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Understanding differing outcomes from semantic and phonological interventions with children with word-finding difficulties: A group and case series study
Cortex ( IF 3.6 ) Pub Date : 2020-11-17 , DOI: 10.1016/j.cortex.2020.09.030
Wendy Best 1 , Lucy Hughes 1 , Jackie Masterson 2 , Michael S C Thomas 3 , David Howard 4 , Anna Kapikian 2 , Kate Shobbrook 1
Affiliation  

Developmental Language Disorder occurs in up to 10% of children and many of these children have difficulty retrieving words in their receptive vocabulary. Such word-finding difficulties (WFD) can impact social development and educational outcomes. This research aims to develop the evidence-base for supporting children with WFD and inform the design and analysis of intervention studies.

We included 20 children (age 6 to 8) with WFD each of whom participated in two interventions one targeting semantic attributes and the other phonological attributes of target words. The interventions, employing word-webs, were carefully constructed to facilitate direct comparison of outcome which was analysed at both group and case-series level.

The study used a robust crossover design with pre-intervention baseline, between–intervention wash-out and post-intervention follow-up testing. We incorporated: matching of item sets on individual performance at baseline, independent randomisation of order of intervention and items to condition, blinding of assessor, evaluation of fidelity and control items. The interventions were clinically feasible, with weekly sessions over six weeks.

Intervention improved children's word-finding abilities with statistically significant change only during treatment phases of the study and not over baseline, wash-out or follow-up phases. For the group the semantic intervention resulted in a gain of almost twice as many items as the phonological intervention, a significant difference.

However, children differed in their response to intervention. Importantly, case-series analysis revealed outcomes predictable on the basis of children's theoretically driven language profiles. Taking account of individual profiles in determining choice of intervention would enable more children to benefit.

The study provides new evidence to inform and refine clinical practice with this population. Future studies should be designed such that results can be analysed at both group and case series levels to extend theoretical understanding and optimise use of appropriate interventions.



中文翻译:

理解对找词困难儿童进行语义和语音干预的不同结果:一个小组和案例系列研究

多达 10% 的儿童出现发育性语言障碍,其中许多儿童难以在其接受词汇中检索单词。这种找词困难(WFD)会影响社会发展和教育成果。本研究旨在开发支持 WFD 儿童的证据基础,并为干预研究的设计和分析提供信息。

我们纳入了 20 名 WFD 儿童(6 至 8 岁),他们每人都参与了两项干预,一项针对目标词的语义属性,另一项针对目标词的语音属性。采用词网的干预措施经过精心构建,以促进直接比较在组和案例系列层面分析的结果。

该研究采用稳健的交叉设计,包括干预前基线、干预间清除和干预后随访测试。我们纳入了:项目组在基线时个人表现的匹配、干预顺序和项目与条件的独立随机化、评估者的盲法、保真度评估和控制项目。这些干预措施在临床上是可行的,在六周内每周进行一次。

干预提高了儿童的单词查找能力,仅在研究的治疗阶段而不是超过基线、清除或后续阶段有统计学意义的变化。对于该组而言,语义干预导致的项目增益几乎是语音干预的两倍,这是一个显着的差异。

然而,儿童对干预的反应不同。重要的是,案例系列分析揭示了基于儿童理论驱动的语言档案可预测的结果。在确定干预选择时考虑个人概况将使更多儿童受益。

该研究提供了新的证据来告知和改进该人群的临床实践。未来的研究应设计为可以在组和案例系列水平上分析结果,以扩展理论理解并优化适当干预措施的使用。

更新日期:2020-12-03
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