A Classroom-Based Model of Language Intervention for Preschool Language-Impaired Children: Principles and Procedures Diane Paul-Brown TRI-Services' National Institute of Dyslexia Chevy Chase, Maryland

It is now generally recognized that a language impairment in preschool children may be predictive of later linguistic, reading, and academic difficulties. Language intervention procedures, derived from theoretically-based principles of language development and implemented in a child's regular classroom environment, may benefit children at risk for persistent language and learning problems. This paper describes the development and application of individualized intervention procedures in a classroom for preschool language-impaired children. The discussion focuses on selected language development principles which helped determine the setting, timing, interactive participants, purpose, and content of the language intervention program. Resulting changes in language comprehension and production are reported based on individual classroom performance as well as a comparison of preand posttest scores for a range of comprehension skills.

Introduction In recent years it has b e c o m e increasingly a p p a r e n t that a strong relationship exists b e t w e e n early oral l a n g u a g e p r o b l e m s a n d later learning disabilities involving s p o k e n a n d written language. In fact, a l a n g u a g e A version of this paper was presented at the Annual Conference of the Orton Dyslexia Society, November 5, 1987, San Francisco. The author gratefully acknowledges the help and expertise of teachers, J. Clarke and E. Naranjo, academic therapist, M. Beall, and school director, Dr. R. Spodak. Thanks are also extended to the children enrolled in TRI-Services'Cottleston Hall Preschool/Primary Program in Chevy Chase, Maryland. Annals of Dyslexia, Vol. 38, 1988. Copyright ©1988 by The Orton Dyslexia Society ISSN 0474- 7534

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disorder in the preschool years is a recognized predictor of later difficulties in reading, writing, and spelling (see Broman, Bien, and Shaughnessy 1985). Furthermore, problems in oral language frequently persist beyond the preschool years (Aram and Nation 1980; King, Jones, and Lasky 1982; Maxwell and Wallach 1984; Strominger and Bashir 1977). The importance of early identification and intervention to remediate language problems is clear given this critical relationship between early language development and later linguistic and academic success. Attempts have been made to identify the specific language problems in preschool children that may predict persistent learning disabilities (Bashir et al. 1983; Bishop and Edmundson 1987). Little information exists, however, related to early language intervention procedures which may be particularly beneficial to preschool children considered at risk for persistent learning disabilities (see Snyder-Mclean and Mclean 1987). The main focus of this paper will be to present a set of language intervention principles which were used to direct the selection of specific language development goals. The application of these principles to foster communicative interactions in a preschool classroom for language-impaired children will be described. The specific principles and procedures were devised as a first step in the development of a working clinical model before implementing a related research program. Nevertheless, at this initial stage, attempts were taken to evaluate the general effectiveness of the language intervention program. Accordingly, specific outcome measures obtained following implementation of the intervention strategies are reported.

Assessment Procedures and Identification of Language Problems

The language development principles and intervention procedures were specifically developed for use in a classroom of young children who displayed a wide range of language problems. Before describing these principles and procedures, it is important to understand the particular needs of the children for whom the program was initially created. Sixteen children (11 boys and 5 girls) between the ages of 4.2 years and 6.9 years (mean age--5.6 years) were enrolled in a diagnostic preschool program (TRI-Services' Cottleston Hall Preschool/Primary Program, Chevy Chase, Maryland). The children were considered at risk for learning disabilities based on their difficulties with receptive and/or expressive language. Some children also demonstrated deficiencies in motor development and/or attentional deficits. A Montessori curriculum used in the classroom had been chosen primarily because of its strengths as a structured, sequential, multisensory approach. Adaptations in the curriculum were made to accommodate the needs of individual language-impaired children. In addition, children who were at least six years of age received daily individual academic therapy in the Orton-Gillingham method of reading instruction.

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All children demonstrated at least normal intelligence (FSIQ = 90 or above) as determined by the Wechsler Preschool and Primary Scale of Intelligence-Revised (WPPSI) (Wechsler 1974b) or the Wechsler Intelligence Scale for Children--Revised (WISC-R) (Wechsler 1974a), administered no more than two years prior to enrollment. A battery of language assessment procedures was used to determine the type and severity of each child's language problem. The selected procedures assessed a broad spectrum of skills in each major language component: phonology, syntax, semantics, and pragmatics. Comprehension and production (ranging from single words to connected discourse units) were measured by standardized tests and/or informal ratings. The specific comprehension skills assessed for each child included single word receptive vocabulary (Peabody Picture Vocabulary Test--Revised [PPVT-R] Dunn and Dunn 1981), auditory comprehension of connected discourse (Test for Auditory Comprehension of Language-Revised [TACL-R] Carrow-Woolfolk 1985), ability to follow directions of increasing length and syntactic complexity (Token Test for Children, DiSimoni 1978), auditory memory for related (sentence memory) and unrelated (digit span) linguistic information (Stanford-Binet Intelligence Scale, Terman and Merrill 1973), and conceptual development (Boehm Test of Basic Concepts, Boehm 1969). An expressive language sample was collected during each child's interactions with peers and adults in different situations. Language samples were analyzed along a variety of communicative parameters: syntax level (Lee 1974), variety and use of language functions (such as questions, statements, and comments), and discourse features (such as responsiveness, connectedness, and relevance during conversational interactions). An assessment of phonemic awareness (recognition of sounds in words) was also conducted as a general index of reading readiness. 1 Based on this comprehensive diagnostic evaluation, particular language problems were identified and individual language goals were determined for each child. As detailed in Table I, seven different general types of language problems were identified. Language difficulties were experienced to some degree by all of the children in the program in the areas of comprehension of orally presented directions and information, vocabulary and concept development, conversational, narrative, and metalinguistic skills. Difficulties occurred less frequently and with less severity in the areas of syntactic/morphok)gical usage and articulation/ intelligibility. Only two of the sixteen children required remedial attention in those areas. Patterns of language impairment which predict later learning difficulties have been proposed by Bashir and his colleagues (see Bashir et al. 1983). Four profiles which characterize this group are: (1) mixed receptive/ expressive problems; (2) oral formulation problems; (3) dysnomia; and 1A copy of the test used to assess phonemic awareness is available from the author.

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(4) phonologic disorders. The children identified in this preschool sample generally fell into the first two groups.

Language Intervention Principles An individualized language intervention plan was developed for each child which related directly to the specific language needs as determined

Table 1 Types of Language Problems Experienced by a Group of Preschool LanguageImpaired Children Individuals experienced difficulties in the following communication skills: 1. Comprehension of Orally Presented Directions and Information --Following multipart directions --Comprehending information in stories 2. Vocabulary and Concept Development --Using diverse and specific vocabulary --Understanding and using temporal concepts --Demonstrating ease with word-finding 3. Conversational Skills --Providing consistent, related responses to questions --Reducing discrepancy between spontaneous language and language on demand --Formulating information to contribute to conversation --Initiating conversation with peers --Initiating conversation with adults --Asking adults for help --Using appropriate social greetings --Signaling topic shifts in conversation --Providing elaborated responses during conversations --Maintaining eye contact during conversation 4. Narrative Skills --Recalling events in sequence --Producing stories in sequence 5. Metalinguistic Skills --Demonstrating understanding of the effect of talk through awareness of nonverbal emotional signals --Developing phonemic awareness skill (recognition of sounds in words) --Providing and asking for clarification 6. Syntactic/Morphological Usage --Producing irregular past tense forms correctly --Producing irregular plural forms correctly --Using correct subject and object pronouns 7. Articulation~Intelligibility --Using an appropriate rate of speech to enhance intelligibility --Producing/r/,/th/, and/1/correctly

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by the diagnostic evaluation procedure. The intervention plan was based on major principles of language development. Since one's theoretical orientation concerning the development of language determines the type of language intervention approach used, principles were derived on the basis of a particular theoretical perspective, specifically an interactionist viewpoint (see Fey 1986). From this perspective, language is viewed as an interaction of language content, form, and use, with consideration given also to the impact of the child's cognitive attainment and to the environmental influences on language development (see Bloom and Lahey 1978). Six language intervention principles were selected to reflect salient aspects of an interactionist model of language development. In a discussion of the importance of a principled approach to language intervention, Johnston (1984) underscored that, "Language intervention is best understood, not as a set of lesson plans or program descriptions, but as a set of principles which apply for all language disordered children, in all settings" (p. 15). These principles, presented in Table II, helped determine the setting, the timing, the interactive participants and purpose, and three different aspects of the content of language intervention. The first principle relates to the setting for language development. Table II Language Development Principles Guiding Language Intervention Procedures

Setting for LanguageIntervention 1. The social context for language intervention should be the child's natural environment.

Timing of LanguageIntervention 2. Language is pervasive in all social interactions.

Interactive Participantsand Purposeof LanguageIntervention 3. Since the primary purpose of language is communication, the use of language for interpersonal communication with adults and peers is the major focus of teaching.

Content of LanguageIntervention 4. The content and sequence for teaching new language forms and functions are based on normal language developmental processes. 5. Language teaching should be conducted within a discourse context (i.e., extended sequence of utterances for conversations or narratives) rather than following an approach that focuses on words or utterances in isolation. 6. Language goals should be selected based on the individual social, cognitive, and linguistic level of each child as determined by a comprehensive evaluation.

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1) The social context for language intervention should be the child's natural environment. Home and classroom are the natural settings for language teaching. The focus on pragmatics in recent years, i.e., the social use of language in context (Bates 1976), has led to language intervention models directed toward the primary goal of developing communicative competence in social interactions.

Accordingly, all of the language intervention procedures were implemented in the classroom setting. 2The target language goals for each child within the classroom were derived directly from the diagnostic evaluation. Thus, the language intervention plan was individualized even with a classroom-based model (see Language Principle #6 on page 202). The role of the speech/language pathologist, therefore, was that of a language facilitator working in the classroom where language use is relevant to the task at hand and where natural, frequent interactions occur among children, teachers, and peers (see Frassinelli, Superior, and Meyers 1983; Simon 1987). The following techniques were used by the speech/language pathologist to facilitate language development in the classroom:

A) Providing specific suggestions and feedback to teachers which enhance communication skills for each child. Specific suggestions were translated into weekly language goals for four children at a time, and individual goals were posted in the classroom. Sample goals might be increasing relevant, informative responses to questions, where the teachers would be asked to (a) give the child extra time to answer; (b) cue the child to ask herself "What did the teacher say?"; and (c) expand on responses to provide an appropriate model. The goals were based on individual needs. Limiting each week's focus to four children with one goal per child helped teachers direct their attention and enhanced the quality of their interactions with particular children. In addition to the specific, individualized goals, general classroom language objectives were developed for all children. 3These objectives related to developing conversational rules and conventions, using language for different purposes, following directions, expanding vocabulary, and increasing story recall and production. Even with these general classroom objectives, however, the specific intervention procedures (e.g., frequency and type of 2Complete details of the language intervention strategies used is available from the author. 3A complete description of the general classroom language objectives is available from the author.

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models used, opportunity for practice, particular vocabulary words selected, etc.) were determined on an individual basis. B) Conducting small group communication activities. Twice a day the speech/language pathologist worked in the classroom directly with small groups of three to five children. The groups were formed and target goals for each child were selected according to individual needs based on the initial assessment. Small group activities included (see Dunn, Horton, and Smith 1968; Jorgensen et al. 1985; Plourde 1985): 1) Developing appropriate peer interaction patterns through the use of role-play; 2) Developing narrative discourse skills (recall and production of stories) by exposure to stories (see Page and Stewart 1985). This training included: --improving prediction skills (cause-effect), --talking about what might happen next in a story or situation, --learning to create stories in sequence, and --coordination with art activities by telling stories using drawings. 3) Establishing a conversation time which involved: --discussing past, present, and future events, --drawing and telling about a recent experience, --learning to respond to and initiate topics with peers and adults. 4) Increasing receptive/expressive vocabulary and clarification ability by: --increasing size and specificity of vocabulary, --learning to clarify utterances, and --learning to recognize facial cues of an interactive partner to determine when clarification is needed. Additionally, a monthly theme was followed in the classroom (e.g., "family," "seasons," "solar system"). Particular vocabulary words, activities, and books were drawn from these themes to provide consistency and concentrate attention in a specific area (see Salza and Haynes 1987). Parents were also given suggestions to continue the theme at home. Class projects were planned to develop sequential organization and improve language formulation. A script for each activity was developed in advance to ensure target responses would be elicited (see Nelson and Gruende11986). C) Conducting individual language activities in the classroom. The primary purpose of individual language intervention sessions was to help children who demonstrated difficulties in recalling and describing an event to organize their language in order to accurately retell events of the day in a coherent sequence. A visual framework and verbal cues were used to help each child

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develop recall, organization, and sequencing skills. Individual classroom time was also used by the speech/language pathologist to work with children who had articulation and/or syntax problems to provide intensive, structured instruction. D) Aiding children by providing strategies for following directions and having success in the classroom routine. Children who experienced difficulty during activity transitions or who had trouble finding materials on their own during class were physically or verbally guided until they developed the skills to work on an independent basis. E) Coordinating the language program with parent activities in order to establish appropriate communication patterns at home. Various means were used to establish and maintain communication with parents: parent conferences, phone calls, weekly written suggestions, classroom letters from the teachers discussing the monthly theme and related concepts, and individual letters which included suggestions for language development. Discussions focused on a child's specific language needs. Parents provided input and feedback which was used for planning and modifying classroom language intervention procedures. Implementation of language intervention in the classroom, rather than in an isolated therapy room away from usual communication partners, is an approach that parallels what has been called milieu language teaching (Hart and Rogers-Warren 1978), a naturalistic approach (Taenzer, Cermak, and Hanlon 1981), and incidental language teaching (Warren and Kaiser 1986). These approaches have been found effective for children with varying language skills (see Warren and Kaiser 1986 for review). This type of language intervention has been characterized by Fey (1986) as a hybrid approach, combining trainer-oriented and child-oriented procedures. He maintains it is " . . . ideal for the facilitation of comprehension skills of language impaired children" (p. 233). A second language development principle guiding the intervention plan relates to the timing of language training: 2) Language is pervasive in all social interactions. Language cannot be viewed as a separate, isolated subject. Rather, language is recognized as a complex, ongoing, developmental process which permeates all aspects of a child's day. Language learning and, consequently, language teaching occurs during all communicative exchanges. Throughout the child's day, concepts are taught or information is shared, and there are specific expected language behaviors for the teacher and the child. All of these components-language content, student language, and teacher language-influence each other (see Gruenewald and Pollak 1984).

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Language lessons were not limited to the small group or individual language times with the speech/language pathologist. Teachers followed suggestions to enhance communicative interactions throughout the day. Strategies were used to foster language interaction based on a child's particular language needs during outdoor pla~ snack time, lunch time, and art activities (see Kwiatkowski 1984). Furthermore, children were encouraged throughout the day to use language to resolve conflicts by talking to another child, or talking about their feelings, or the impact of another's actions or statements (e.g., "That hurt me when you pushed in line."). The third of the six language principles relates to interactive participants and the purpose of language. It follows directly from the first two principles which concern setting and timing: 3) Since the primary purpose of language is communication, the use of language for interpersonal communication with adults and peers is the major focus of teaching. Again, language intervention activities were based in the classroom and took place throughout the day. The primary purpose was to improve children's ability to interact with peers and adults. Children need to adjust different parameters of their language with different communicative partners. It is known that young children can modify their language depending on whether the listener is younger, an adult, or a peer (Shatz and Gelman 1973). Normally developing children can also appropriately moderate their language level during interactions with developmentally delayed peers (Guralnick and Paul-Brown 1977, 1980, 1984, 1986). In fact, cognitively-delayed and language-delayed children make similar language adjustments (Fey and Leonard 1984; Fey, Leonard, and Wilcox 1981; Guralnick and Paul-Brown 1988, submitted for publication). Given this ability for flexible language use, and the need to make listener distinctions in the classroom, children in the preschool were encouraged, for example, to initiate interactions with peers, to ask adults for help, and to learn to give their peers an opportunity to respond when formulation time was delayed. The final three language development principles relate to the content of language teaching: 4) The content and sequence for teaching new language forms and functions are based on normal language developmental processes (see Miller and Yoder 1974). In the areas of phonology, syntax, semantics, and pragmatics, information known about the normal sequence of development was used to plan individual language sessions. Children would not be expected to understand idiomatic expressions, for example, if they had a very limited

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basic, concrete vocabulary. Similarly, children would not be expected to be able to converse about past events if they had trouble describing present, ongoing activities. Another important principle related to content is that: 5) Language teaching should be conducted within a discourse context (i.e., extended sequence of utterances for conversations or narratives) rather than following an approach that focuses on words or utterances in isolation.

Teaching or expecting only single words or single utterances is a very limited, unrealistic goal for language development. Typically, conversations extend beyond just a two-part sequence such as a question and answer. Children need to learn what to say next in order to be successful conversational partners. Children were encouraged to elaborate as much as possible if formulation of information were a difficulty. Some children, however, also had to be taught to be aware of the amount of information they provided. One principle for cooperative conversation is to be brief (Grice 1975). Sometimes children gave too much information or did not know when to talk. The final language principle, also related to content, is perhaps the most recognized and obvious. Nevertheless, it is a key to successful language programming in a classroom. 6) Language goals should be selected based on the individual social, cognitive, and linguistic level of each child as determined by a comprehensive evaluation.

This principle addresses the importance of individualization in language intervention. The principle mandates that each child's social, cognitive, and language level be determined on the basis of a comprehensive diagnostic evaluation procedure. This information should then be used to determine individual goals and objectives. Language intervention procedures should relate directly to the initial assessment. The fact that language intervention takes place in the classroom, does not mean that children in the class are viewed or treated as one unit--all being at the same level. Individual priorities are established based on the nature and severity of the presenting problem. Various models and prompts were appropriately adapted to elicit responses from children using language at a level which was challenging, but not overwhelming (see Johnson 1983). Specific goals and objectives were modified on an ongoing basis as appropriate to maximize the benefit of individualized language intervention. Thus, even within a group situation, intervention procedures were individualized on the basis of particular language needs.

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Resulting Changes in Language Comprehension and Production Children's progress was monitored on a daily basis; goals and activities were modified accordingly. Individual progress in language comprehension and production was evaluated informally primarily by regular teacher and clinician classroom observations and through comparisons of different language samples. An ability to engage in conversational interactions with peers was a difficulty documented for a number of the children following the initial assessment. Improvement occurred in the frequency, extent, and variety of such conversations when the development of specific peer-interaction skills was a target communication goal. Story narration skills, another area of difficulty for most of the children, also improved for particular children following directed intervention efforts. However, limitations remained in story production, as evaluated by story grammar, syntactic, and reference cohesion analyses, compared to a sample of peers who were not language impaired (Roth and Paul-Brown in preparation). Formal pre- and post-language comprehension test measures were compared to determine overall progress and to obtain a classroom profile of strengths and weaknesses. Results on measures of language comprehension (see Table III) showed that posttest scores were significantly higher than pretest scores on three instruments: the Boehm Test of Basic Concepts (Boehm 1969); the Token Test for Children (DiSimoni 1978) and a test of the ability to follow multipart commands (J.F. Kennedy Commands Test n.d.). These results indicate that generally children made the most change in the areas of concept development and following multipart directions. Improvement was also noted in the areas of receptive vocabulary and auditory memory, although not to a significant degree. These test scores revealed skill areas where greater needs existed and provided the direction for future remedial efforts.

Summary To summarize, six language development principles, derived from an interactionist perspective of language development, were used to develop an individualized, classroom-based language intervention program. These principles helped determine the setting, timing, participants, purpose, and content of the intervention procedures. Target language objectives were selected for each individual following a diagnostic evaluation and were based on the child's specific needs and expectations according to the normal developmental sequence. Language intervention took place throughout a child's day during all classroom activities and was extended to the home environment as well. Appropriate conversational exchanges between peers and adults were fostered in the child's natural settings. A

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Table III Language Comprehension Test Results Test Pre Mean Post Mean (Type of Score) Score (SD) Score (SD) PPVT-R 6.1 yrs. (1.2) 6.9 yrs. (1.8) (Age Equivalent) Boehm 37.3 (6.6) 41.8 (6.5) (No. Correct) TACL-R 5.8 yrs. (1.1) 6.8 yrs. (1.3) (Age Equivalent) Digit Span 10.6 (3.3) 10.9 (3.5) (No. Correct) Sentence Memory 5.7 yrs. (1.5) 5.9 yrs. (1.3) (Age Equivalent) TokenTest for Children 495.63(5.9) 497.94(5.1) (Overall Scores) J.EK. Commands1.31 (1.3) 2.25 (1.3) Objects (No. Correct) J.F.K. Commands2.50 (1.2) 3.19 (1.8) Action Directions (No. Correct)

Difference 1.25 mos*

P n.s.

4.50

sig.

2.62 mos*

n.s.

0.38

n.s.

4.18 mos*

n.s.

2.31

sig.

0.94

sig.

0.69

sig.

p

A classroom-based model of language intervention for preschool language-impaired children: Principles and procedures.

It is now generally recognized that a language impairment in preschool children may be predictive of later linguistic, reading, and academic difficult...
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