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

2021 ◽  
pp. 1-36
Author(s):  
Pauline Frizelle ◽  
Anna-Kaisa Tolonen ◽  
Josie Tulip ◽  
Carol-Anne Murphy ◽  
David Saldana ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Oral Language ◽  
Intervention Studies ◽  
Language Disorder ◽  
Optimal Dose ◽  
Future Research ◽  
Original Research ◽  
Developmental Language Disorder ◽  
The Impact ◽  
Dose Form

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.

scholarly journals A preliminary evaluation of a manualised intervention to improve early literacy skills in children with Developmental Language Disorder

2021 ◽  
pp. 026565902110520
Author(s):  
Anna Louise Taylor ◽  
Samuel David Calder ◽  
Simmone Pogorzelski ◽  
Stagoll Lauren Koch
Keyword(s):  
Early Literacy ◽  
Oral Language ◽  
Language Disorder ◽  
Intervention Group ◽  
Literacy Skills ◽  
Future Research ◽  
Preliminary Evaluation ◽  
Developmental Language Disorder ◽  
Early Literacy Skills ◽  
Tier 1

Children with Developmental Language Disorder (DLD) commonly present with oral language weaknesses which disrupt the development of literacy and impede related academic progress. While there is evidence to support the delivery of manualised Tier 2 interventions with this population, little is known about the effects of Tier 1 interventions. A retrospective cohort comparison was used to evaluate whether there was an observable effect of a manualised Tier 1 intervention compared to ‘business-as-usual’ on early literacy skills for children with DLD. Participants were 140 children attending a specialised education program with equivalent oral language skills and alphabetic knowledge at baseline. After 18 months formal literacy intervention, both groups were assessed on measures of early literacy skills. The differences between group means on all measures favoured the manualised intervention group, and they performed significantly better on a measure of nonword reading fluency. The findings indicate that a manualised Tier 1 intervention may be advantageous for children with DLD in developing proficiency in phonological recoding. This research contributes to the sparse evidence-base supporting the implementation of Tier 1 interventions for at risk populations, and findings warrant future research using experimental designs with tighter controls.

Do Children With Developmental Language Disorder (DLD) Have Difficulties With Interference Control, Visuospatial Working Memory, and Selective Attention? Developmental Patterns and the Role of Severity and Persistence of DLD

2020 ◽  
Vol 63 (9) ◽  
pp. 3036-3050
Author(s):  
Elma Blom ◽  
Tessel Boerma
Keyword(s):  
Working Memory ◽  
Selective Attention ◽  
Language Disorder ◽  
Typically Developing ◽  
Developmental Language Disorder ◽  
Visuospatial Working Memory ◽  
Interference Control ◽  
Developmental Patterns ◽  
Search Tasks ◽  
The Impact

Purpose Many children with developmental language disorder (DLD) have weaknesses in executive functioning (EF), specifically in tasks testing interference control and working memory. It is unknown how EF develops in children with DLD, if EF abilities are related to DLD severity and persistence, and if EF weaknesses expand to selective attention. This study aimed to address these gaps. Method Data from 78 children with DLD and 39 typically developing (TD) children were collected at three times with 1-year intervals. At Time 1, the children were 5 or 6 years old. Flanker, Dot Matrix, and Sky Search tasks tested interference control, visuospatial working memory, and selective attention, respectively. DLD severity was based on children's language ability. DLD persistence was based on stability of the DLD diagnosis. Results Performance on all tasks improved in both groups. TD children outperformed children with DLD on interference control. No differences were found for visuospatial working memory and selective attention. An interference control gap between the DLD and TD groups emerged between Time 1 and Time 2. Severity and persistence of DLD were related to interference control and working memory; the impact on working memory was stronger. Selective attention was unrelated to DLD severity and persistence. Conclusions Age and DLD severity and persistence determine whether or not children with DLD show EF weaknesses. Interference control is most clearly impaired in children with DLD who are 6 years and older. Visuospatial working memory is impaired in children with severe and persistent DLD. Selective attention is spared.

Emergent Literacy in Spanish-Speaking Children With Developmental Language Disorder: Preliminary Findings of Delays in Comprehension- and Code-Related Skills

2020 ◽  
Vol 63 (12) ◽  
pp. 4193-4207
Author(s):  
Amy S. Pratt ◽  
John A. Grinstead ◽  
Rebecca J. McCauley
Keyword(s):  
Emergent Literacy ◽  
Language Disorder ◽  
Literacy Skills ◽  
Future Research ◽  
Developmental Language Disorder ◽  
Writing Ability ◽  
Transparent Orthography ◽  
Spanish Speaking ◽  
Phonological Structure ◽  
Name Writing

Purpose This exploratory study describes the emergent literacy skills of children with developmental language disorder (DLD) who speak Spanish, a language with a simple phonological structure and transparent orthography. We examine differences between children with DLD and their typically developing (TD) peers on a battery of emergent literacy measures. Method Participants included 15 monolingual Spanish-speaking children with DLD (who did not present with cognitive difficulties) and 15 TD controls matched for age, gender, and socioeconomic status, ranging in age from 3;10 to 6;6 (years;months; M age = 4;11). All children completed a battery of comprehension-related emergent literacy tasks (narrative retell, print concept knowledge) and code-related emergent literacy tasks (beginning sound, rhyming awareness, alphabet knowledge, and name-writing ability). Results On average, children with DLD performed significantly worse than TD controls on a battery of comprehension- and code-related emergent literacy measures. On all code-related skills except rhyming, children with DLD were more likely than their TD peers to score “at risk.” Conclusions The results suggest some universality in the effect of DLD on reading development. Difficulties with emergent literacy that are widely documented in English-speaking children with DLD were similarly observed in Spanish-speaking children with DLD. Future research should explore long-term reading outcomes in Spanish for children with DLD.

Sentence Repetition: A Clinical Marker for Developmental Language Disorder in Danish

2019 ◽  
Vol 62 (12) ◽  
pp. 4450-4463
Author(s):  
Rikke Vang Christensen
Keyword(s):  
Language Disorder ◽  
Future Research ◽  
Typically Developing ◽  
Developmental Language Disorder ◽  
Older Children ◽  
Likelihood Ratios ◽  
Clinical Marker ◽  
Sentence Repetition ◽  
Good Identification ◽  
Syntactic Properties

Purpose The aim of the study was to explore the potential of performance on a Danish sentence repetition (SR) task—including specific morphological and syntactic properties—to identify difficulties in children with developmental language disorder (DLD) relative to typically developing (TD) children. Furthermore, the potential of the task as a clinical marker for Danish DLD was explored. Method SR performance of children with DLD aged 5;10–14;1 (years;months; n = 27) and TD children aged 5;3–13;4 ( n = 87) was investigated. Results Compared to TD same-age peers, children with DLD were less likely to repeat the sentences accurately but more likely to make ungrammatical errors with respect to verb inflection and use of determiners and personal pronouns. Younger children with DLD also produced more word order errors that their TD peers. Furthermore, older children with DLD performed less accurately than younger TD peers, indicating that the SR task taps into morphosyntactic areas of particular difficulty for Danish children with DLD. The classification accuracy associated with SR performance showed high levels of sensitivity and specificity (> 90%) and likelihood ratios indicating good identification potential for clinical and future research purposes. Conclusion SR performance has a strong potential for identifying children with DLD, also in Danish, and with a carefully designed SR task, performance has potential for revealing morphosyntactic difficulties. Supplemental Material https://doi.org/10.23641/asha.10314437

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

2021 ◽  
pp. 1-17
Author(s):  
Pauline Frizelle ◽  
Anna-Kaisa Tolonen ◽  
Josie Tulip ◽  
Carol-Anne Murphy ◽  
David Saldana ◽  
...  
Keyword(s):  
Oral Language ◽  
Language Disorder ◽  
Controlled Trial ◽  
Experimental Manipulation ◽  
Quantitative Aspect ◽  
Developmental Language Disorder ◽  
Dose Frequency ◽  
Language Interventions ◽  
Quasi Experimental ◽  
Language Measures

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

scholarly journals Advancing Medication Reconciliation in an Outpatient Internal Medicine Clinic through a Pharmacist-Led Educational Initiative

2010 ◽  
Vol 1 (1) ◽  
pp. 11
Author(s):  
Sarah M. Westberg ◽  
Kathrine Beeksma
Keyword(s):  
Internal Medicine ◽  
Nursing Staff ◽  
Medication Reconciliation ◽  
Future Research ◽  
Original Research ◽  
Educational Initiative ◽  
Medicine Clinic ◽  
Internal Medicine Clinic ◽  
The Impact ◽  
Competency Assessments

Objectives: To develop and deliver an effective pharmacist-led educational initiative to clinic staff to advance medication reconciliation in the electronic medical record of an outpatient internal medicine clinic. Methods: An educational initiative designed to improve the ability of nursing staff in medication reconciliation was launched in the outpatient internal medicine clinic of a regional healthcare system. The education was provided by the pharmacist to clinic nursing staff, including registered nurses, licensed practical nurses, and certified medical assistants. The impact of this training was measured through pre-initiation and post-implementation surveys, competency assessments and an audit. Results: The educational initiative was successfully designed and delivered to clinic nursing staff. Assessment of the initiative found that all nursing staff completing competency assessments successfully passed. Pre-initiation- and post-implementation- survey responses on the self-assessed ability to gather and document accurate medication lists did not show significant changes. Informal observations in the clinic indicated that this initiative changed the culture of the clinic, creating increased awareness of the importance of accurate medications and increased emphasis on medication reconciliation. Conclusions: The expertise of pharmacists can be utilized to educate nursing staff on the skills and abilities necessary to gather and document accurate medication lists. This study did not find measurable changes in the accuracy of medication lists in this clinic. Future research is needed to determine the best methods to train health professionals in medication reconciliation to ensure accurate medication lists in the outpatient setting. Type: Original Research

scholarly journals Effectiveness of Mobile Health Interventions on Diabetes and Obesity Treatment and Management: Systematic Review of Systematic Reviews (Preprint)

2019 ◽  
Author(s):  
Youfa Wang ◽  
Jungwon Min ◽  
Jacob Khuri ◽  
Hong Xue ◽  
Bo Xie ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Systematic Reviews ◽  
Mobile Health ◽  
Weight Reduction ◽  
Text Messaging ◽  
Meta Analysis ◽  
Obesity Treatment ◽  
Future Research ◽  
The Impact ◽  
Diabetes And Obesity

BACKGROUND Diabetes and obesity have become epidemics and costly chronic diseases. The impact of mobile health (mHealth) interventions on diabetes and obesity management is promising; however, studies showed varied results in the efficacy of mHealth interventions. OBJECTIVE This review aimed to evaluate the effectiveness of mHealth interventions for diabetes and obesity treatment and management on the basis of evidence reported in reviews and meta-analyses and to provide recommendations for future interventions and research. METHODS We systematically searched the PubMed, IEEE Xplore Digital Library, and Cochrane databases for systematic reviews published between January 1, 2005, and October 1, 2019. We analyzed 17 reviews, which assessed 55,604 original intervention studies, that met the inclusion criteria. Of those, 6 reviews were included in our meta-analysis. RESULTS The reviews primarily focused on the use of mobile apps and text messaging and the self-monitoring and management function of mHealth programs in patients with diabetes and obesity. All reviews examined changes in biomarkers, and some reviews assessed treatment adherence (n=7) and health behaviors (n=9). Although the effectiveness of mHealth interventions varied widely by study, all reviews concluded that mHealth was a feasible option and had the potential for improving patient health when compared with standard care, especially for glycemic control (−0.3% to −0.5% greater reduction in hemoglobin A<sub>1c</sub>) and weight reduction (−1.0 kg to −2.4 kg body weight). Overall, the existing 6 meta-analysis studies showed pooled favorable effects of these mHealth interventions (−0.79, 95% CI −1.17 to −0.42; I2=90.5). CONCLUSIONS mHealth interventions are promising, but there is limited evidence about their effectiveness in glycemic control and weight reduction. Future research to develop evidence-based mHealth strategies should use valid measures and rigorous study designs. To enhance the effectiveness of mHealth interventions, future studies are warranted for the optimal formats and the frequency of contacting patients, better tailoring of messages, and enhancing usability, which places a greater emphasis on maintaining effectiveness over time.

What is the impact of physicians in prehospital treatment for patients in need of acute critical care? – An overview of reviews

2019 ◽  
Vol 35 (1) ◽  
pp. 27-35 ◽  
Author(s):  
Gitte Valentin ◽  
Lotte Groth Jensen
Keyword(s):  
Cardiac Arrest ◽  
Systematic Reviews ◽  
Critical Conditions ◽  
Current Evidence ◽  
Cochrane Library ◽  
Future Research ◽  
Success Rates ◽  
Prehospital Treatment ◽  
The Impact ◽  
Hospital Cardiac Arrest

AbstractObjectivesThe aim of this overview was to systematically identify and synthesize existing evidence from systematic reviews on the impact of prehospital physician involvement.MethodsThe Medline, Embase, and Cochrane library were searched from 1 January 2000 to 17 November 2017. We included systematic reviews comparing physician-based with non–physician-based prehospital treatment in patients with one of five critical conditions requiring a rapid response.ResultsTen reviews published from 2009 to 2017 were included. Physician treatment was associated with increased survival in patients with out-of-hospital cardiac arrest and patients with severe trauma; in the latter group, the result was based on more limited evidence. The success rate of prehospital endotracheal intubation (ETI) has improved over the years, but ETI by physicians is still associated with higher success rates than intubation by paramedics. In patients with severe traumatic brain injury, intubation by paramedics who were not well skilled to do so markedly increased mortality.ConclusionsCurrent evidence is hinting at a benefit of physicians in selected aspects of prehospital emergency services, including treatment of patients with out-of-hospital cardiac arrest and critically ill or injured patients in need of prehospital intubation. Evidence is, however, limited by confounding and bias, and comparison is hampered by differences in case mix and the organization of emergency medical services. Future research should strive to design studies that enable appropriate control of baseline confounding and obtain follow-up data for the proportion of patients who die in the prehospital setting.

scholarly journals Embryo–Maternal Interactions Underlying Reproduction in Mammals

2020 ◽  
Vol 21 (14) ◽  
pp. 4872
Author(s):  
Stefan Bauersachs ◽  
Carmen Almiñana
Keyword(s):  
Current Knowledge ◽  
Mammalian Species ◽  
Stress Factors ◽  
Research Articles ◽  
Future Research ◽  
Original Research ◽  
Special Issue ◽  
New Findings ◽  
As Stress ◽  
The Impact

This Special Issue, “Embryo-Maternal Interactions Underlying Reproduction in Mammals”, gathers a collection of 23 articles, 16 original research articles and 7 up-to-date reviews, providing new findings or summarizing current knowledge on embryo–maternal interactions in seven different mammalian species including humans. Considering the different players involved in these embryo-maternal interactions, articles are mainly focused on one of these different players: the oviduct, the uterus, the embryo or the emergent extracellular vesicles. Additionally, a few articles bring up the impact of reproductive, but also non-reproductive, diseases, as well as stress factors, on the establishment of pregnancy. We hope the readers enjoy this collection of articles and that the knowledge assembled here will support and inspire current and future research investigations. We would like to thank all authors for their contributions to this Special Issue.

scholarly journals The Impact of Dose and Dose Frequency on Word Learning by Kindergarten Children With Developmental Language Disorder During Interactive Book Reading

2019 ◽  
Vol 50 (4) ◽  
pp. 518-539 ◽  
Author(s):  
Holly L. Storkel ◽  
Rouzana Komesidou ◽  
Mollee J. Pezold ◽  
Adrienne R. Pitt ◽  
Kandace K. Fleming ◽  
...  
Keyword(s):  
Word Learning ◽  
Language Disorder ◽  
Intensity Variation ◽  
Kindergarten Children ◽  
Book Reading ◽  
Developmental Language Disorder ◽  
Dose Frequency ◽  
Response Variation ◽  
The Impact ◽  
Interactive Book

Purpose The goal was to determine whether interactive book reading outcomes for children with developmental language disorder (DLD) were affected by manipulation of dose (i.e., the number of exposures to the target word during a book reading session) and dose frequency (i.e., the number of repeated book reading sessions) and whether pretreatment factors predicted treatment response variation. Method Thirty-four kindergarten children with DLD (aged 5;0–6;2 [years;months]) were taught 1 set of words using the Dose 6 and Dose Frequency 6 format from a prior study ( Storkel, Voelmle, et al., 2017 ) and taught a different set of words using an alternative format, either Dose 4 × Dose Frequency 9 or Dose 9 × Dose Frequency 4, determined through random assignment. Word learning was tracked for each treatment via a definition task prior to, during, and after treatment. Results Results showed that children with DLD learned a significant number of words during treatment regardless of the dose and dose frequency format but that significant forgetting of newly learned words occurred in all formats once treatment was withdrawn. Individual differences in word learning were related to Clinical Evaluation of Language Fundamentals Core Language and Understanding Spoken Paragraphs scores. Conclusion When administered at an adequate intensity, variation in the dose and dose frequency of interactive book reading does not appear to influence word learning by children with DLD. Although interactive book reading continues to show promise as an effective word learning intervention for children with DLD, further development is needed to enhance the effectiveness of this treatment approach. Supplemental Material https://doi.org/10.23641/asha.9745181

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