Intervention for oral language comprehension skills in preschoolers with developmental language disorder
Authors: Acosta‐Rodríguez Víctor M. , Ramírez‐Santana Gustavo M. , Hernández‐Expósito Sergio 
Published: December 2021

AbstractBackgroundThere is a clear predominance of programmes aimed at improving aspects related to language production in pupils with developmental language disorder (DLD). However, programmes aimed at improving their receptive skills are limited.AimsThe main aim was to assess the effectiveness of an intervention programme for oral language comprehension skills in preschoolers with typical development (TD) and pupils with DLD.Methods & ProceduresParticipants were 99 five‐year‐old pupils, with and without DLD, divided into four groups: two control groups (TD‐C = 25; DLD‐C = 25) and two experimental groups (TD‐T = 24; DLD‐T = 25), from schools on the Spanish island of Tenerife. The study used, as pre‐ and post‐measures, the receptive language subtests of the CELF‐4‐Spanish: Concepts and Following Directions, Word Classes—Receptive and Sentence Structure, as well as two tasks assessing comprehension of paragraphs and narratives. Due to the strong link between oral comprehension skills and executive functions, working memory and semantic fluency are included in this research. The Backward Digit Span subtest of the Wechsler Intelligence Scale for Children (WISC‐IV) and Semantic Fluency subtest of the Controlled Oral Word Association Test (COWAT) were used to assess working memory and semantic fluency, respectively. The intervention programme followed a multitiered system of support (MTSS) model, with 95 sessions lasting 60 min each delivered jointly by teachers and speech and language therapists, and focused on lexical–semantic, morphological, syntactic and narrative skills; inferences; verbal working memory; and semantic fluency.Outcomes & ResultsThe results showed, as expected, that pupils diagnosed with DLD initially performed worse on oral language comprehension and executive functions than pupils with TD. Further, the DLD‐T and TD‐T groups showed greater gains following the programme, especially in word classes—receptive, sentence structure, verbal working memory and semantic fluency. Finally, a significant positive correlation was found between the gains obtained by the participants in verbal working memory and semantic fluency, with the gains obtained in the three CELF‐4‐Spanish subtests.Conclusions & ImplicationsAn intervention programme applied at an early age fosters oral language comprehension skills and executive functions in pupils with DLD and TD. The intervention organized at different levels of support, following an MTSS model, showed clear progress of the DLD and TD groups in oral language comprehension and executive functions.What this paper addsPupils with DLD present deficits in linguistic comprehension and executive functions. There are many intervention programs focused on improving language production skills. It is also necessary to consider the skills underlying language problems in pupils with DLD. Oral language, inference, working memory and semantic fluency activities improve comprehension. A collaborative and inclusive intervention of teachers and speech language therapists. Psycholinguistic and neuropsychological skills training should become part of the academic curriculum as early as preschool age.What is already known on the subjectPupils with DLD show problems related to both comprehension and production language. However, there is a clear predominance of programs just aimed at improving aspects related to language production.Clinical implications of this studyAn intervention program applied at an early age fosters oral language comprehension skills and executive function in pupils with DLD. The intervention organized at different levels of support, following an adaptation of the Response Tier Intervention models, showed clear progress of the DLD in comprehension oral language and executive functions.