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What's the problem?
Developmental Language Disorder (DLD) is a hidden but common lifelong condition that affects one in 14 people - around two children in every classroom. It causes difficulties understanding and/or using both spoken and written language, which can affect a child's ability to participate in everyday conversations and can impact their education and future life chances.
Whilst most interventions for school-aged children with DLD target vocabulary, grammar or narrative skills, conversation is a neglected area, despite being the main medium through which we learn, share our thoughts and feelings, and build social relationships. Work being undertaken in the Better Conversations with Developmental Language Disorder (BCDLD) programme of research aims to:
1) co-design with key stakeholders a new treatment protocol for effecting change in children's everyday conversation and structural language skills, based on published theory and interventions used successfully with other clinical populations.
2) characterise the conversations of typically-developing primary school children and their parents with respect to key conversational behaviours which are targeted within BCDLD to provide a context for intervention findings.
3) investigate the response of children with DLD and their main carers to the BCDLD programme.
4) evaluate the feasibility of using this approach, including recruitment and retention, acceptability of the intervention, IRR and suitability of chosen outcome measures.
5) explore how dyadic turn sequences shape development of children's language and communication skills through detailed Conversation Analysis, in order to inform future clinical development of BCDLD.
What do we know already?
Conversation is the primary and most natural context for child language acquisition. For children with DLD, learning to converse well with others presents significant challenges, due to difficulties understanding and responding 'online' in the quick back-and-forth of natural conversation. This, in turn, can limit children's access to the rich language-learning opportunities, which arise from everyday interactions with parents, carers and peers.
An initial trial of BCDLD with six parent-child dyads suggests that school-aged children with language disorder can benefit from direct intervention to enhance their everyday conversations. Five of the dyads showed a significant change in conversation behaviours which were targeted during therapy. Overall, children showed an increase in their average utterance length and demonstrated progress on both receptive and expressive language assessments. Change in child-to-adult ratio of speech was also achieved, in line with intervention targets.
Current Project
Larger-scale studies will be needed to establish whether our initial findings can be generalised to the wider population of children with DLD. Work is currently underway to conduct a service evaluation of Speech and Language Therapists to establish what methods they currently use to address conversation difficulties, with a view to carrying out a larger-scale trial, with BCDLD delivered by trained clinicians who are practising within the NHS.
An important next stage of this process will be to consult extensively with parents, young people with DLD, SLTs and school staff through patient and public involvement to ensure that therapy and recruitment protocols are robust and meet the needs of the widest sample of participants with DLD and their main carers.
Social Media Outputs
| Presentation slides from the RCSLT conference | |
| Presentation slides from Atypical Interaction Conference | |
| Presentation slides from talk to Birmingham City University |
Key Publications
Hughes, L., Corrin, J., Newton, C. and Best, W. (2022). 'Where does Granny live?' The role of test questions in conversational remembering between mothers and their children with developmental language disorder. Journal of Interactional Research in Communication Disorders. doi: 10.1558/jircd.20235
Hughes, L., Best, W., Newton, C. & Corrin, J. (in preparation) Evaluation of a novel intervention 'Better Conversations with Developmental Language Disorder': feasibility and findings from experimentally controlled case studies.
Kwok, Y. T., Hughes, L., Best, W., & Newton, C. (under review). Cross cultural differences in parent-child interaction: Evidence from parents and children from Hong Kong and the United Kingdom.
Best, W., Hughes, L., Masterson, J., Thomas, M. S. C., Howard, D., Kapikian, A., & Shobbrook, K. (2020). Understanding differing outcomes from semantic and phonological interventions with children with word-finding difficulties: a group and case series study. Cortex. doi:10.1016/j.cortex.2020.09.030
Best, W., Hughes, L. M., Masterson, J., Thomas, M., Fedor, A., Roncoli, S., Kapikian, A. (2018). Intervention for children with word-finding difficulties: A parallel group randomised control trial. International Journal of Speech-Language Pathology. doi:10.1080/17549507.2017.1348541