1. EBP Extravaganza 2008 Cracking Into Language Paediatric Language EBP Group Leader: Brooke Funnell Brooke.Funnell@sswahs.nsw.gov.au

2. EBP Extravaganza 2008 Our Team SCH Liverpool Auburn USYD Dubbo CHC And many new members from across Sydney

3. EBP Extravaganza 2008 Clinical Question 1 What techniques are effective for improving word-finding difficulties in children aged 2 – 12 years old? Clinical Bottom Line: Strategies in discourse such as request for associations, request for clarification, confirmation, reconstruction, and phonological cueing or at single word level such as phonological association cues and syllables, may reduce word-finding errors.

4. EBP Extravaganza 2008 Clinical Question 1 References –Stiegler, L.N. & Hoffman, P.R. (2001). Discourse- based intervention for word finding in children. Journal of Communication Disorders, 34, 277-303. –German, D. J, (2002). A phonologically based strategy to improve word finding abilities in children. Communication Disorders Quarterly, 23:4, 179-192. –German, D. and Newman, R. (June 2004). The impact of lexical factors on childrens word finding errors. Journal of Speech, Language & Hearing Research, 47, 624-636.

5. EBP Extravaganza 2008 Implications for Clinical Practice There are a variety of strategies available for assisting in children with word finding difficulties. It helped to clarify for us what types of WFE there are (blocked and phonological) and then to discern which cues work for which errors

6. EBP Extravaganza 2008 Clinical Question 2 Does the use of books and narratives increase expressive language in 2-4 year old children? Clinical Bottom Line: Training parents and teachers in using books and narratives can be effective in increasing the expressive language of 2-4 year old children in the general population.

7. EBP Extravaganza 2008 Clinical Question 2 References –Arnold, D.H., Lonigan, C.J., Whitehurst, G.J., Epstein, J.N. (1994). Accelerating language development through picture book reading: replication and extension to a videotape training format. Journal of Educational Psychology, 86(2), 235-243. –Whitehurst, G.J., Falco, F.L., Lonigan, C.J., Fischel, J.E., DeBaryshe, B.D., Valdez-Menchaca, M.C., Caulfield, M. (1998). Accelerating language development through picture book reading. Developmental Psychology, 24(4), 552-559. –Peterson, C., Jesso, B. & McCabe, A. (1999). Encouraging narratives in preschoolers, an intervention study. Journal of Child Language, 26, 49-67. –Wasik, B.A. & Bond, M.A. (2001). Beyond the pages of a book: Interactive book reading and language development in preschool classrooms. Journal of Educational Psychology, 93(2), 243-250.

8. EBP Extravaganza 2008 Implications for Clinical Practice Supports our knowledge that book reading assists language development in children Encourages us to train parents and teachers more explicitly on how to use books with children Beneficial for preschool projects in using books and extension activities (theme-based) to improve vocabulary development

9. EBP Extravaganza 2008 Clinical Question 3 What strategies facilitate word learning in children with an average age of 4;0 – 5;11 (2;3 – 8;2)? Clinical Bottom Line: Certain strategies can facilitate word learning under specific conditions. These strategies include emphatic stress, frequency of exposure, shape and function cues, phonemic cues, and a supported learning context.

10. EBP Extravaganza 2008 Clinical Question 3 References –Kieran, B., Gray, S. (1998). Word learning in a supported-learning context by preschool children with SLI. Journal of Speech, Language, & Hearing Research, 41(1). –Weismer, S. & Hesketh, L. (1998). The impact of emphatic stress on novel word learning by children with SLI. JSLHR, 41, 1444-1458. –Gray, S. (2003). Word-learning by preschoolers with SLI: what predicts success? JSLHR, 46, 56- 67.

11. EBP Extravaganza 2008 Clinical Question 3 References –Alt, M., Plante, E. & Creusere, M. (2004). Semantic features in fast-mapping: Performance of preschoolers with SLI versus preschoolers with normal language. JSLHR, 47, 407-420. –Riches, N.G., Tomasello, M. & Conti-Ramsden, G. (2005). Verb learning in children with SLI: Frequency and spacing effects. JSLHR, 48, 1397-1411. –Gray, S. (2005). Word learning by preschoolers with SLI: Effect of phonological or semantic cues. JSLHR, 48, 1452-1467. –Capone, N. & McGregor, K. (2005). The effect of semantic representation on toddlers word retrieval. JSLHR, 48, 1468-1480.

12. EBP Extravaganza 2008 Implications for Clinical Practice There are lots of cues and supports that we can use (and probably already are) to assist word learning. Further studies need to look at what happens when we combine some of these cues together; does it detract from or enhance word learning?

13. EBP Extravaganza 2008 Where to from here??? Finish collating articles for CATs Clinical questions: –In school aged children with SLI, is an in-class, school based model better than a withdrawl model in managing SLI in the classroom? –In school aged children with SLI, is a school based treatment model an effective way of managing SLI in the classroom? –In preschool children with SLI, what techniques are effective In improving childrens comprehension? Increase attendance to meetings Utilise teleconferencing for our meetings Academic involvement

14. EBP Extravaganza 2008 Thank you for everyones contribution in 2007 Contact: Brooke Funnell Liverpool Hospital 9828 4776 Brooke.Funnell@sswahs.nsw.gov.au