As an interactive app designed to build expressive language for everyone, LinguaPix is not only engaging but was also developed with research in mind. The American Speech Language and Hearing Association highly advocates for practicing Speech-Language Pathologists to use evidence-based practices which include integration of clinical expertise, the perspective of the client and family, as well as external scientific evidence (ASHA, 2005). Thus, we wanted to highlight how the skills practiced using the LinguaPix app aligns to research.

Considerations for Design

A study by Gilliam, Gillam, and Reece (2012) indicated that both contextualized and decontextualized intervention yielded significant statistically gains (e.g., children improved the skills on post-testing), yet, contextualized language intervention had a larger group effect. Authors stated that,

“The results of the study alone should not compel a clinician to change from using a decontextualized approach to language intervention. However, if a clinician who is using cards like the ones used in the [Decontextualized Language Intervention] approach notes that children are not making desired progress in grammatical complexity or narrative comprehension, he or she might consider trying an approach similar to the contextualized language intervention ” (pg. 285)

Key point for LinguaPix:  Research evidence still supports that decontextualized intervention, which LinguaPix might be considered, is effective for children with SLI. Thus, specific work on discrete grammar skills as used in the app will be beneficial. Moreover, since the app allows for client-specific decks, clinicians can design vocabulary for a contextually literacy-based narrative theme for additional practice and integration of academic concepts including Tier 2 vocabulary.

Considerations for Vocabulary

A study by Steele and Mills (2011) suggested providing direct instruction on vocabulary regardless of service delivery model (e.g., collaboration, classroom, or traditional; with team teaching collaboration identified to show greatest gains per model). Specifically, they advocated for small group individualized direct instruction per the level of each student and intervention including activities of:

• in-depth word meaning (synonyms/antonyms, similarities/differences),
• expanding to new contexts (sentence formulation),
• providing prompts/supports (scaffolding using visual supports such as pictures, imitation, fill-in-the blank, and recast/expansion)
• keyword (pictorial mnemonic ) to facilitate recall of word meaning using phonologically similar word.
• visual organizers (semantic maps and semantic features analyses).

In addition, McGregor, Newman  Reilly, Capone (2002) completed a study that showed children with SLI had limited semantic representations with errors due to missing or sparse representation of words, in particular a lack of robust word knowledge.  Authors suggested intervention focus on teaching robustness of semantic representations. Moreover, Sheng and McGregor (2010) compared noun versus action naming in 42 children with and without language impairment for 120 black and white line drawn items in a computerized confrontational naming task.  Results showed that action naming was significantly harder than object naming.

Key point for LinguaPix: Research supports direct intervention on vocabulary for children with language impairments and good effective intervention practice activities of sentence formulation, imitation, use of picture scaffolds, fill-in-the blank, and expansion, which are activities found in the LinguaPix app.

Considerations for WH-Questions

Deevy and Leonard (2004) compared 44 children (ages 2-6) with and without SLI on comprehension of WH questions using line drawings. Children with SLI performed worse than typically developing children on comprehension likely due to poor word-order sentence level processing and memory.

Key point for LinguaPix: The LinguaPix app provides users the option to control the complexity of WH questions and sentence types to allow for focused and repeated practice, which is supported by research.

Considerations for Users

Ketelaars, Hermans, Cuperus, Jansonius, and Verhoeven (2011) examined semantic naming skills of 84 5yr-old children with Pragmatic Language Impairments and 80 typically developing age-matched children. Children performed receptive vocabulary, picture naming, and definition tasks.  Results showed that children with pragmatic language impairments had weaker semantic skills than peers.

Key point for LinguaPix: The LinguaPix app can be used for more than just children with SLI, but also those who show pragmatic problems due to potentially reduced semantic representation skills.

Cirrin and Gillam (2008) performed a meta-analysis of 21 research articles that met high-standard criteria for review which examined treatment efficacy for oral language intervention of school-age children across six domains: syntax/morphology (3 studies), semantics/vocabulary (6 studies), phonological awareness/metalinguistics (5 studies), language processing (5 studies), and pragmatics/discourse (2 studies).  For syntax, imitation, model, and modeling plus evoked production were effective techniques. Also, language processing using technology was most effective when facilitated by a live person. In addition, a study by Cirrin, Schooling, Nelson, Diehl, Fylnn, Staskowdki, Torrey, and Adamczyk (2010) found that services provided by SLPs and highly trained SLPAs using a manual prepared by SLP to guide intervention targeting vocabulary is effective in both group and individual service models for children with language impairments.

Key point for LinguaPix:  For most beneficial outcomes, the LinguaPix app should be used with facilitation of a trained live professional (SLP/SLPA) and not just as a reward as the evidence-based techniques proved valid for syntax included activities of imitation, modeling, and evoked production.

Conclusion

In closing, we hope that sharing some of the research will help users be confident in using LinguaPix as an interactive teaching tool within their evidence-based practice for building expressive language skills.  As the research presented here supports targeting vocabulary, syntax, and WH-questions using a variety of technology-based activities for many different types of learners under the guidance of trained professionals. Users are encouraged to consult the original research for additional specifics per study.

References

American Speech-Language-Hearing Association. (2005). Evidence-based practice in communication disorders [Position Statement]. Available from www.asha.org/policy. 

Cirrin, F., and Gillam, R., (January, 2008). Language Intervention Practices for School-Age Children with Spoken Language Disorders: A Systematic Review.  Language Speech and Hearing Services in Schools, vol. 39, S110-S137.

Cirrin, F., Schooling, T., Nelson, N., Diehl, S., Fylnn, P., Staskowski, M., Torrey, T., and Adamczyk, D. (July, 2010). Evidence-Based Systematic Review: Effects of Different Service Delivery Models on Communication Outcomes for Elementary School-Age Children.  Language Speech and Hearing Services in Schools, vol. 41, 233-264.

Deevy, P., and Leonard, L. (August, 2004). The Comprehension of WH Questions in Children with Specific Language Impairments. Journal of Speech, Language, and Hearing Research, vol. 47,802-815.

Gilliam, S., Gillam, R., and Reece, K. (July, 2012).  Language Outcomes of Contextualized and Decontextualized Language Intervention: Results of an Early Efficacy Study. Language Speech and Hearing Services in Schools, vol. 43, 276-291.

Ketelaars, M., Hermans, S., Cuperus, J., Jansonius, K., Verhoeven, L. (February, 2011). Semantic Abilities in Children with Pragmatic Language Impairment: The Case of Picture Naming Skills. Journal of Speech, Language, and Hearing Research, vol. 54, 87-98.

McGregor, K., Newman, R., Reilly, R., Capone, N. (October, 2002). Semantic Representation and Naming in Children with SLI. Journal of Speech, Language, and Hearing Research, vol. 45, 998-1014.

Sheng, L., and McGregor, K. (December, 2010). Object and Action naming in Children with Specific Language Impairment. Journal of Speech, Language, and Hearing Research, vol. 53, 1704-1719.

Steele, S., and Mills, M. (2011). Vocabulary intervention for school-age children with language impairment: A review of evidence and good practice. Child Language Teaching and Therapy, vol. 27(3), 354-370.