Intervention Goals for Preschoolers With Language Difficulties and Disorders: A Scoping Review Using the International Classification of Functioning, Disability and Health Framework

PURPOSE

The primary aim of this scoping review was to categorize language therapy goals reported in intervention studies for preschoolers (i.e., children from birth to 5;0 [years;months]) with language difficulties and disorders within the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework. A secondary aim was to determine whether different therapy goals were reported for two language difficulty/disorder subtypes (i.e., comparing language difficulty/disorder associated with a biomedical condition to those without an associated biomedical condition).

METHOD

The scoping review followed Arksey and O'Malley (2005) guidelines. Articles were retrieved from speechBITE, with age (under 5 years), intervention area (language), and study design (all but systematic reviews and clinical practice guidelines) specified as inclusion criteria. Language goals were extracted and categorized into the ICF components, and the distribution of goals across ICF components was compared for studies involving children with the two language difficulty/disorder subtypes.

RESULTS

A total of 287 articles were identified; 140 met inclusion criteria. Of the 293 goals extracted, 48% aligned with the activities component of the ICF framework, followed by participation (26%), environmental factors (20%), body functions and structures (3%), and personal factors (3%). Most participation-focused goals were reported from intervention studies involving preschoolers with a language difficulty/disorder associated with a biomedical condition.

CONCLUSIONS

Few participation-focused goals were reported in intervention studies for preschoolers with language difficulty/disorder without an associated condition. Future work is needed to support integrating the ICF framework in goal setting for both research and practice.

Cultural and Linguistic Adaptations of Early Language Interventions: Recommendations for Advancing Research and Practice

Purpose Speech-language pathologists are responsible for providing culturally and linguistically responsive early language intervention services for legal, ethical, and economic reasons. Yet, speech-language pathologists face challenges in meeting this directive when children are from racial, ethnic, or linguistic backgrounds that differ from their own. Guidance is needed to support adaptation of evidence-based interventions to account for children's home culture(s) and language(s). This review article (a) describes a systematic review of the adaptation processes applied in early language interventions delivered to culturally and linguistically diverse populations in the current literature and (b) offers a robust example of an adaptation of an early language intervention for families of Spanish-speaking Mexican immigrant origin. Method Thirty-three studies of early language interventions adapted for culturally and linguistically diverse children ages 6 years and younger were reviewed. Codes were applied to describe to what extent studies document the purpose of the adaptation, the adaptation process, the adapted components, and the evaluation of the adapted intervention. Results Most studies specified the purpose of adaptations to the intervention evaluation, content, or delivery, which typically addressed children's language(s) but not culture. Study authors provided limited information about who made the adaptations, how, and when. Few studies detailed translation processes or included pilot testing. Only one used a comprehensive framework to guide adaptation. A case study extensively documents the adaptation process of the Language and Play Every Day en español program. Conclusions Future early language intervention adaptations should focus on both linguistic and cultural factors and include detailed descriptions of intervention development, evaluation, and replication. The case study presented here may serve as an example. Increased access to such information can support research on early language interventions for diverse populations and, ultimately, responsive service provision.

English and Spanish Predictors of Grade 3 Reading Comprehension in Bilingual Children

Purpose The purpose of this study was to examine the kindergarten, first-, and second-grade predictors of reading comprehension in bilingual children. Specifically, we evaluated the role that Spanish and English skills play in predicting English reading comprehension in third grade. Method As part of a longitudinal study, 248 bilingual children were followed from prekindergarten to third grade. Participants completed Spanish and English measures in the spring of each academic year. We reported results on measures of oral language, memory, and literacy skills that were 1administered in kindergarten, first, second, and third grade. Results Analysis under the structural equation modeling framework indicated that English oral language and word reading are the strongest predictors of English reading comprehension in third grade. Furthermore, results supported previous evidence indicating that Spanish language skills make significant direct and indirect contributions to the English oral language and word reading skills that predict reading comprehension. Discussion This study provides a comprehensive view of the language resources that Spanish-English bilinguals use for reading comprehension. In light of previous evidence, we discuss our findings and offer theoretical and practical implications. Supplemental Material https://doi.org/10.23641/asha.14083373.

Dynamic Assessment Language Tasks and the Prediction of Performance on Year-End Language Skills in Preschool Dual Language Learners

Purpose Early identification is a key element for accessing appropriate services for preschool children with language impairment. However, there is a high risk of misidentifying typically developing dual language learners as having language impairment if inappropriate tools designed for monolingual children are used. In this study of children with bilingual exposure, we explored performance on brief dynamic assessment (DA) language tasks using graduated prompting because this approach has potential applications for screening. We asked if children's performance on DA language tasks earlier in the year was related to their performance on a year-end language achievement measure. Method Twenty 4-year-old children from Spanish-speaking homes attending Head Start preschools in the southwestern United States completed three DA graduated prompting language tasks 3-6 months prior to the Head Start preschools' year-end achievement testing. The DA tasks, Novel Adjective Learning, Similarities in Function, and Prediction, were administered in Spanish, but correct responses in English or Spanish were accepted. The year-end achievement measure, the Learning Accomplishment Profile-Third Edition (LAP3), was administered by the children's Head Start teachers, who also credited correct responses in either language. Results Children's performance on two of the three DA language tasks was significantly and positively related to year-end LAP3 language scores, and there was a moderate and significant relationship for one of the DA tasks, even when controlling for age and initial LAP3 scores. Conclusions Although the relationship of performance on DA with year-end performance varies across tasks, the findings indicate potential for using a graduated prompting approach to language screening with young dual language learners. Further research is needed to select the best tasks for administration in a graduated prompting framework and determine accuracy of identification of language impairment.