenges in all aspects of life. Unfortunately, language disorders are common, either as a distinct condition (e.g., Developmental Language Disorder) or as a part of another neurodevelopmental condition (e.g., autism). Finding ways to attenuate language problems through intervention has the potential to yield great benefits not only for the individual but also for society as a whole. This meta-analytic review examined the effect of oral language interventions for children with neurodevelopmental disorders. The last electronic search was conducted in April 2022. Intervention studies had to target language skills for children from 2 to 18 years of age with Developmental Language Disorder, autism, intellectual disability, Down syndrome, Fragile X syndrome, and Williams syndrome in randomised controlled trials or quasi-experimental designs. Control groups had to include business-as-usual, waiting list, passive or active conditions. However, we excluded studies in which the active control group received a different type, delivery, or dosage of another language intervention. Eligible interventions implemented explicit and structured activities (i.e., explicit instruction of vocabulary, narrative structure or grammatical rules) and/or implicit and broad activities (i.e., shared book reading, general language stimulation). The intervention studies had to assess language skills in receptive and/or expressive modalities. The search provided 8195 records after deduplication. Records were screened by title and abstract, leading to full-text examinations of 448 records. We performed Correlated and Hierarchical Effects models and ran a retrospective power analysis via simulation. Publication bias was assessed via p-curve and precision-effect estimate. We examined 38 studies, with 46 group comparisons and 108 effects comparing pre-/post-tests and eight studies, with 12 group comparisons and 21 effects at follow-up. The results showed a mean effect size of d = 0.27 at the post-test and d = 0.18 at follow-up. However, there was evidence of publication bias and overestimation of the mean effects. Effects from the meta-analysis were significantly related to these elements: (1) receptive vocabulary and omnibus receptive measures showed smaller effect sizes relative to expressive vocabulary, grammar, expressive and receptive discourse, and omnibus expressive tests; and (2) the length of the intervention, where longer sessions conducted over a longer period of time were more beneficial than brief sessions and short-term interventions. Neither moderators concerning participants' characteristics (children's diagnosis, diagnostic status, age, sex, and non-verbal cognitive ability and severity of language impairment), nor those regarding of the treatment components and implementation of the language interventions (intervention content, setting, delivery agent, session structure of the intervention or total number of sessions) reached significance. The same occurred to indicators of study quality. The risk of bias assessment showed that reporting quality for the studies examined in the review was poor. In sum, the current evidence base is promising but inconclusive. Pre-registration and replication of more robust and adequately powered trials, which include a wider range of diagnostic conditions, together with more long-term follow-up comparisons, are needed to drive evidence-based practice and policy.

Kia Tīmata Pai (Best Start): a study protocol for a cluster randomised trial with early childhood teachers to support children’s oral language and self-regulation development

IntroductionOral language skills are associated with children’s later self-regulation and academic skills; in turn, self-regulation in early childhood predicts successful functioning later in life. The primary objective of this study...

Oral Language Intervention Programs for Preschool-aged Children: A Systematic Literature Review

Oral Language Intervention Programs for Preschool-aged Children: A Systematic Literature Review

‘What's the magic word?’: mapping oral language interventions implemented in prevention and early intervention programmes

ABSTRACT The nationally funded Prevention and Early Intervention (PEI) programme aimed to design, deliver and evaluate interventions to improve a range of outcomes for children growing up in areas of low socio-economic status (SES). A key focus for many PEI programmes was to improve the oral language abilities of children, recognising its important link to a range of literacy, learning, social, emotional and behavioural indicators. This paper reviewed the published reports of PEI and community programmes that implemented oral language interventions for children, parents and practitioners. This mapping exercise demonstrated that the oral language interventions implemented varied extensively and were predominantly evaluated through gathering the perspectives of those receiving the supports. A noticeable gap was the lack of a national evaluation framework of the oral language interventions provided, resulting in difficulties making comparisons, determining impact and contributing to the evidence base of the effectiveness of bespoke interventions designed and delivered. Implications of this mapping exercise are outlined for the future implementation and evaluation of universal and targeted oral language interventions.

Early language intervention improves behavioral adjustment in school: Evidence from a cluster randomized trial

Oral language skills are critical for psychosocial development and children with language difficulties are more likely than peers to experience behavioral problems. This study investigated the effects of an oral language intervention on behavioral adjustment. We collected teacher ratings of behavioral adjustment for 1173 children taking part in a cluster randomized trial of the Nuffield Early Language Intervention (NELI) program in 193 primary schools. Ratings were collected before and immediately after the 20-week intervention. Children receiving the language program showed significantly greater improvements than the untreated control group on a latent variable reflecting behavioral adjustment (d = 0.23). However, the improvements in behavioral adjustment for children receiving language intervention were not mediated by improvements in language. We suggest that the improvements in behavioral adjustment are a consequence of the small group and individual teaching sessions in the language intervention program, which emphasizes the need to pay attention and regulate behavior. This emphasis appears to produce generalized improvements in children's behavior regulation outside of the targeted language teaching sessions.

Delivering language intervention at scale: promises and pitfalls

BackgroundThere is now substantial evidence that language interventions delivered to small groups can be effective for improving language skills and hence strengthening the foundation for formal schooling. However, there are remaining challenges when delivering such interventions in naturalistic environments at scale.MethodWe reflect on three randomised trials designed to evaluate the impact of an early years language programme, prior to the implementation of a large effectiveness trial, delivered in partnership with speech and language professionals. We consider findings within a framework from implementation science.ResultsWe found that, in contrast to policy‐led interventions for reading and mathematics, language interventions are not prioritised in mainstream settings. Aside from this, other obstacles to delivery were the time taken to prepare and to timetable sessions, lack of communication about the requirements of delivery and the need for language screening. Crucial to success was the support from the class teacher of teaching assistants delivering the intervention. However, feedback was largely positive from most stakeholders, and the intervention was found to have a positive impact on children's language with preliminary evidence for effects on behaviour and on reading comprehension.ConclusionsWhile many educators recognise the importance of language for communication, the benefits of oral language interventions are only recently becoming prioritised by policy‐makers. We propose that challenges to successful delivery and adoption of evidence‐based language interventions in mainstream settings can be remedied through better communication with stakeholders and collaboration between researchers and professional colleagues including senior leaders, teachers, teaching assistants, speech and language therapists and psychologists. It is imperative to take account of issues of implementation when designing an intervention and to do this successfully is a multidisciplinary enterprise.

The effects of a multi-tiered system of language support on oral narrative language, writing, and reading comprehension in India

Background: Children in India are among the lowest performing students on international reading comprehension and writing assessments. Oral language instruction may improve these literacy outcomes. Aim: This pilot study investigated whether a multi-tiered system of language support (MTSLS) improved oral narrative language comprehension, reading comprehension, and writing in second and third grade students in India. Methods & Procedures: There were 121 second and third grade participants in this quasi-experimental study. Twelve classrooms were randomly assigned to a treatment, an alternate-treatment, or a no-treatment control condition. The treatment group participated in 8 weeks of multi-tiered Story Champs oral language intervention, the alternate-treatment group participated in 8 weeks of shared storybook intervention, and the no-treatment group served as a control. Teachers in India received training and feedback from researchers in the U.S. using videoconferencing. Videoconferencing was also used to deliver the small group, tier-2 Story Champs intervention. Results: Results indicated that students who received Story Champs instruction had significantly higher scores across all outcomes compared to the students in the alternate-treatment and in the no-treatment control groups. Conclusions: This pilot study indicates that oral narrative MTSLS instruction may help students in India improve their oral language, reading comprehension, and writing performance.

The Impact of Intervention Dose Form on Oral Language Outcomes for Children With Developmental Language Disorder.

Purpose The aim of this study was to extract key learning from intervention studies in which qualitative aspects of dosage, dose form, have been examined for children with developmental language disorder (DLD)-in vocabulary, morphosyntax, and phonology domains. This research paper emerged from a pair of systematic reviews, aiming to synthesize available evidence regarding qualitative and quantitative aspects of dosage. While quantitative aspects had been experimentally manipulated, the available evidence for dose form (tasks or activities within which teaching episodes are delivered) was less definitive. Despite this, the review uncovered insights of value to DLD research. Method A preregistered systematic review (PROSPERO ID: CRD42017076663) adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was completed. Included papers were quasi-experimental, randomized controlled trial, or cohort analytic studies, published in any language between January 2006 and May 2019; oral language interventions with vocabulary, morphosyntax, or phonology outcomes; and participants with DLD (M = 3-18 years). The intention was to include papers in which dose form was experimentally manipulated or statistically analyzed, while quantitative dosage aspects were controlled, such that definitive conclusions about optimal dose form could be drawn and gaps in the evidence identified. Results Two hundred and twenty-four papers met the above inclusion criteria; 27 focused on dose form. No study controlled for all quantitative aspects of dosage such that we could effectively address our original research questions. Despite this, key points of learning emerged with implications for future research. Conclusions There is tentative evidence of advantages for explicit over implicit instruction and of the benefits of variability in input, elicited production, and gestural and other visual supports. With careful design of dose form, there is potential to design more efficient interventions. Speech-language pathology research would benefit from an agreed taxonomy of dose form components and standardized reporting of intervention studies, to enable cross-study comparisons and a systematic accrual of knowledge to identify optimal dose form for clinical application.

Early language screening and intervention can be delivered successfully at scale: evidence from a cluster randomized controlled trial.

It is well established that oral language skills provide a critical foundation for formal education. This study evaluated the effectiveness of the Nuffield Early Language Intervention (NELI) programme in ameliorating language difficulties in the first year of school when delivered at scale. We conducted a cluster randomized controlled trial (RCT) in 193 primary schools (containing 238 Reception classrooms). Schools were randomly allocated to either a 20-week oral language intervention or a business-as-usual control group. All classes (N = 5,879 children) in participating schools were screened by school staff using an automated App to assess children's oral language skills. Screening identified 1,173 children as eligible for language intervention: schools containing 571 of these children were allocated to the control group and 569 to the intervention group. Children receiving the NELI programme made significantly larger gains than the business-as-usual control group on a latent variable reflecting standardized measures of language ability (d = .26) and on the school-administered automated assessment of receptive and expressive language skills (d = .32). The effects of intervention did not vary as a function of home language background or gender. This study provides strong evidence for the effectiveness of a school-based language intervention programme (NELI) delivered at scale. These findings demonstrate that language difficulties can be identified by school-based testing and ameliorated by a TA delivered intervention; this has important implications for educational and social policy.

The Influence of Quantitative Intervention Dosage on Oral Language Outcomes for Children With Developmental Language Disorder: A Systematic Review and Narrative Synthesis.

Purpose The aim of this study was to examine the degree to which quantitative aspects of dosage (dose, dose frequency, and total intervention duration) have been examined in intervention studies for children with developmental language disorder (DLD). Additionally, to establish the optimal quantitative dosage characteristics for phonology, vocabulary, and morphosyntax outcomes. Method This registered review (PROSPERO ID CRD42017076663) adhered to PRISMA guidelines. Search terms were included in seven electronic databases. We included peer-reviewed quasi-experimental, randomized controlled trial or cohort analytical studies, published in any language between January 2006 and May 2020. Included articles reported on participants with DLD (M = 3-18 years); oral language interventions with phonology, vocabulary, or morphosyntax outcomes; and experimental manipulation or statistical analysis of any quantitative aspect of dosage. Studies were appraised using the Cochrane risk-of-bias tool. Results Two hundred forty-four articles reported on oral language interventions with children with DLD in the domains of interest; 13 focused on experimentally/statistically manipulating quantitative aspects of dosage. No article reported phonological outcomes, three reported vocabulary, and eight reported morphosyntax. Dose frequency was the most common characteristic manipulated. Conclusions Research is in its infancy, and significant further research is required to inform speech-language pathologists in practice. Dosage characteristics are rarely adequately controlled for their individual effects to be identified. Findings to date suggest that there is a point in vocabulary and morphosyntax interventions after which there are diminishing returns from additional dosage. If dose is high (number of learning opportunities within a session), then the literature suggests that session frequency can be reduced. Frequent, short sessions (2/3 × per week, approximately 2 min) and less frequent, long sessions (1 × per week, approximately 20 min) have yielded the best outcomes when composite language measures have been used; however, replication and further research are required before clinicians can confidently integrate these findings into clinical practice. Supplemental Material https://doi.org/10.23641/asha.13570934.

Improvement in oral language interventions: Differences and relation between effects on treatment-inherent measures and effects on standardized tests

Whether the effects of an oral-language intervention is tested with measures of trained vocabulary (treatment-inherent tests) or standardized measures (treatment-independent tests) can have consequences for the mean effect size in meta-analyses. Moreover, based on a theory of transfer effects, effects on the trained words could serve as an index of how much benefit is gained by children from the intervention. We present a meta-analysis that assesses the differences and relation between the intervention effects of these two types of outcomes, trained vocabulary and standardized vocabulary tests. The results show large effects on trained vocabulary, limited effects on standardized measures, and no clear relation between the two. The moderator analysis indicates that less instruction time is associated with larger effect sizes on trained vocabulary but that trained vocabulary is not a predictor of either standardized expressive or receptive vocabulary. Thus, in interventions and meta-analyses, it is important to distinguish between effects on trained vocabulary and standardized tests, and trained vocabulary effects does not necessarily transfer to standardized measures. This indicates that effects on trained vocabulary outcomes provide limited information when evaluating language interventions.

Interactive elaborative storytelling fosters vocabulary in pre-schoolers compared to repeated-reading and phonemic awareness interventions

Early childhood represents a crucial time for ameliorating language difficulties, particularly for children who speak a minority language at home. Previous approaches have focused on teaching vocabulary, often embedded in story reading sessions. We reason that contextualization of interventions influences children’s interest in stories and language, testing a new interactive elaborative storytelling (IES) approach against a repeated-reading and phonemic awareness condition. 293 children, of whom 44.6 % spoke a minority language at home, were randomly assigned (in clusters) to three intervention conditions, conducted over the course of four months. Pre-test and post-test measures tapped receptive and expressive story-vocabulary, receptive and expressive general vocabulary, phonemic awareness, and oral narrative skill. Additionally, we measured story-delivery and children’s behavior during the intervention sessions. Children were more actively involved in the IES and more off-task in the phonemic awareness condition. Story-vocabulary improved most in the IES conditions and phonemic awareness in the phonemic awareness condition. Children with minority home languages profited equally from the interventions. Results are discussed in terms of the challenges and benefits of oral language interventions for children.

Oral sentence generation training to improve fifth and 10th graders\u2019 writing

Text generation—the mental translation of ideas into language at word, sentence, and discourse levels—involves oral language abilities. However, oral language skills are rarely a target of writing interventions. We ran an intervention to improve fifth and 10th graders’ written production through the development of oral sentence generation (grammatical and syntactic) skills. One hundred and fifteen students—68 fifth graders (four classrooms) and 47 tenth graders (four classrooms)—participated in a stepped-wedge cluster-randomized controlled trial. Two fifth-grade classrooms (n = 35) and two 10th-grade classrooms (n = 20) received nine 90-min sessions (3 weeks, three sessions a week) of oral language intervention immediately after the pretest (experimental groups); the two other fifth- (n = 33) and 10th-grade classrooms (n = 27) received business-as-usual writing instruction and received a delayed oral language intervention after the posttest (waiting list group). The intervention consisted of team-based games to improve oral sentence generation and sentence reformulation skills. We assessed written sentence generation, written sentence reformulation, written text quality (macrostructure and language), and text writing fluency before (pretest) and after (posttest) the intervention and 5 weeks after the intervention (follow-up). The results showed that training on oral sentence generation skills can lead to significant gains in both sentence generation and sentence reformulation skills and text macrostructural quality. Improvement at the sentence level was, however, significant only for the younger writers (fifth graders).

Examining the Effects of Multitiered Oral Narrative Language Instruction on Reading Comprehension and Writing

This early-stage feasibility study investigated the effects of a multitiered oral narrative language intervention on oral language, reading comprehension, and writing. Twenty-eight second-grade students participated in this quasi-experimental control group study with assignment at the classroom level. The independent variable was large- and small-group oral narrative language intervention that required students to retell increasingly complex stories that were strategically crafted to include academic language typically found in grade-level reading material. Story grammar, causal adverbial subordinate clauses, elaborated noun phrases, adverbs, and the acquisition of word meanings through context were explicitly taught. Students' performance on proximal measures of oral narrative retells, as well as distal measures of reading comprehension and writing, was assessed at pretest and posttest. Statistically significant differences between the treatment and control groups were found on all outcome measures using nonparametric analyses. Large- and small-group multitiered oral narrative instruction improved not only oral narrative language but also reading comprehension and written composition.

From the Editors

In this last issue of Volume 40, the invited issue editor, Dr. Kelly Farquharson, brings together researchers from across the country and the globe who have a strong devotion to helping school-based speech–language pathologists provide evidence-based, educationally impactful services to the students on their caseloads. Two articles deal with services to children with speech sound disorders. Cabbage and DeVeney (this issue) present diverse intervention paradigms for speech sound disorders of unknown etiology—namely, the cycles, contrasts, and complexity therapeutic approaches—and describe how the selected treatment approach may be based on the types and patterns of sound production errors, consistency of those errors, stimulability for correct sound production, and concomitant language concerns. Ireland, McLeod, Farquharson, and Crowe (this issue) discuss means for effectively navigating federal and state laws, regulations, and guidance regarding when a student with a speech sound disorder also may be considered a student who is eligible for the receipt of special education and related services (including speech therapy), which does not always go hand in hand because of the three successive “gates” used to determine special education eligibility: (1) Does the child have a disability that is encompassed by one of the categories identified in federal legislation? (2) Does the disability have an adverse impact on the child's educational or functional performance and/or progress (including academic, social, and behavioral aspects of development)? (3) Does the child require specialized instruction to participate/make adequate progress in the general education curriculum (or appropriate preschool activities)? Their article also provides an overview of more recent articulation development research that suggests most children in the United States and other English-speaking nations should be able to correctly produce just about all English consonant sounds, even those once considered “late-developing,” by the age of 5 years. The remaining four articles address language and literacy interventions for children with speech and language disorders. Tambyraja and Schmitt (this issue) make a strong case for why school-based speech–language pathologists should integrate literacy (they focus on reading in their article, but writing should not be ignored by practitioners) into their services for students, including the mandate to do so promulgated in recent national certification and practice standards for the profession. The authors discuss a number of barriers clinicians may face in addressing literacy in school settings and offer some practical suggestions to overcome them. Their article sets the stage for the last few articles, in which literacy or literacy-related interventions and assessments that may be employed by school-based speech–language pathologists are described and evaluated. Gillon, McNeill, Denston, Scott, and Macfarlane (this issue) report the effects of a 10-week teacher-led whole-class literacy intervention, the Better Start Literacy Approach, that combined code-based and language-based activities on the speech, language, and word-level reading and spelling outcomes for children with weak oral language or weak oral language plus speech sound production difficulties. Koutsoftas, Srivastava, and Harris (this issue) present a spelling coding rubric that includes 15 codes to represent four primary types of knowledge needed for spelling: phonological, orthographic, morphological (both structural and semantic), and mental graphemic representations of words in long-term memory. The rubric can be used to assess spelling performance in actual writing samples (rather than just on dictated word lists) and changes in spelling performance due to application of the writing process. Petersen, Mesquita, Spencer, and Waldron (this issue) examine the feasibility of a multitiered (whole-class plus small-group) oral narrative language intervention, Story Champs, for improving narrative skills, reading comprehension, and writing performance using a sample of typically developing second graders. We hope readers will find the information in these articles helpful for their clinical activities in schools on behalf of children with speech sound disorders and reading and writing challenges. Schools are complex organizations where policies, practices, and people sometimes falter in achieving intended objectives. Nevertheless, shared values and insights, communicated, in part, through research articles like those here, go far in helping attain the goal of providing the best therapeutic services to the students who need them. —Gary A. Troia, PhD, CCC-SLP —Sarah E. Wallace, PhD, CCC-SLP Co-Editors

Contemporary Speech and Oral Language Care for Deaf and Hard-of-Hearing Children Using Hearing Devices.

Contemporary speech and language interventions are not limited to disabilities but embrace the pragmatics of communication behaviors from the perspective of functional social participation. Accordingly, current speech and language therapies for deaf and hard-of-hearing children include a broad spectrum of approaches and techniques. This paper explores contemporary approaches and techniques for speech and oral language interventions for deaf and hard-of-hearing children using hearing devices, evidence of efficacy and how they are implemented in diverse clinical practices.

Feasibility and evaluation of Talk Boost KS2: A school-based programme for oral language skills in children with low-average communication skills in Key Stage 2

Oral language skills in childhood are known to predict literacy levels and academic performance. Identification of children’s low-average oral language skills in school is challenging when clear criteria for developmental language disorder are not met. There are few studies of targeted, school-based oral language interventions for the older child. This study aimed to investigate the feasibility of implementing and evaluating a manualized language intervention (Talk Boost KS2) for children aged between 7 and 9 years who were identified as having low-average oral language skills, as delivered by trained teaching assistants in mainstream schools. Twenty-one UK mainstream primary schools each selected eight Year 3 (7–8-year-olds) and Year 4 (8–9-year-olds) children with low-average oral language skills. School staff received training in a new manualized intervention, Talk Boost KS2. Schools were allocated to an Active Intervention (AI) or a Waiting Control condition (WC) condition. The final sample consisted of 162 children of which 87 were allocated to the AI condition and 75 to the WC condition. Progress in favour of the intervention was found on teacher ratings of speech, language and communication needs and on a Learning Behaviours Checklist but not on standardized language or reading comprehension tests. Parents of AI children reported improvements in communication and language skills. Teaching staff reported significant increases in confidence and knowledge in managing children with low-average oral language skills as a result of being involved in the intervention. The findings are discussed in relation to the imperative to provide practical language intervention tools as well as training and support for education staff in order to support children with low-average oral language skills in mainstream schools.