Abstract: Do you have clients with narrative language challenges? We present evidence-based strategies from a meta-analysis on interventions designed to improve narrative language. Join us for an interactive session to gain knowledge about the characteristics of effective narrative interventions and gain hands on experience applying them in everyday clinical practice.
Description: Main Argument: How important is a child’s ability to tell a story? For children of all ages, storytelling or the ability to produce an oral narrative is related to later language and academic outcomes (e.g., Wellman et al., 2011). The importance of narrative language for academic outcomes is evidenced by the inclusion of retelling and recounting narratives in the United States (US) Common Core standards (National Governors Association Center for Best Practices & Council of Chief State School Officers, 2010). In addition to academic outcomes, oral narrative language has social importance, as children use narratives to relate to their peers and connect with their parents. Thus, difficulties with narrative language may negatively affect academic success, friendships, and social interactions for young children (e.g., Nation et al., 2004). Experts in speech-language pathology and education have developed and implemented a variety of interventions that aim to improve narrative language for students with and without disabilities (Spencer & Petersen, 2020).
For children with disabilities that affect language, multiple studies have demonstrated the potential of oral narrative language interventions to improve production and comprehension. One of the many benefits of oral narrative language interventions is their adaptability. Within the context of narrative language, interventionists can target narrative macrostructure, such as identifying the problem and solution in a story, or microstructure, such as the use of temporal conjunctions. Oral narrative interventions can also vary in the type of narrative language solicited, for example, a story retell, a personal story generation, or a fictional story generation. Oral narrative interventions can differ in focus, targeting narrative language comprehension, narrative language production, or a combination of both.
In this presentation, we first present results of a recent meta-analysis examining the characteristics of interventions designed to improve narrative language and their effectiveness (Pico et al., 2021). High-quality meta-analyses are among the highest level of scientific evidence as systematically assessing the results of previous research enables us to derive conclusions about a body of research. These meta-analytic findings provide the empirical evidence for evidence-based strategies to promote narrative language. Next, we discuss how to apply the study findings in implementing interventions to improve oral narrative language within one’s own clinical practice.
Procedures: A systematic search was conducted to locate studies that met the following inclusion criteria based on the PICOS framework: (a) Participants-pre-school or school-aged children, with or without disabilities, (b) Interventions-interventions that aimed to improve children’s oral narrative language, (c) Comparison-studies implementing experimental designs, (d) Outcomes-any oral narrative language outcomes, and (e) Settings-preschool, elementary school, and clinical settings in the US. Data extracted from the included studies related to: study, participant, and intervention characteristics as well as study findings. To quantify the magnitude of treatment effects, effect sizes were calculated using Cohen’s d or the Log Response Ratio, dependent on study design. Two meta-analyses were completed for (1) narrative production and (2) narrative comprehension outcomes.
Results: Our systematic search yielded 40 studies that included one or more narrative language outcome. Twenty-four of the included studies were group designs and 16 were single case designs (SCDs). The studies included participants with a range of learner characteristics (e.g., race, language, disability) as well as a range of settings (e.g., school, clinic), interventionists (e.g., speech-language pathologist, teacher), and intervention characteristics (e.g., narrative retells, story generations, explicit instruction). Based on visual analysis (i.e., three demonstrations of behavior change), the coders identified strong evidence of a functional relation in 11 studies, moderate evidence of a functional relation in two studies, and no evidence of a functional relation in 18 studies. Lastly, studies were analyzed based on narrative production and comprehension outcomes. The meta-analyses indicated overall positive effects of the interventions, with effect sizes of d = 0.51 (comprehension) and 0.54 (production) in the group design studies and 1.24 (production) in the SCDs.
Clinical Application and
Discussion: The number of published intervention studies with narrative outcomes has more than doubled in the past decade. Findings from this study indicate that a variety of interventions are effective at improving child narrative production and comprehension outcomes. Some common characteristics across these interventions include manualized curriculum, narrative language elicitation, verbal and visual supports, direct instruction of story grammar, and use of authentic children’s literature. We discuss each of these evidence-based intervention characteristics in detail and provide case-based examples of how to implement them in practice. We also discuss other contextual variables related to intervention as our cadre of studies showed increased diversity in interventionists, participants, settings, and outcome measures as compared with prior syntheses. Overall, findings indicate that measurable and lasting improvements in narrative outcomes can result from relatively few hours of evidence-based, targeted intervention. As narrative skills are known to contribute to academic skills, these results suggest that interventions that affect narrative language have positive benefits for children when provided with fidelity.
In this interactive presentation, attendees will watch and discuss video case examples and gain hands on experience with narrative intervention strategies. We present the intervention strategies that were found to be effective for improving narrative production and comprehension outcomes in children with diverse learner characteristics (Pico et al., 2021) using these interactive methods. The case studies include children varying in age and language profiles. Video examples and think-pair-share small group discussions are used to increase audience participation.
Presentation Format & Methods: • PowerPoint • Interactive lecture • Case study videos
Supporting Research: Reference 1: Leuschen de Pico, D., Hessling Prahl, A., Biel, C.H., Peterson, A.K., Biel, E.J., Woods, C. & Contesse, V.A. (2021). Interventions Designed to Improve Narrative Language in School-Aged Children: A Systematic Review and Meta-Analysis. Language, Speech, and Hearing Services in Schools, 52(4), 1109-1126. Doi: 10.1044/2021_LSHSS-20-00160
Supporting Research: Reference 2: Nation, K., Clarke, P., Marshall, C. M., & Durand, M. (2004). Hidden language impairments in children: Parallels between poor reading comprehension and specific language impairment? Journal of Speech, Language, and Hearing Research, 47(1), 199–211. https://doi.org/10.1044/1092-4388(2004/017)
Supporting Research: Reference 3: National Governors Association Center for Best Practices and Council of Chief State School Officers (NGAC). (2010). Common core state standards. http://www.corestandards.org
Supporting Research: Reference 4: Spencer, T. D., & Petersen, D. B. (2020). Narrative intervention: Principles to practice. Language, Speech, and Hearing Services in Schools, 51(4), 1081-1096.
Supporting Research: Reference 5: Wellman, R. L., Lewis, B. A., Freebairn, L. A., Avrich, A. A., Hansen, A. J., & Stein, C. M. (2011). Narrative ability of children with speech sound disorders and the prediction of later literacy skills. Language, Speech, and Hearing Services in Schools 42(4), 561-579. doi: 10.1044/0161-1461(2011/10-0038)
Learning Objectives:
List three evidence-based characteristics of interventions designed to improve oral narrative language in pre-school and school-aged children
Describe at least one key finding regarding the effectiveness of interventions designed to improve oral narrative language
Apply study findings in implementing interventions to improve oral narrative language within one’s own clinical practice