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Ebbels S.H.,Moor House School | Ebbels S.H.,University College London | Dockrell J.E.,Institute of Education | Van Der Lely H.K.J.,Harvard University | And 2 more authors.
International Journal of Language and Communication Disorders | Year: 2012

Background: Non-word repetition (NWR) difficulties are common, but not universal, among children with specific language impairment (SLI). However, older children and adolescents with SLI have rarely been studied. Studies disagree on the relationship between NWR difficulties and difficulties with other areas of language and literacy. There is also no consensus about the underlying reason for the difficulties (some) children with SLI have with NWR. Some scholars argue that difficulties with phonological short-term memory or storage cause NWR and other language difficulties, whereas others argue that difficulties with NWR may be due more to difficulties with phonological representations. Aims: To investigate NWR abilities and their relationship to other language and literacy abilities in a group of older children with SLI and typically developing controls. To investigate the relative effects of increasing phonological complexity and the number of syllables on the ability of the participants to repeat non-words. Methods & Procedures: An NWR test (The Test of Phonological Structure; TOPhS), which systematically varies phonological complexity, was administered to 15 participants with SLI (aged 11-15 years), 30 language and 15 age controls. Standardized language and literacy tests and a specific test of verb agreement and tense marking (Verb Agreement and Tense Test; VATT) were also administered. Outcomes & Results: The participants with SLI showed a bimodal distribution: half achieved age-appropriate NWR, while half scored significantly below language and age controls (d > 7). The two groups of participants with SLI (high versus low scorers) only differed in NWR (d > 5) and agreement (d > 3) and tense marking (d > 2.5), not on the standardized language and literacy measures administered. NWR was also highly correlated with verb agreement (r= 0.97) and tense marking (r= 0.89) among participants with SLI, but not among controls (r= 0.16 and 0.30 respectively). Phonological complexity was related to NWR accuracy, particularly among participants with SLI. The number of syllables had no independent effect on NWR performance for any group. Conclusions & Implications: Some children with SLI (who have good NWR) have language difficulties unrelated to any of the factors underlying NWR. Others have a (probably additional) deficit which affects NWR and also leads to greater difficulties with verb agreement and tense marking. The results indicate that difficulties with this particular NWR test are more likely to be due to a deficit with phonology per se, rather than with phonological short-term memory or storage. © 2011 Royal College of Speech and Language Therapists.


Ebbels S.H.,Moor House School | Ebbels S.H.,University College London | Nicoll H.,Moor House School | Clark B.,Moor House School | And 7 more authors.
International Journal of Language and Communication Disorders | Year: 2012

Background: Word-finding difficulties (WFDs) in children have been hypothesized to be caused at least partly by poor semantic knowledge. Therefore, improving semantic knowledge should decrease word-finding errors. Previous studies of semantic therapy for WFDs are inconclusive. Aims: To investigate the effectiveness of semantic therapy for secondary school-aged pupils with WFDs using a randomized control trial with blind assessment. Methods & Procedures: Fifteen participants with language impairments and WFDs (aged 9;11-15;11) were randomly assigned to a therapy versus waiting control group. In Phase 1 the therapy group received two 15-min semantic therapy sessions per week for 8 weeks with their usual speech and language therapist. Therapy for each participant targeted words from one of three semantic categories (animals, food, clothes). All participants were tested pre- and post-phase 1 therapy on the brief version of the Test of Adolescent Word Finding (TAWF), semantic fluency and the Test of Word Finding in Discourse (TWFD). In Phase 2 the waiting control group received the same therapy as the original therapy group, which received therapy targeted at other language areas. Testing after Phase 2 aimed to establish whether the waiting control group made similar progress to the original therapy group and whether the original therapy group maintained any gains. Outcomes & Results: The original therapy group made significant progress in standard scores on the TAWF (d= 0.94), which was maintained 5 months later. However, they made no progress on the semantic fluency or discourse tests. Participants in the waiting control group did not make significant progress on the TAWF in Phase 1 when they received no word-finding therapy. However, after Phase 2, when they received the therapy, they also made significant progress (d= 0.81). The combined effect of therapy over the two groups was d= 1.2. The mean standard scores on the TAWF were 67 pre-therapy and 77 post-therapy. Conclusions & Implications: Four hours of semantic therapy on discrete semantic categories led to significant gains on a general standardized test of word finding, enabling the participants to begin to close the gap between their performance and that of their typically developing peers. These gains were maintained after 5 months. A small amount of therapy can lead to significant gains even with secondary aged pupils with severe language difficulties. However, further studies are needed to find ways of improving word-finding abilities in discourse. © 2011 Royal College of Speech and Language Therapists.


Ebbels S.H.,Moor House School | Ebbels S.H.,University College London | Maric N.,Moor House School | Murphy A.,Moor House School | And 2 more authors.
International Journal of Language and Communication Disorders | Year: 2014

Background Little evidence exists for the effectiveness of therapy for children with receptive language difficulties, particularly those whose difficulties are severe and persistent. Aims To establish the effectiveness of explicit speech and language therapy with visual support for secondary school-aged children with language impairments focusing on comprehension of coordinating conjunctions in a randomized control trial with an assessor blind to group status. Methods & Procedures Fourteen participants (aged 11;3-16;1) with severe RELI (mean standard scores: CELF4 ELS = 48, CELF4 RLS = 53 and TROG-2 = 57), but higher non-verbal (Matrices = 83) and visual perceptual skills (Test of Visual Perceptual Skills (TVPS) = 86) were randomly assigned to two groups: therapy versus waiting controls. In Phase 1, the therapy group received eight 30-min individual sessions of explicit teaching with visual support (Shape Coding) with their usual SLT. In Phase 2, the waiting controls received the same therapy. The participants' comprehension was tested pre-, post-Phase 1 and post-Phase 2 therapy on (1) a specific test of the targeted conjunctions, (2) the TROG-2 and (3) a test of passives. Outcomes & Results After Phase 1, the therapy group showed significantly more progress than the waiting controls on the targeted conjunctions (d = 1.6) and overall TROG-2 standard score (d = 1.4). The two groups did not differ on the passives test. After Phase 2, the waiting controls made similar progress to those in the original therapy group, who maintained their previous progress. Neither group showed progress on passives. When the two groups were combined, significant progress was found on the specific conjunctions (d = 1.3) and TROG-2 raw (d = 1.1) and standard scores (d = 0.9). Correlations showed no measures taken (including Matrices and TVPS) correlated significantly with progress on the targeted conjunctions or the TROG-2. Conclusions & Implications Four hours of Shape Coding therapy led to significant gains on comprehension of coordinating conjunctions which were maintained after 4 months. Given the significant progress at a group level and the lack of reliable predictors of progress, this approach could be offered to other children with similar difficulties to the participants. However, the intervention was delivered one-to-one by speech and language therapists, thus the effectiveness of this therapy method with other methods of delivery remains to be evaluated. © 2013 Royal College of Speech and Language Therapists.


PubMed | Moor House School
Type: Journal Article | Journal: International journal of language & communication disorders | Year: 2012

Non-word repetition (NWR) difficulties are common, but not universal, among children with specific language impairment (SLI). However, older children and adolescents with SLI have rarely been studied. Studies disagree on the relationship between NWR difficulties and difficulties with other areas of language and literacy. There is also no consensus about the underlying reason for the difficulties (some) children with SLI have with NWR. Some scholars argue that difficulties with phonological short-term memory or storage cause NWR and other language difficulties, whereas others argue that difficulties with NWR may be due more to difficulties with phonological representations.To investigate NWR abilities and their relationship to other language and literacy abilities in a group of older children with SLI and typically developing controls. To investigate the relative effects of increasing phonological complexity and the number of syllables on the ability of the participants to repeat non-words.An NWR test (The Test of Phonological Structure; TOPhS), which systematically varies phonological complexity, was administered to 15 participants with SLI (aged 11-15 years), 30 language and 15 age controls. Standardized language and literacy tests and a specific test of verb agreement and tense marking (Verb Agreement and Tense Test; VATT) were also administered.The participants with SLI showed a bimodal distribution: half achieved age-appropriate NWR, while half scored significantly below language and age controls (d > 7). The two groups of participants with SLI (high versus low scorers) only differed in NWR (d > 5) and agreement (d > 3) and tense marking (d > 2.5), not on the standardized language and literacy measures administered. NWR was also highly correlated with verb agreement (r= 0.97) and tense marking (r= 0.89) among participants with SLI, but not among controls (r= 0.16 and 0.30 respectively). Phonological complexity was related to NWR accuracy, particularly among participants with SLI. The number of syllables had no independent effect on NWR performance for any group.Some children with SLI (who have good NWR) have language difficulties unrelated to any of the factors underlying NWR. Others have a (probably additional) deficit which affects NWR and also leads to greater difficulties with verb agreement and tense marking. The results indicate that difficulties with this particular NWR test are more likely to be due to a deficit with phonology per se, rather than with phonological short-term memory or storage.

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