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Visual Support in Intervention for Preschoolers With Specific Language Impairment

Washington, Karla N.; Warr-Leeper, Genese A.

doi: 10.1097/01.TLD.0000437941.08860.2f
Original Articles

This study was conducted as a follow-up analysis to two prior studies using existing data gathered in those original studies. In the current study, we focus on those preschoolers who received one of two interventions that varied in terms of the level of visual supports for grammatical elements (n = 22 of the original 34 participants). Utilizing random selection for intervention, our study examined potential session-to-session differences in rate of progress between two interventions. One intervention provided visual support using color-coded screens and syntactic slots for grammatical and semantic sentence elements (Group 1, Computer-Assisted Intervention, n = 11). The other intervention provided visual support through objects in play, books, and picture cards with actions for semantic elements only (Group 2, Table-Top Intervention, n = 11). Both interventions targeted accurate production of a basic simple sentence (i.e., third person singular present progressive sentences). Twenty-two, 3- to 5-year-old preschoolers with specific language impairment (SLI) participated in 20-minute once weekly sessions. Both interventions included sentence breakdown (i.e., breaking sentences into subject, verb, object components that are trained to an 80% criterion) and build-up (i.e., putting the entire sentence together). Rate of progress in intervention was monitored for (a) efficiency (first session that the 80% criterion was achieved) and (b) syntactic growth (movement beyond the basic simple sentence level). Blinded assessors scored session-to-session data to establish potential differences in rate of progress between groups. The results showed that Group 1 outperformed Group 2 for efficiency and syntactic growth. This study demonstrated that use of multiple visual supports in expressive grammar training facilitated a therapeutic advantage in session-to-session grammatical learning for preschoolers with SLI.

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Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, Ohio (Dr Washington); and School of Communication Sciences and Disorders, University of Western Ontario, London, Ontario Canada (Dr Warr-Leeper).

Corresponding Author: Karla N. Washington, PhD, CCC-SLP, S-LP(C), Department of Communication Sciences and Disorders, College of Allied Health Sciences, University of Cincinnati, 3202 Eden Avenue, 345D French East Building, Cincinnati, Ohio (

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The authors have indicated that they have no financial and no nonfinancial relationships to disclose.

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