Interactive Book Reading to Accelerate Word Learning by Kindergarten Children With Specific Language Impairment: Identifying Adequate Progress and Successful Learning Patterns

Abstract

Purpose: The goal of this study was to provide guidance to clinicians on early benchmarks of successful word learning in an interactive book reading treatment and to examine how encoding and memory evolution during treatment contribute to word learning outcomes by kindergarten children with specific language impairment (SLI).

Method: Twenty-seven kindergarten children with SLI participated in a preliminary clinical trial using interactive book reading to teach 30 new words. Word learning was assessed at 4 points during treatment through a picture naming test.

Results: The results indicate that the following performance during treatment was cause for concern, indicating a need to modify the treatment: naming 0-1 treated words correctly at Naming Test 1; naming 0-2 treated words correctly at Naming Test 2; naming 0-3 treated words correctly at Naming Test 3. In addition, the results showed that encoding was the primary limiting factor in word learning, but rmemory evolution also contributed (albeit to a lesser degree) to word learning success.

Conclusion: Case illustrations demonstrate how a clinician's understanding of a child's word learning strengths and weaknesses develop over the course of treatment, substantiating the importance of regular data collection and clinical decision-making to ensure the best possible outcomes for each individual child.

Figures

Figure 1.

Top panel shows the average number of words correct, with error bars indicating the standard deviation for untreated control words for all children (circles, short-dashed line) and treated words (long-dashed line) for children with no treatment response (squares), an average treatment response (triangles), or a high treatment response (diamonds). Bottom panels show the percent of children in each intensity condition (12, 24, 36, or 48 exposures) for each treatment response group: no treatment response (left), average treatment response (middle), and high treatment response (right).

Figure 2.

Fourth/last naming test scores for treated words plotted by first (upper left panel), second (upper right panel), and third (lower left panel) naming test scores. Vertical line indicates the criteria for a treatment response based on the fourth/last naming test, which also is shown by the color of the circles, with unfilled corresponding to no treatment response and filled corresponding to a treatment response. The horizontal line indicates the cutoff score on the earlier naming test for predicting a positive or negative response to treatment. Within a panel, the cutoff lines divide the data into four quadrants representing false positives (upper left), true positives (upper right), true negatives (lower left), and false negatives (lower right).

Figure 3.

Partial naming data from the four test points for KAW018 (intensity: 24 cumulative exposures). 0 indicates an incorrect response. 1 indicates a correct response. A repeated correct response is noted by shading. Only a subset of the 30 treated words are shown, namely the treated words that were named correctly at least one time.

Figure 4.

Clinical decision-making framework for performance at each early naming test.

Figure 5.

Data for four children in the 24-exposure condition: KAW009, KAW050, KAW018, and KAW070. Graphs in the top of each panel show the number of treated words named correctly by the target child (solid line), the average treatment response group (triangles with long-dashed line), and the high treatment response group (diamonds with long-dashed line). The minimum cutoff for adequate progress is shown by the short-dashed line. Tables in the bottom of each panel show the specific treated words that were named correctly for the first time (unshaded cells) or for a second or third time (shaded cells) at each naming test to illustrate encoding (unshaded cells) or memory evolution (shaded cells).