Treatment occurred between Tests 2 and 3. Test 3 measured
post-treatment skills.
A grammatical construction was considered a potential
treatment target if the child made at least six
errors on the Grammar Elicitation Test. If a child made
errors on several target constructions, the construction
which occurred first on the developmental continuum
was chosen.
Group allocation
Treatment conditions were allocated on the basis of site.
The LDC was located on three sites, all under the direction
of one school principal and senior speech pathologist.
Three classes on one site were allocated to the
expressive grammar programme and two classes at two
different sites were assigned to the control program. As
the three sites were under the same administration, class
sizes, access to professional development and administrative
procedures were the same. There is no reason
to believe that the general level of teaching expertise or
language environment differed between the sites. The
sites drew on the same socio-economic population. All
testing and intervention was carried out at the children’s
school. The study was approved by the Macquarie University
Human Ethics Committee.
Interventions
Each child received one of two interventions; either
an expressive grammar programme (experimental intervention)
or one of the school’s regular programmes
which focused on following directions and comprehension
of prepositions (control intervention). Treatment
took place as part of the regular classroom program,
within the established treatment model of the school.
Groups differed in that the experimental group received
focused grammar treatment for individually identified
targets (as detailed below) and the control group received
their usual program, in this case, focused on comprehension.
Thus, both groups received small group intervention
within a language-enriched classroom, with the
critical difference being the language targets.
Experimental intervention: expressive grammar
programme
As detailed above, children who participated in the
expressive grammar programme completed grammar
tests and had two grammatical targets identified for
them. One target was treated and one target remained
untreated.
The treatment programme consisted of the regular
model employed by the LDC, manualized and monitored
for research purposes. As per usual practice, once
weekly, for 8 weeks, the staff speech pathologist visited
each classroom. She first delivered a whole group lesson
focused on one of three treatment goals (subject pronouns
‘he’ and ‘she’, possessive ‘s’ or past tense ‘ed’).
Children were then divided into three groups, based on
their identified treatment target. All the children in each
group were learning the same target. Each small group
carried out three activities designed to teach them their
specific grammatical target. The activities were lead by
the speech pathologist, the classroom teacher or a teacher
272 Karen M. Smith-Lock et al.
assistant.Groups rotated such that each child completed
activitieswith each of the speech pathologist, teacher and
teacher assistant. The number of children in each group
ranged from three to six. The entire session, including
the whole class introduction and the three small group
activities, lasted 1 h.
Treatment used the techniques of focused stimulation,
recasting and imitation, which have been shown
in the literature to be efficacious. In addition, direct
teaching was used, as it was a technique in use in the
LDC. The grammatical target was first introduced using
direct teaching. For example, the speech pathologist
explained that ‘when we talk about boys, we say “he”
and when we talk about girls, we say “she”’. Activities
were designed which demonstrated the meaning of the
target and allowed for frequent modelling of the structure.
Modelling included a slight emphasis of the target.
Each child was asked a question which would elicit the
grammatical target in question. If the child made an error,
the teacher/clinician was instructed to offer the child
the opportunity to repeat himself and potentially correct
the error. If that did not result in a correct answer, the
teacher would model the correct answer (recast), with
slight emphasis on the grammatical target in question,
and then give the child another chance to respond. If
the child still produced an incorrect answer, the teacher
would model the structure, then instruct the child ‘you
say that.’ After a correct response, the teacher would say
‘yes’ and model the correct response again.
Treatment sessions consisted of play-based activities
designed to incorporate the targeted grammatical
items. Teachers were provided with detailed activity
plans, scripts and vocabulary. For example, one activity
involved playing with Play-Doh. Each child was provided
with Play-Doh and given an instruction such as
‘You roll your Play-Doh’. The past tense group then
discussed what the child did (e.g. ‘he rolled his Play-
Doh’). The next child was given a different instruction
(e.g. ‘you squish your Play-Doh’). Each child in the
group was given an equal number of opportunities to
use the past tense in these situations. The activities were
designed to be naturalistic, fun activities and the teachers
were encouraged to model and cue grammar targets
systematically, in the context of play.
The key factors that distinguished the treatment programme
fromthe general classroom programmewere (1)
the identification of specific targets for each individual,
(2) the repeated modelling of grammatical targets, followed
by (3) multiple opportunities for the children to
produce the targets, followed by (4) feedback to the
child, and (5) opportunities for the child to correct
him/herself. An example of a treatment plan can be
found in appendix B.
Outside of these treatment sessions, teachers were
asked to carry out their classroom programme as they
normally would. They were provided with a list of
the items that would be targeted during the treatment.
Teachers were not discouraged from modelling
or reinforcing the targets in whatever fashion they normally
would throughout the day, but neither were
they specifically asked to do so. Teachers reported that
they generally did reinforce the goals between weekly
sessions.