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JCPSLP
Volume 14, Number 1 2012
Journal of Clinical Practice in Speech-Language Pathology
input intervention would result in stronger treatment effect
than the output intervention.
The outcome measures used to test these hypotheses
were derived from child language transcripts from videos
of parent–child interactions at home which were analysed
using SALT analysis (Miller & Chapman, 1985). For
expressive vocabulary scores, both AAC groups performed
better than the spoken communication intervention at
both the end of the treatment and a follow-up assessment
however children in the output intervention performed
better than children in the input group contrary to the
second hypothesis. Other measures such as type token
ratio and mean length of utterance followed this pattern.
These treatment effects are modest in size which means
that some children may not respond to the treatment with
a substantial change in their vocabulary and indeed some
children, particularly those in the spoken communication
group, did not use any words at all at follow up.
Interestingly, those who received the augmented output
intervention were more likely to retain their newly acquired
vocabulary skills than children in the other two groups.
The clinical bottom lines are: 1) toddlers who received
any of the three treatments improved their communication
with their parents; 2) those who are required to produce
words using the SGD make more and more sustained
gains in vocabulary than children who use SGD supports
for learning vocabulary without the requirement to use the
words or those who have speech-only based intervention;
(3) augmented language intervention did not impair the
child’s development of spoken language; finally (4) the use
of AAC with very young children may be warranted.
Reference
Miller, J., & Chapman, R. (1985). Systematic Analysis of
Language Transcripts [Computer software]. Madison:
University of Wisconsin.
enhance their child’s speech and language development.
Although there is research literature which supports this
advice in a range of populations, much of the literature is
focused on older children and few randomised control trials
have been completed to date.
In this study, 68 toddlers with severe communication
impairment arising from a range of conditions were
randomly assigned to one of three treatment groups.
Children were included in the research if they had no more
than 10 spoken words. The children were average age of
30 months and most scored below the first percentile on
the Mullen Scales of Early Language. Parents came from a
wide range of demographic groups in metropolitan Atlanta,
USA.
The treatment consisted of a parent-coached language
intervention focused on vocabulary acquisition. Groups
differed by the method that the allocated intervention used.
The first group received an augmented input intervention
(speech generating device [SGD] used to provide input), the
second an augmented output intervention (child uses SGD
to communicate) and the third group of children received
a spoken communication intervention. All three groups
received the same average dose (amount) of intervention,
which was approximately 16 weeks of treatment.
The vocabulary targeted was customised for each
child through discussion between the treating speech
pathologist and the parent. Vocabulary items selected
included names, actions and commands. Clinicians and
parents were encouraged to use all items on the child’s
list in each treatment session. The intervention included
modelling and parent coaching on a range of language
stimulation approaches in the clinic and at home. Examples
of the intervention dialogue are provided which will allow
clinicians to use these approaches with their own clients.
The researchers hypothesised that children in all groups
would benefit from the intervention, that the two augmented
interventions would result in better outcomes, and that the
Peer review
(January – December 2011)
The editors wish to thank the following people who reviewed papers for
ACQuiring Knowledge in Speech, Language
and Hearing
:
Susan Balandin
Norway
Petrea Cahir
Australia
Natalie Ciccone
Australia
Julie Cichero
Australia
Susanne Döpke
Australia
Patricia Eadie
Australia
Linda Espinosa
USA
Silke Fricke
UK
Judy Gould
Australia
Anna Hearne
Australia
John Heilmann
USA
Gayle Hemsley
Australia
Deborah Hersh
Australia
Tami Howe
New Zealand
Belinda Kenny
Australia
Claire Langdon
Australia
Tao-yuan Li
USA
Valerie Lim
Singapore
Suze Leitão
Australia
Michelle Lincoln
Australia
Anne Lowell
Australia
Sue McAllister
Australia
Tricia McCabe
Australia
Jane McCormack
Australia
Susan Morrison
Australia
Rosalyn Neilson
Australia
Ruth Nicholls
Australia
Anna O’Callaghan
Australia
Carl Parsons
Australia
Wendy Pearce
Australia
Nerina Scarinci
Australia
Tanya Serry
Australia
Lyndall Sheepway
Australia
Kate Taylor
Australia
David Trembath
Australia
Nicole Watts-Pappas
Australia
Cori Williams
Australia
Philippa Williams
New Zealand
Chris Wilson
Australia
Linda Wilson
Australia