Susan Ebbels, Ph.D.
Director, Moor House Research and Training Institute
Language and communication skills are vital in our personal, social and work lives in a highly verbal world. All children deserve access to an education that promotes good spoken and written communication skills. Children with developmental language disorder (DLD) may require additional support in these areas. This support can take many different forms:
- Extra support in the classroom, preferably using a language program with good evidence of effectiveness and delivered by someone with sufficient training and time to deliver it well
- Additional training, support and coaching for those caring for and working with the child
- Collaboration between Speech-Language Pathologists (SLPs), teachers and parents
- Individualized intervention led by an SLP focused on the specific needs of the child
This post will focus only on the last of these.
Individualized Intervention Led by an SLP
Many studies indicate that individualized intervention can improve the language skills of children with DLD, especially their expressive language and vocabulary. However, some children make more progress than others. Most studies involved intervention delivered directly by an SLP in-person to an individual child; a few examined small-group intervention. Good evidence exists that telehealth can also be helpful.
Individualized intervention can be successfully delivered by others when the intervention is planned by the SLP and the SLP has given sufficient coaching to the person delivering the intervention. We have good evidence that parents can deliver this intervention, and emerging evidence that teachers and support staff can as well, as long as they are given sufficient time to do so with easy access to support and coaching.
The evidence for the helpfulness of intervention for children with severe DLD, including those with difficulties understanding language, is weaker. But several studies have shown that with direct intervention from an SLP, they too can make good progress with a range of targets, including vocabulary and word finding, comprehension and production of grammar. These children, in particular, benefit from the specialist skills of an SLP.
Is Intervention Effective for Teenagers with DLD?
Children continue to learn throughout their teenage years and there is evidence that demonstrates that they continue to benefit from intervention. Unfortunately, no intervention studies have been carried out with adults with DLD and intervention for this group is rarely available. However, it is likely that they too could benefit from focused intervention targeted at specific problems that are affecting their lives.
The focus and nature of intervention is likely to be very different for children of different ages and indeed teenagers and adults. Interventionists must consider not just the person’s difficulties, but also the potential to make a difference to their functioning and well-being. Thus, the targets of intervention for a young adult may well be on areas necessary for accessing the world of work, whereas for younger children it may be on communicating basic needs.
Overall, evidence suggests that intervention with trained individuals, working with a knowledgeable expert like a speech-language pathologist, can help individuals with DLD achieve more effective language and communication skills. Individuals with DLD and their family members are encouraged to seek intervention.
- Calder, S. D., Claessen, M., Ebbels, S., & Leitão, S. (2020). Explicit Grammar Intervention in Young School-Aged Children With Developmental Language Disorder: An Efficacy Study Using Single-Case Experimental Design. Language, Speech, and Hearing Services in Schools, 51(2), 298–316. doi:doi:10.1044/2019_LSHSS-19-00060.
- Campbell, L., Nicoll, H., & Ebbels, S. H. (2019). The effectiveness of semantic intervention for word-finding difficulties in college-aged students (16–19 years) with persistent Language Disorder. Autism & Developmental Language Impairments, 4, 2396941519870784. doi:10.1177/2396941519870784.
- Ebbels, S., Nicoll, H., Clark, B., Eachus, B., Gallagher, A. L., Horniman, K., . . . Turner, G. (2012). Effectiveness of semantic therapy for word-finding difficulties in pupils with persistent language impairments: a randomized control trial. International Journal of Language & Communication Disorders, 47(1), 35-51. doi:10.1111/j.1460-6984.2011.00073.x.
- Ebbels, S. H. (2014). Effectiveness of intervention for grammar in school-aged children with primary language impairments: A review of the evidence. Child Language Teaching and Therapy, 30(1), 7–40.
- Ebbels, S. H., Maric, N., Murphy, A., & Turner, G. (2014). Improving comprehension in adolescents with severe receptive language impairments: a randomised control trial of intervention for coordinating conjunctions. International Journal of Language & Communication Disorders (Vol. 49, pp. 30–48). (Reprinted from: In File).
- Ebbels, S. H., van der Lely, H. K. J., & Dockrell, J. E. (2007). Intervention for verb argument structure in children with persistent SLI: a randomized control trial. Journal of Speech Language and Hearing Research, 50, 1330–1349.
- Ebbels, S. H., Wright, L., Brockbank, S., Godfrey, C., Harris, C., Leniston, H., . . . Marić, N. (2017). Effectiveness of 1:1 speech and language therapy for older children with (developmental) language disorder. International Journal of Language & Communication Disorders. doi:10.1111/1460-6984.12297.
- Gallagher, A., & Chiat, S. (2009). Evaluation of speech and language therapy interventions for pre-school children with specific language impairment: a comparison of outcomes following specialist intensive, nursery-based and no intervention. International Journal of Language & Communication Disorders, 44(5), 616–638.
- Law, J., Garrett, Z., & Nye, N. (2003). Speech and Language Therapy Interventions for Children with Primary Speech and Language Delay or Disorder (Cochrane Review). Cochrane Database of Systematic Reviews, Issue 3, Art.No: CD004110. DOI: 004110.001002/14651858.
- Lowe, H., Henry, L., Müller, L. M., & Joffe, V. L. (2018). Vocabulary intervention for adolescents with language disorder: a systematic review. International Journal of Language & Communication Disorders, 53(2), 199–217. doi:doi:10.1111/1460-6984.12355.
- Wales, D., Skinner, L., & Hayman, M. (2017). The Efficacy of Telehealth-Delivered Speech and Language Intervention for Primary School-Age Children: A Systematic Review. International Journal of Telerehabilitation, 9(1), 55–70. doi:10.5195/ijt.2017.6219.
- Wright, L., Pring, T., & Ebbels, S. (2018). Effectiveness of vocabulary intervention for older children with (developmental) language disorder. International Journal of Language & Communication Disorders, 53(3), 480–494. doi:doi:10.1111/1460-6984.12361.