背景:形态句法问题是发展性语言障碍(DLD)的核心症状。在荷兰,患有(推测的)DLD的儿童可以在以语言为中心的治疗组中接受特殊照顾.这些群体的重点主要在于提高交际意向,词汇和语音。句法技能受到的关注较少。
目的:作者开发了一种针对DLD幼儿形态句法技能的基于脚本组的干预措施。在这项研究中,测试了干预措施对患有(假定)DLD的学龄前儿童的形态句法技能的影响,并评估了对教学从业者(PPs)的可用性.
方法:27名患有DLD的学龄前儿童(2岁;10-3岁;10[岁;月])参加了A-B组研究,其中通过形态句法任务和语言样本分析(LSA)监测语法结构的发展。使用贝叶斯混合效应模型检查了8周常规护理(UC)和8周形态句法干预期间的进展。在LSA,将靶向结构与对照结构进行比较.干预包括每周一次的基于脚本的小组会议,其中针对形态句法结构,以及重复这些目标结构的日常活动。干预由训练有素的PP提供,由言语治疗师指导。使用在线问卷评估了可用性和可行性的早期指标。
结果:分析表明,在干预期间,形态句法技能得到了改善,有强有力的证据证明LSA中形态句法任务以及目标和控制结构上目标结构的生产增长,虽然几乎没有发现任何证据表明这些结构在UC中的使用有所增加。然而,目标结构和控制结构似乎以相同的速度发展。在UC和干预阶段,形态句法能力的一般测量均显示出改善。从业人员之间的评估表明,干预措施被认为是可用和可行的。
结论:显示了干预期儿童形态句法技能的增长,但这不能证明与干预有关,因为干预期间目标和控制结构都得到了改善。这种增长可能是由于成熟而不是干预。然而,我们的研究表明,患有DLD的学龄前儿童的形态句法技能可以在8周内显示出相当大的改善。此外,我们的研究强调了在监测儿童形态句法发展时使用LSA措施的重要性,因为它们可能比标准化测试对变化更敏感。
结论:关于该主题的已知内容大多数患有发育性语言障碍(DLD)的儿童在形态句法发育中遇到困难。在荷兰,患有DLD的学龄前儿童可以在以语言为中心的治疗组中接受特殊护理。这些群体主要集中在激发交际意图上,词汇和语音,但在刺激形态句法技能方面就更少了。这项研究的补充我们设计了一种新的基于小组的干预措施,针对DLD儿童的表达形态句法技能,检查了效果,并研究了可用性和可行性。尽管有强有力的证据表明形态学技能的增长,干预效果无法证明。从业人员之间的评估表明,干预措施被认为是可用和可行的。此外,这项研究表明,儿童的形态句法技能可以在相对较短的时间内提高,语言样本分析似乎对检测这些变化很敏感。这项工作的临床意义是什么?目前,很少有基于群体的形态句法干预(在荷兰)。由于从业者普遍对干预措施及其可用性和可行性持积极态度,拟议的干预措施可能有利于DLD儿童形态句法问题的治疗.
BACKGROUND: Morphosyntactic problems are a core symptom of Developmental Language Disorder (DLD). In the Netherlands, children with (presumed) DLD can receive special care in language-focused treatment groups. The focus of these groups mainly lies in improving communicative intentions, vocabulary and phonology. Morphosyntactic skills receive less attention.
OBJECTIVE: The authors developed a scripted group-based intervention targeting morphosyntactic skills in young children with DLD. In this study, the effect of the intervention on the morphosyntactic skills of preschoolers with (presumed) DLD was tested and the usability for pedagogical practitioners (PPs) was evaluated.
METHODS: Twenty-seven preschoolers with DLD (aged 2;10-3;10 [years;months]) participated in an A-B group study in which the development of grammatical structures was monitored with a morphosyntactic task and language sample analyses (LSA). Progression during 8 weeks usual care (UC) and 8 weeks morphosyntactic intervention was examined using Bayesian mixed effects models. In LSA, structures that were targeted were compared to control structures. The intervention consisted of a weekly script-based group session in which morphosyntactic structures were targeted, and daily activities in which these target structures were repeated. The intervention was provided by trained PPs, who were coached by a speech-language therapist. An early indication of usability and feasibility was evaluated using an online questionnaire.
RESULTS: The analyses show that morphosyntactic skills improved during the intervention period, with strong evidence for growth in the production of target structures on the morphosyntactic task and target and control structures in LSA, while barely any evidence was found for growth in the use of these structures in UC. However, target structures and control structures seem to develop at the same rate. General measures of morphosyntactic ability showed improvement both during UC and the intervention phase. Evaluation among practitioners suggested that the intervention is regarded as usable and feasible.
CONCLUSIONS: Growth in morphosyntactic skills of children in the intervention period was demonstrated, but this could not be proven to be related to the intervention because both target and control structures improved during the intervention. This growth might be due to maturation instead of the intervention. Nevertheless, our study demonstrates that the morphosyntactic skills of preschoolers with DLD can show considerable improvement over a period of 8 weeks. Furthermore, our study underlines the importance of using LSA measures when monitoring the morphosyntactic development of children, as they might be more sensitive to change than standardised tests.
CONCLUSIONS: What is already known on the subject Most children with Developmental Language Disorder (DLD) experience difficulties in their morphosyntactic development. In the Netherlands, preschoolers with DLD can receive special care in language-focused treatment groups. These groups mainly focus on stimulating communicative intentions, vocabulary and phonology, but less so on stimulating morphosyntactic skills. What this study adds We designed a new group-based intervention targeting the expressive morphosyntactic skills of children with DLD, examined the effect and investigated the usability and feasibility. Although there is strong evidence for growth in morphological skills, intervention effects could not be demonstrated. Evaluations among practitioners suggested that the intervention is regarded as usable and feasible. Furthermore, this study shows that children\'s morphosyntactic skills can improve over relatively short periods of time and language sample analyses seem to be sensitive to detect these changes. What are the clinical implications of this work? Currently, very few group-based morphosyntactic interventions exist (in the Netherlands). Since practitioners were generally positive about the intervention and its usability and feasibility, the proposed intervention might benefit the treatment of morphosyntactic problems in children with DLD.