Stakeholder perspectives on educational needs and supports for students with developmental language disorder.

Students with developmental language disorder (DLD) often experience academic underachievement, and require adjustments and accommodations to access the curriculum. Teachers, allied health professionals and parents/caregivers have varying roles in the education process, and it is essential they work together to provide optimal support. However, their perspectives on the areas of functioning most impacting learning, the difficulty of school-based tasks and the helpfulness of educational support have received limited attention. A between-group survey design was used with recruitment occurring from September 2020 to October 2021. A total of 293 participants was comprised of teachers (n = 78), allied health professionals (n = 138) and parents/caregivers (n = 77). All respondents rated the learning impact of seven areas of functioning (academic behaviour, fine/gross motor, language/communication, literacy, numeracy, sensory and social/emotional), the difficulty of 39 school-based tasks, and the helpfulness of 27 educational supports for primary and/or secondary school-aged students with DLD. The groups of school-based tasks were combined into seven subscales (academic behaviour-related tasks, fine/gross motor tasks, language/communication tasks, literacy tasks, numeracy tasks, sensory-related tasks and social/emotional tasks) for analysis. The educational supports were also combined into six subscales (additional time, differentiation/adjustments, individualized support, social/emotional support, technology and visual supports). All participants rated literacy and language/communication as the areas of functioning most impacting learning and requiring the highest level of support for students with DLD. Literacy tasks were rated the most difficult across stakeholder groups. However, comparison between stakeholder groups showed statistically significant differences between ratings for six (of seven) areas of functioning. Statistically significant differences were identified when rating the difficulty of four (of seven) school-based task subscales. Additional time and visual supports were rated the most helpful educational supports across groups. Overall, teachers and allied health professionals rated areas of functioning and school-based tasks as more difficult than parents/caregivers, although they shared similar perspectives on five (of six) educational support subscales. Literacy and language/communication are the areas of functioning rated to be most impacting learning for students with DLD. However, literacy tasks were reported to be the most difficult for students with DLD to complete. Teachers, allied health professionals and parents/caregivers are recommended to regularly discuss the areas of functioning, school-based tasks and educational support to facilitate inclusive educational practices. Future research needs to consider the perspectives of students with DLD. What is already known on the subject There is extensive evidence demonstrating the increased risk of academic failure for students with DLD, particularly with literacy and numeracy. Although research on academic achievement or individual groups has occurred, limited research has compared stakeholders supporting students with DLD, which is vital for collaboration and optimal inclusive educational practices. What this study adds to the existing knowledge Teachers, allied health professionals and parents/caregivers have unique roles in the education of students with DLD and show differing perspectives that may link to these roles. Literacy and language/communication were the areas of functioning rated as most impacting learning, whilst literacy tasks were the most difficult activity undertaken at school for primary and secondary school-aged students with DLD. Additional time and visual support were rated as the most helpful educational supports for students with DLD. What are the practical and clinical implications of this work? Stakeholders demonstrate variable views on the areas of functioning and school-based tasks requiring support for students with DLD; however, they agreed on the helpfulness of most educational supports. Participants rated social/emotional tasks easier and their related supports less helpful than other areas of functioning. Given the associations between academic underachievement and mental health difficulties, more consideration needs to be given to the social/emotional well-being of students with DLD in school. Taken together, establishing differences in perspective will help with the implementation of inclusive educational practices.

Ziegenfusz S ，Westerveld MF ，Fluckiger B ，Paynter J ... -  《-》

"They don't realise how hard he has to try every day": The rewards and challenges of parenting a child with developmental language disorder.

An emerging body of literature explores the impact of living with developmental language disorder (DLD) on children, individuals and families. This work has identified a range of challenges and strengths. However, there is limited evidence from the DLD community about the impacts of living with DLD in relation to parenting. We explored the perspectives of caregivers in response to an open-text survey question: "What is most rewarding and challenging about being a parent to a child with DLD?" Respondents were caregivers of children with DLD who had signed up to Engage with Developmental Language Disorder. Qualitative content analysis was used to explore the open-ended responses from 112 parents who completed the yearly survey (child average age = 9.6 years; SD = 3.5 years, 46.9% female). Most caregivers lived in the United Kingdom, but we also had responses from around the world. For 'rewards', 52 codes and seven higher-order categories were identified. These comprised the many rewards experienced from caring for a child with DLD, including seeing and celebrating progress, celebrating their child's personality and being proud to be their child's parent. Caregivers mentioned the positives gained from learning about DLD and working together with their child to help them achieve their potential. They reflected on the supportive nature of the 'right' environment, in particular the school context and social connectedness. For 'challenges', 84 codes and 11 higher-order categories were identified. Caregivers often noted the lack of awareness of DLD amongst the community and professionals in general, within the school system and amongst teachers. Caregivers reported support and information about DLD were difficult to find and were impacted by a constant need for advocacy. They reflected on the increased time needed to support their child and worried about their child's social and community participation. Many commented on the impact of DLD on the family and the mental health and well-being of both them and their children. Hearing the views of caregivers of children with DLD is key because shared decision-making is central to client-centred care. Furthermore, 'client perspectives' are a cornerstone of evidence-based practice. There is much to take from the responses and for professionals to reflect on and use. Collaboration with children, young people and families is needed for effective advocacy, and to develop awareness of DLD. What is already known on the subject An emerging body of literature has explored the impact of living with developmental language disorder (DLD) on the child, the individual and the family. This work has identified a range of challenges and strengths. These are important considerations to support the evidence-based practice of those working with the DLD community from planning treatment goals to designing and providing services. What this paper adds to existing knowledge Caregivers highlighted a range of rewards in parenting a child with DLD. They also identified a wide range of challenges, including a lack of awareness and support from professionals, the constant need for advocacy and the impact on the family as well as the impact on the mental health of their child and themselves as parents. What are the potential or actual clinical implications of this work? Shared decision-making is central to client-centred and family-centred care, and client perspectives are a key aspect of evidence-based practice. There is much for clinicians and practitioners to take from this data set of parent perspectives. The findings from this study will guide researchers and clinicians to reflect on how to work in collaboration with individuals with DLD and their families, including in their design and delivery of services and advocacy to continually raise awareness of DLD.

Leitão S ，St Clair MC ，Botting N ，Gibson J ，Jackson E ... -  《-》

Supporting language development in Lebanese preschools: SLT and pre-KT practice and perception of roles.

Speech and language therapists (SLTs) are increasingly engaging in school-based interventions targeting children with language difficulties. Collaborative work between teachers and SLTs has shown to be beneficial in fostering language development in all children. Both groups of professionals have different but complementary roles in offering language support, according to children's needs. Effective collaboration between SLTs and teachers requires both parties to understand their roles and practices in schools. However, little is known about language support practices in Lebanese preschools and the roles of SLTs in these contexts. (1) To explore the perceptions and reported practices among preschool teachers (pre-KTs) to support language development; (2) to investigate the current practices of SLTs in preschools; and (3) to understand pre-KTs' and SLTs' perceptions of the SLTs' role in Lebanese preschools. Using a quantitative method, the study reports the results of two questionnaires (one for pre-KTs and one for SLTs) that were developed based on a review of the academic literature and adapted to the contextual realities. Questionnaires were completed in hard or soft copy by pre-KTs and through an online survey by SLTs. The questionnaires were completed by 1259 out of 1442 pre-KTs from 175 Lebanese preschools, and by 200 out of 391 SLTs from across Lebanon. First, the findings show that both professional groups recognize they have a role in supporting language development. Second, differences in reported practices were identified regarding language strategies for children with communication needs. In particular, pre-KTs reported less use of specific language strategies targeting children with language difficulties, while SLTs reported that their practices in schools remain primarily focused on children with communication needs. Finally, the analysis of perceptions showed a lack of acknowledgement of the SLTs' role in the prevention of communication and language disorders among all children. This study provides an overview of the perceptions and reported practices of language development support in Lebanese preschools. The majority of SLTs and pre-KTs acknowledge their role in supporting language development. However, the slight differences in perceptions of SLT roles in prevention interventions highlight the necessity for SLTs to promote their active involvement in services targeting all children. Future research will investigate how SLTs are beginning to reconceptualize their role in intervention for preschool children. This will help to better define SLTs' roles and responsibilities in educational settings and foster effective professional collaboration. What this paper adds What is already known on the subject Collaboration between teachers and SLTs has been shown to be beneficial in supporting language among all children. The way SLTs and pre-KTs view each other's roles could result in more effective professional collaboration. The SLT profession in Lebanon emerged about 20 years ago, yet SLTs are still struggling to define a framework for the scope of their practice in Lebanese preschools and to increase awareness of the relevance of their intervention in language. What this paper adds to existing knowledge The results revealed that there are major agreements between pre-KTs and SLTs concerning the support of language development in preschools. However, the findings highlight slight differences in the perception of the SLTs' role in the prevention of communication, language and literacy disorders in educational settings. It seems that their role is more commonly acknowledged for children with identified language and communication needs. Moreover, despite the strong agreement between both professionals on the role of the SLT to target all children, SLTs' practices in preschools are still mostly limited to meeting only referred and diagnosed needs in children. What are the potential or actual clinical implications of this work? This study's findings contribute to a better understanding of the perceptions regarding the roles and practices of both groups of professionals in language development. The differences in how the SLTs' roles are perceived could lead to a more difficult implementation of collaborative language practices in preschools. It is therefore necessary to ensure a better understanding of the roles played by professionals, who could receive the relevant training in undergraduate education programmes. There is also a pressing need to provide a clearer definition of SLTs' roles in educational settings by reconceptualizing them into a preventive approach in collaboration with teachers.

Kouba Hreich E ，Moitel Messarra C ，Martinez-Perez T ，Richa S ，Maillart C ... -  《-》

'It depends on who I'm with': How young people with developmental language disorder describe their experiences of language and communication in school.

The risks of developmental language disorder (DLD) for both educational progress and socio-emotional development are well documented, but little is known about how children and young people with DLD experience and describe their language and communication. The need to complement experimental and quantitative studies with qualitative perspectives of the lived experience of individuals with DLD for speech and language therapists (SLT) practice has recently been foregrounded. To understand further the experiences of young people with DLD focusing on language and communication in a school context, and thereby contribute to the improvement of the communicative situation in school for this group. The study is guided by the following research question: How do young people diagnosed with DLD describe their experiences of language and communication in school? The study is based on data generated from qualitative semi-structured interviews with 23 participants diagnosed with DLD (age 13-19 years old) living in Sweden. All participants attended mainstream schools. To enable data to be collected during COVID-19 restrictions, all interviews were conducted using Zoom. Reflexive thematic analysis was used to analyse the data. Four main themes related to experiences of language and communication in school were constructed from the interviews: (1) feelings of inadequacy and comparisons with others; (2) feelings of being misjudged and misunderstood; (3) the importance of feeling safe and comfortable; and (4) the significance of the social and communicative context. The results bear witness of difficult and challenging aspects related to language and communication in school, including educational, social and emotional dimensions. An important outcome of this study is how young people diagnosed with DLD describe their language and communication functioning to be dependent on both individual characteristics and abilities, as well as situational, contextual and social factors. The results from this study show that young people with DLD can have persisting problems related to language and communication in school, including educational, social and emotional dimensions. SLT services may therefore be needed throughout the school years to ensure that students with DLD receive adequate support. In addition, support that goes beyond language abilities and targets social, contextual and emotional aspects should be considered. What is already known on this subject Children and young people have unique knowledge about their language and communication which is instrumental for designing interventions and support strategies. Qualitative analyses of interview data have been able to identify both risk factors and protective strategies in relation to the well-being of individuals with DLD. Despite this, children and young people with DLD are rarely heard in research or clinical discussions. What this paper adds to existing knowledge In this study we listen to the voices of young people with DLD as they describe their experiences of language and communication in school. The participants describe a condition that makes them struggle to keep up with peers and puts them at risk of being misjudged by teachers, but also give examples of situations where negative consequences are hardly felt. What are the potential or actual clinical implications of this work? DLD is a complex and dynamic disorder where contextual and social factors interact with individual abilities in creating the end result. The results of the study indicate that DLD can cause persisting problems related to language and communication in school, with impact on educational, social and emotional dimensions. To counteract these effects, SLT services may be needed throughout the school years, and support that goes beyond language abilities must be considered.

Ekström A ，Sandgren O ，Sahlén B ，Samuelsson C ... -  《-》

Predictors of school concern across the transition to secondary school with developmental language disorder and low language ability: A longitudinal developmental cascade analysis.

Developmental language disorder (DLD) has clear functional ramifications in the areas of social competency, emotion recognition, emotional well-being and literacy skill, which have been found to persist from childhood to adolescence. These domains are important factors during the transition from primary to secondary school in typical development (TD). Nevertheless, there is a paucity of research on the transition from primary to secondary school for adolescents with DLD and low language (LL) ability. To investigate the association between psychosocial domains, literacy skill and concerns about school during the transition to secondary school for adolescents with DLD, LL and their TD peers. The first research question examined whether levels of social competency, emotion recognition, emotional well-being and literacy skill predicted school concern for the three groups. The second research question explored the longitudinal relationship between school concern and psychosocial and literacy indicators over the transition. Participants (aged 10-11 years) with DLD (n = 30), LL ((n = 29) and TD (n = 42) were recruited for this longitudinal study from eight UK primary schools. Standardized language and psychosocial assessments were administered in the spring and summer terms of the final year of primary school, and the autumn and summer terms of the first year in secondary school. Regression analyses showed pre-transition school concern to be predicted by emotion recognition for the DLD group, by social competence and emotional well-being for the LL group, and by social competence for the TD group. Post-transition concern was predicted by emotional well-being for the LL group; with no significant predictors for the DLD/TD groups. Path analyses revealed an association between literacy skill and emotion recognition for the DLD group. A developmental cascade illustrated a relationship between social competence and emotional well-being for the TD group. This study concludes that transition interventions must be differentiated according to language ability; support for DLD adolescents should focus on emotion recognition skill, provision for LL adolescents should centre on emotional well-being, and TD participants should be particularly supported in the domain of social competence in advance of the move to secondary school. Additionally, this study emphasizes the importance of the inclusion of a LL group, as their outcomes cannot be predicted using DLD/TD research. What is already known on the subject There is limited research exploring the transition from primary school to secondary for adolescents with DLD or LL ability. Research on TD has highlighted vulnerable domains at this time. As these key areas are evidenced spheres of difficulty in DLD and LL, there was a strong impetus for this study. What this paper adds to existing knowledge This study reveals differences between language ability groups in the predictors of school concern both pre- and post-transition. Concerns of adolescents with DLD were predicted by emotion recognition, those of adolescents with LL were predicted by emotional well-being, and a longitudinal link between social competence and emotional well-being was evidenced for TD adolescents. What are the potential or actual clinical implications of this work? This study has implications for researchers and clinicians, as a need has been identified for a new clinical group. It also has practical implications for transition support planning for educational practitioners, families and adolescents.

Gough Kenyon SM ，Palikara O ，Lucas RM 《-》