Enhancing Discourse Fluency by Increasing Work Selection Proficiency in School-Age Children With Language Learning Disorders.
Date of Award
Doctor of Philosophy (PhD)
Communication Sciences and Disorders
Paul R. Hoffman
There is growing clinical and research interest in the area of children's "word finding" difficulties, but treatment efficacy data are sparse. Previous treatments have been concerned with training students with language-learning disorders (LLD) to retrieve pre-selected, concrete nouns. Recommended intervention strategies have included retrieval exercises and activities focused on improving students' elaborative knowledge of training exemplars. The current study presents and evaluates a discourse-based, contextual intervention strategy for increasing word selection proficiency and discourse fluency. Three nine year old boys with diagnosed language-learning disorders participated in three discourse tasks: picture-elicited narratives, story-retelling, and conversation. During treatment, the experimenter identified problematic word selection behaviors as they occurred, allowed their completion, then provided appropriate feedback. Feedback consisted of (1) requests for associative information, (2) requests for clarification, (3) comments to confirm the appropriateness of word choices, and (4) comments to facilitate discourse restructuring. All sessions were videotaped, then transcribed, coded and analyzed. All three subjects exhibited a decrease in the production of problematic word selection behaviors from initial baseline to posttreatment baseline. One subject demonstrated a significant decrease in overt word selection behaviors when baseline phases were compared with adjacent treatment phases. All subjects exhibited greater observable word selection difficulty when engaged in the story-retelling task. In addition, they all produced significantly more overt word selection behaviors during communication units that were above average in length. These results support the belief that children's "word finding" problems are symptoms of more generalized language deficits. Moreover, the symptoms are highly variable depending upon the demands of each linguistic task. Clinical intervention should be provided in such a way that students are afforded multiple opportunities to engage in meaningful discourse throughout the school day. When problematic word selection behaviors occur, speech-language pathologists and teachers should provide appropriate feedback designed to help students shift from less productive to more productive word selection processing.
Stiegler, Lillian Nielsen, "Enhancing Discourse Fluency by Increasing Work Selection Proficiency in School-Age Children With Language Learning Disorders." (1994). LSU Historical Dissertations and Theses. 5758.