Professional Counter Strike Team (Dribble was taken)

One-on-one vocabulary intervention for adolescent students with DLD.
FIX LEGISLATION REFERENCES: ANON, EDUCATION, ICAN/RCSLT

Introduction:
According to Bishop and Norbury (2008) Developmental Language Disorder (DLD), also referred to as Specific Language Impairment (SLI), is a disorder which affects how an individual learns language when there is no other apparent disorder present. Some academics such as Mc. Gregor et al (2020) suggest there is a difference between the disorders, however, this essay will use the definition of DLD set by Bishop, et al. (2017) suggesting DLD and SLI mean the same thing. For the purposes of this essay DLD will be the preferred term referring to any instance where DLD or SLI could be used.
It is shown in Durkin, et al. (2012) that DLD in adolescents can affect academic achievement negatively when compared to typically developing adolescents. Additionally, the results of Conti-Ramsden, et al. (2013) reveals that adolescents with DLD perceive themselves as having more social problems than their peers as well as more mental health issues. This suggests that DLD is an issue which can affect an individual’s social well-being as well as their academic achievement.
The purpose of this essay is to establish the effectiveness of a hypothetical intervention designed to support the affected adolescent student in their studies to reduce the impact of DLD on achievement. This will be achieved by teaching vocabulary which an individual with DLD may struggle with. This is required as results from studies such as Kan & Windsor, (2010) show that those with DLD are often at a disadvantage with learning vocabulary when compared to their typically developing peers. This could be an explanation for their poor academic achievement as it suggests that vocabulary relevant to their academic studies may not be learned as effectively.




Literature Review
The Government and DLD
One of the most important piece of government literature on DLD is the Bercow Report (Bercow, 2008) which reported that special educational needs and disabilities (SEND) children and young people, such as those with DLD, are not taken into consideration as much as they should. It outlined the importance of communication within the educational system and wrote that this is something those with DLD need extra support for. It also reported the need for early intervention and that those with DLD are often not given it as it is not distinguished from other language disabilities or as being misdiagnosed as having behavioural issues.
This report lead to legislation such as the Children and Families Act (2014) which covers how to help those with SEND. The most important part of this legislation is the need for an education, health and care (EHC) plan to be completed. The special education needs code of practice (2015) writes that as DLD must be included in these plans as communication is fundamental to education.
In response to these changes the Bercow report: 10 years on (2018) was completed looking at the effectiveness of the changes brought in by the Bercow report. It writes that while many positive changes have been completed, it is not enough. For example, they write that some local strategies for SEND do not have speech and language at its centre, which is especially relevant for those with DLD who need these skills built upon. They also write that some negatives have been brought in since the Bercow report. Two relevant to DLD are that speaking, and listening have been removed from the national curriculum and spoken language is no longer assessed after five years old. These could have helped diagnose DLD, but their removal may make it more difficult to do so.

Overview of DLD
Through Tomblin, et al’s (1997) research they discovered that at least at least 7.4% of children in their investigation suffered from DLD and that there is a gender difference with 8% of boys suffering from DLD and 6% of girls. They also discovered some unsettling statistics which showed that only 29% percent of these children’s parents were already aware that their child had this speech disorder. Norbury, et al. (2016) suggests that when adjusting the testing requirements to include those with lower non-verbal IQs, the amount of those with DLD in the population could reach 9.9%. The results of the Tomblin et al. (1997) research could be due to the kindergarten age children participants and as such, their educators would not have had a great deal of time to realise that their language skills differ from their typically developing peers.
Bishop, et al. (2006) suggests that the symptoms that lead to the diagnoses of DLD differ from the skills used in standardised tests. This would suggest that in order to increase the successful diagnoses of DLD one would have to use tests specifically designed to pick up on the language differences coming from DLD. Examples of these are poor verbal memory and weak vocabulary; which are easy to miss in younger children.
The lack of diagnosis of DLD at an early age increases the chance of it being diagnosed later in their life. This is an issue because as Bernhardt and Major (2005) showed, early intervention of DLD can drastically reduce the chance of DLD negatively affecting an individual later. Only two of the 12 participants displayed a below average reading skill at the conclusion of their investigation. While this study focuses on one symptom of DLD, it still suggests that the earlier an intervention is given to children, the better off the child will be. However, of the 12 participants, 5 still had spelling difficulties suggesting there are still challenges to overcome regarding DLD Interventions.
Another issue with diagnosing DLD is that those suffering from DLD may also suffer from ADHD. Cohen, et al’s (1998) research suggests that almost two thirds of children with ADHD also meet the criteria for DLD. These results indicate that those with ADHD have an increased risk of DLD and ADHD may increase the chance of misdiagnosis. This is a focus of Cohen, et al’s (1993) study which did in fact reveal that 34.4% percent of children with suspected psychiatric disorder, of which ADHD is one, also had a language impairment. This would suggest that ADHD and DLD could be related and brings forward the question of causes of DLD.
Causes of DLD
DLD is most likely caused by genetic mutations as noted in research by those such as Bishop, et al. (1995) who looked at DLD in twins. Identical twins where more likely to suffer from DLD than non-identical twins supporting that DLD may be genetic as identical twins share genes. Indeed, Lai, et al. (2001) may have found the exact gene responsible for DLD, known as FOXP2. However, Bishop (2006) states that the majority of DLD sufferers have a typical FOXP2 gene and as such they posit that most cases of DLD are caused by multiple genes interacting together alongside environmental factors.
The exact environmental factors allude researchers, however. Dale, et al (2003) eliminate parents’ education as a factor and Paradise, et al. (2003) eliminate bilingualism. Bishop (2003) finds relevance between exposure to live music and ability on auditory repetition tests, a measure of DLD. This implies that lack of live music could be a cause of DLD. Though bishop (2003) himself admits the data is only preliminary, the sample size was small, and the measure for musical exposure was poor. It may be the case that exposure to live music lowers the effects of DLD for that one measure instead of lack of exposure being a cause.

Effects of SLI
While the exact causes of DLD are still understood, its effects are well known and documented. Leonard (2014) writes that there are two primary weaknesses of DLD sufferers. The first is a weakness in grammar; such as a difficulty understanding complex sentences. The second of these is a unique difficulty in repeating non-words which is often described as phonological short-term memory. These two issues also appear to be distinct in that while they can co-exist in a DLD sufferer, they can also appear independently.
As Coady & Evans (2008) write, the difficulty in repeating non-words often indicates a poor overall vocabulary as familiarity with other words increases ability to repeat non-words, which are based on real words. Poor vocabulary has the potential to negatively affect other subjects outside of English too. This is shown in Cross, et al. (2019) who found that, compared typically developing children, those with DLD perform poorer in mathematical tasks that require verbal input like converting written numbers to their numeric form.
Conti-Ramsden, et al. (2013) researched how adolescents with DLD perceive their social skills and mental health as worse than their typically developing peers with those with one in four DLD participants reporting difficulties with peer relations compared to only 2.4% of typically developing children, showing the mental health impact of DLD.

DLD interventions
The interventions for DLD vary considerably and are often built upon tiers depending on how much DLD appears to affect the individual. Interventions for DLD also often focus on one aspect of DLD. For example, Wright, et al. (2017) focused on vocabulary. Their intervention was a one-on-one session lead by a speech language therapist (SLT) who taught the chosen word for the session through tasks such as repeating, both spoken and writing, and reinforcing the phonological features of the word. Their intervention was successful in its goal to teach these words.
Gillon, (2000) looked at what the impacts of building phonological awareness would be through an intervention. This intervention focused on building awareness of the phonological structure of spoken words to develop links between the spoken word and its written form through activities such as rhyming, producing isolated phonemes, and blending and segmenting phonemes. Indeed, the intervention was successful in its goal and those who took part received better reading development and speech development than those who received no intervention and those who received ‘traditional’ intervention.
Broomfield and Dodd (2011) looked speech and language intervention’s effect on comprehension, expressive language and vocabulary, and consistency of phonological production. Their interventions were based specifically around the individuals with it being catered exactly to their needs by a SLT. They found that this method was very effective in reducing the impact of DLD on these measures.
One issue with many intervention studies is that they measure the effectiveness of their intervention on the specific language type they are measuring while the impacts on academic achievement as well as mental and social health are not. This means that while Wright, et al (2017) may have improved the child vocabulary, whether this has a viable impact on academic achievement is unknown.



References
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