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    Child Language Teaching and Therapy

    2014, Vol. 30(1) 7990

    The Author(s) 2013

    Reprints and permissions:sagepub.co.uk/journalsPermissions.nav

    DOI: 10.1177/0265659013507296

    clt.sagepub.com

    A parent-based book-readingintervention for disadvantagedchildren with language difficulties

    Susan Hilary ColmarThe University of Sydney, Australia

    Abstract

    Children with delayed language skills, who were from a socio-economic area defined as

    disadvantaged, made significant improvements in language skills after their parents were trainedin easily learned strategies, enabling them to make simple changes in the way they interactedwith their children. The 36 children, mean age five years, were allocated into three groups:

    an Experimental group and a Control group, where all the children had language delays and/or difficulties, and a second Control group of children whose language was measured withinthe average range. Parents of children in the Experimental group were trained and asked to

    implement the strategies. The intervention strategies used during book reading and during

    everyday conversations included: pausing and encouraging the child to talk more on their chosentopic, over a four-month period. Using an ANCOVA on difference scores with childrens pre-

    intervention language scores for each variable as the covariate, significant results were obtainedat post testing. Further, large effect sizes were measured using Cohens d. In addition, a StudentNewmanKeuls test on difference scores confirmed that the significant changes were obtainedfor the Experimental group, as predicted.

    Keywords

    Book reading, disadvantage, language difficulties, language intervention, parent training

    I Introduction and literature review

    For a young child, the failure to make typically observed progress in learning a first language is

    likely to curtail the childs capacity to communicate effectively, as well as having a major perva-

    sive negative effect on other areas of development and learning (Aarts et al., 2011; Bishop and

    Leonard, 2000), with concomitant links to problems in social and emotional behaviour (Law et al.,

    2012). Young children with language delays typically experience less engagement with

    their linguistic and social environments, both of which are critical sources of teachinglearning

    Corresponding author:

    Susan Hilary Colmar, The University of Sydney, Manning Road, Sydney, New South Wales 2006, Australia.

    Email: [email protected]

    507296CLT30110.1177/0265659013507296Child LanguageTeaching and TherapyColmar-article2013

    Article

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    80 Child Language Teaching and Therapy 30(1)

    interactions (Kaiser and Roberts, 2011). Children from backgrounds described as disadvantaged

    (low socio-economic status [SES]) are specifically considered to be at risk of making poor pro-

    gress in early language learning, with negative impact on their later academic progress, particularly

    in literacy (Hart and Risley, 1995, 1999; Vinson, 2006; Zevenbergen et al., 2003). Further, the

    effect of low SES was found to have additional negative impact when comparing parental reading

    practices with children with developmental difficulties and typically developing children, from

    different socioeconomic environments (Butz et al., 2009).

    Considerable research confirms that parents are able to work successfully with their own young

    child who is experiencing difficulties with language learning (Colmar, 1999; Hancock and Kaiser,

    2002; Law et al., 2004). Evidence of parents natural conversations with their child confirms their

    use of child directed speech (CDS), which appears dynamically and progressively optimal for child

    language learning (Hoff and Tian, 2005; van Kleeck et al., 2010). Professionals often incorporate

    the training of parents as a key element in a consultative approach (Schooling et al., 2010). Direct

    parental involvement in language intervention programs acknowledges that parents, if successfully

    trained, are able to (1) increase the likelihood of many more opportunities for learning being avail-

    able compared to the typical 30-minute weekly session offered by a professional (Justice and

    Pence, 2004), and (2) ensure the generalization of specific skills (Vilaseca and Del Rio, 2004).

    Parents can maximize the communicative opportunities, often of a functionally relevant nature,

    that arise within naturalistic contexts necessitating child comprehension and responding, particu-

    larly when responsive support is provided by the parent to encourage the child to respond more

    fully by talking more and with greater complexity (Reese et al., 2010; Weiss and Theadore, 2011).

    In addition, the existing social-emotional relationship between the parent and child may be an asset

    in this process, with this relationship being further enhanced by successful communicative interac-

    tions. Typically parents are motivated and respond well to training aiming to improve their own

    childs language and communication skills.

    There has been evidence in the literature over several decades of the successful implementation

    by caregivers of naturalistic language strategies subsumed within milieu teaching (e.g. Yoder and

    Warren, 1999), including the seminal research leading to the concept of milieu teaching, which was

    incidental teaching (Hart and Risley, 1974, 1980), and including mand-model (e.g. Alpert and

    Kaiser, 1992) and time delay (Halle et al., 1981). Incidental teaching was originally conceptualized

    as language teaching in preschool contexts, using naturally occurring opportunities during play and

    activities, specifically asking questions in response to child initiations to develop communicative

    interactions. Initial studies of incidental teaching were with children described as disadvantaged,

    with later work in milieu teaching focused more on children with serious language and cognitive

    difficulties. In milieu teaching, the caregiver is trained to implement the strategies with a focus on

    engaging the child in naturally occurring conversations, aiming to increase child language skills

    (Kaiser and Roberts, 2011). Colmar (2011) has reported findings successfully training parents by

    combining milieu strategies within the structure of a book-reading context, with children with a

    range of language and cognitive difficulties.

    The core strategies within milieu teaching are (1) initial responsiveness, typified by being present

    and alert, providing visual attention, listening and acknowledging the childs focus of attention, or

    initiated topic of conversation, and (2) using communicative strategies, such as child topic relevant

    questioning to engage the child in an interactive conversation. Frequently cited adult techniques, aim-

    ing to develop a short communicative exchange involving turn-taking with the young child, include:

    1. commenting (Hockenberger et al., 1999; Kang et al., 2009);2. questioning: generally (e.g. Ard and Beverly, 2004) and functional questioning as in

    Whitehursts dialogic reading (Elias et al., 2006; Whitehurst et al., 1988);

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    Colmar 81

    3. expanding the childs utterance by adding a word/s (Fletcher et al., 2008);

    4. responsiveness to initiations with contingent questioning (Hart and Risley, 1980); and

    5. generic responsiveness to the childs language in a book-reading context (Roberts et al.,

    2005).

    These adult techniques have been reported in use with children with normally developing language

    and children with language delays and difficulties.

    Child engagement and attention focus are key precursors to successful communicative interac-

    tions (Kang et al., 2009). A key indicator of engagement is child initiations, which are spontaneous

    verbal utterances, or vocalizations, which begin a conversational sequence, by introducing a new

    topic. Initiations are typically rare when children have language difficulties (Pennington et al.,

    2009), with adults initiating at higher levels (Colmar, 1999). In a study of spontaneous utterances

    in a book-reading context, Young-Suk et al. (2011) noted that these findings suggest that chil-

    drens propensity for spontaneous verbal participation during joint book reading may have a direct

    relationship with their retelling skills (p. 402), thus demonstrating greater quality in their use of

    language. A second indicator of active engagement is a childs responsiveness to adult comments

    and questions in developing a conversational interchange. Typically responsiveness involves pre-

    established joint attention (White et al., 2011), as would be indicated by a child initiation, with the

    resulting adult response encouraging a further child response (Hart and Risley, 1974).

    Previous research using within-subject design methodology (Colmar, 1999) found that adult

    pausing is an appropriate strategy allowing children with language difficulties an opportunity to

    initiate a conversation. Pausing meant that the adults did not speak or communicate at all. Pausing

    proved to be an unexpectedly powerful intervention technique on its own, leading to a number of

    additional positive changes in child and adult language use in an interactive context, including

    increases in child initiations and utterances, coupled with reductions in adult utterances, and

    increases in child turn-taking with decreases for adults (Colmar, 1999). When adults were trained

    to speak less, children were able to speak more. The implementation of the pausing strategy, cou-

    pled with the key conversation building strategy of incidental teaching, which is open questioning

    in response to and contingently linked to the content of a child initiation, appeared to be sufficient

    to alter the original non-interactive, adult-controlled conversational style into a shared interactive

    pattern in which the child partner in the dyad could initiate more frequently and respond more by

    contributing more language in conversational contexts (Colmar, 1999). However, although the

    findings from this study were important in demonstrating that interactive communicative sequences

    could be changed, there was no evidence that these changes resulted in improvements in child

    language skills.

    Colmars work utilized book reading, such that childrens picture books were used as a struc-

    tured base for communication and language use. Importantly the use of naturalistic strategies, such

    as pausing and open questioning, has only rarely been combined within a book-reading context

    (Colmar, 1999). Only three studies (Colmar, 1999, 2011; McNeill and Fowler, 1999) have com-

    bined books as the stimulus for language with specified naturalistic language intervention tech-

    niques. Positive changes in child and adult language and communication behaviours were

    demonstrated in all three studies. Whitehurst and his colleagues research on dialogic reading also

    aims to facilitate language skills using book reading in children described as disadvantaged, with

    good evidence of success (Whitehurst et al., 1988); however, the functional questioning technique

    was not derived from the naturalistic milieu tradition, nor is pausing emphasized.

    Book reading is used in home and early childhood settings by parents and teachers, often implic-itly for language and literacy facilitation, or explicitly when using a technique such as dialogic

    reading (Zevenbergen et al., 2003), or when developing early reading skills (Justice and Pullen,

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    82 Child Language Teaching and Therapy 30(1)

    2003). Book reading has been evaluated quantitatively (Roberts et al., 2005; Rodriguez et al.,

    2009) and also qualitatively, both descriptively with typical and atypical populations (Barachetti

    and Lavelli, 2011; Senechal and LeFevre, 2001), and experimentally (Wasik et al., 2006). Different

    types of book-reading approaches to language and literacy facilitation and intervention exist, with

    the range of specifics beyond the scope of this article. The present studys strategies fall within the

    scope of interactive shared book reading (Institute of Education Sciences, 2007), defined as an

    adult reading with a child, aiming to enhance their language and/or literacy skills by ensuring text

    engagement. The analyses carried out by the Institutes researchers found that effects were mixed

    for spoken language and, whilst interactive shared book reading was not effective for print knowl-

    edge, it had some impact on initial reading and writing.

    Only one previous experimental study has combined elements of incidental teaching; specifi-

    cally, pausing and responsive open questioning, in a book-reading context with parents implement-

    ing the program (Colmar, 2011). The study was with children who had major language difficulties

    (and most also had additional difficulties), and language outcomes were measured before and after

    the intervention, with significant results for the intervention group for expressive and overall lan-

    guage, and effect sizes (Cohens d) ranging from .86 to 1.25. The present study was with children

    described as disadvantaged, with major language delays and difficulties but no additional difficul-

    ties, and included two control groups, one of children also with language difficulties and one of

    children with normally developing language. Based on previous research (Colmar, 2011), it seemed

    likely that the intervention would be effective, both compared with the two Control groups receiv-

    ing no intervention, and at levels indicating important gains for the children with language difficul-

    ties as measured by effect size using Cohens d. The inclusion of children with typically developing

    language, who were still described as disadvantaged, strengthened the design by exploring a pre-

    dicted acceleration of the Experimental groups trajectory of progress when compared with a group

    of children with normal language, predicted to be making age typical progress, and a group of

    children with similar language difficulties, making slow progress in learning language skills.

    The key research question examined in the present study is: what is the impact of the book-

    reading intervention program on socio-economically disadvantaged children with language diffi-

    culties, including expressive, receptive and overall language measures. The hypotheses are that:

    1. Following the intervention the Experimental (Language Difficulties) group will perform

    significantly better than the Control (Language Difficulties) group and the Control

    (Language Normal) group on measures of expressive, receptive, and overall language.

    2. The effect size, measured with Cohens d, will be over .50 (medium) on all dependent

    measures.

    II Method

    Ethics approval for the study was sought and successfully obtained from The University of Sydney

    Human Ethics Committee and from the State Education Research Assessment Procedure.

    1 Participants

    The study involved 36 children and their parents, divided into three groups, with two groups of

    children with language delays and difficulties, an Experimental Language Difficulties (ELD)

    group and a Control Language Difficulties (CLD) group, and one Control Language Normal (CLN)group. Child participants in the study were selected from three separate preschools comprising

    seven classes. Child mean age was 5:0 years, with a range from 4:3 years to 5:7 years. All children

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    Colmar 83

    attended special preschool centres for children from backgrounds designated as disadvantaged,

    funded by the State Education system. The geographic area was designated in the lowest 5% in

    New South Wales, Australia, based on multiple indicators of disadvantage across five broad head-ings of social distress, health, community safety, economics and education. Informed parental con-

    sent was obtained for all participants: child and adult. The numbers of children, the gender balance,

    and the mean ages and range are presented in Table 1.

    Children were assigned to the ELD or CLD group according to the preschool they attended to

    ensure that the CLD group parents were not aware of the intervention techniques prior to training.

    All children in the ELD group attended one preschool with two classes, whilst the CLD group was

    selected from five classes in two other preschools. The CLN group was drawn from children with

    normally developing language who attended all seven classes at the three preschools.

    2 Procedurea Initial assessment. All children were pre-tested using two standardized tests, both of which have

    parallel forms, yielding four measures of language. The tests were the Test of Early Language

    Development (TELD3, Hresko et al., 1999, 3rd edition), and the Peabody Picture Vocabulary Test

    (PPVT3, Dunn and Dunn, 1997, 3rd edition). The TELD3 and the PPVT3 have test means of 100

    with standard deviations (SDs) of 15. The TELD3 has testretest reliability ranging from .85 to .94

    across the three quotients, and the PPVT3 has testretest reliability of .91. The TELD3 yields three

    scores: Expressive Language Quotient (ELQ), Receptive Language Quotient (RLQ) and Spoken

    Language Quotient (SLQ), with the SLQ representing a total language score. The PPVT3 is also a

    measure of Receptive Language but of single word vocabulary, whereas the TELD3 RLQ meas-

    ures instruction following, more complex grammatical understanding and some interpretation, as

    well as single word understanding.

    The summary pre-testing findings are shown in Table 1. For the Experimental Language

    Difficulties (ELD) group and the Control Language Difficulties (CLD) group, the mean SLQ was

    used as the criteria for inclusion in both Language Difficulties groups. An SLQ standard score

    below 70, which is more than two standard deviations (SD) below the mean, and named as very

    poor in the tests descriptors, confirmed that all children in the ELD and CLD groups had difficul-

    ties in language. Conversely the mean SLQ for the children in the CLN group was 101.8, defined

    as average.

    b Parent training and intervention programme. One of the childs parents, usually the mother (not-

    ing that two fathers participated), of children in the ELD group were individually trained within a

    Table 1. Child participants numbers, gender and ages at pre-testing.

    Group Numbers Male Female Mean age Age range Mean Spoken LanguageQuotients (SLQ) (mean100, SD15)

    Experimental(language difficulties)

    11 9 2 4:11 4:35:5 68

    Control (languagedifficulties)

    12 8 4 5:0 4:55:7 68

    Control (languagenormal)

    13 9 4 4:11 4:35:4 102

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    84 Child Language Teaching and Therapy 30(1)

    single hour session to use the strategies of pausing and open questioning during interactive joint

    book reading (see details later). A short demonstration using the key strategies was conducted with

    each child by the author, with the parent observing, and suitable picture books were shown and

    discussed. Each parent was provided with personalized written guidelines, including a simplified

    summary of the four elements of the program. A spoken version of the strategies was also available

    on CD if required by parents with low literacy levels. Parents were encouraged to implement the

    strategies in a book-reading context for 515 minutes per day with their child for the next four

    months, and to use the strategies during daily activities when suitable opportunities arose. Parents

    were supplied with record books to record the books used, time spent and dates on which they

    implemented the book-reading intervention program. They were given contact details to follow up

    on any concerns. In addition, all available parents were contacted once during the intervention

    period to discuss how they were managing implementing the program.

    The four key components of the intervention program were:

    1. pausing (not talking or communicating) at each page turn to allow the child an opportunity

    to talk first, that is, to choose or initiate a topic of interest to them;

    2. asking an open question related to the childs chosen topic, encouraging the child to say

    more and to use more complex language, thus giving the child an opportunity to respond or

    to talk more on their chosen topic;

    3. using childrens picture books as a stimulus for language teaching and learning in regular

    book-reading sessions; and

    4. using the same strategies of pausing and conversation building in everyday settings.

    Examples of the childrens picture books were selected on the basis of the attractiveness of the

    pictures and story, with a limited amount of text on each page. Parents were encouraged to obtain

    similar books, with a collection made available at the preschool. A full list of the books is available

    on request.

    c Post intervention assessment. All 36 children in the three groups were re-tested four months later

    using the parallel forms of the TELD3 and PPVT3. A short follow-up interview was completed

    with each available trained parent in the ELD group following their four months of intervention,

    eliciting their views on the training, the implementation of the techniques, and their opinion of their

    childs progress in language and other areas. When their formal involvement was completed, every

    child in the three groups was presented with a certificate and a childrens picture book to thank

    them for their participation. Further, a report was sent to parents of children in the ELD group.

    3 Design and analysis

    The design of the study was experimental with three groups: Experimental Language Difficulties

    (ELD) group, Control Language Difficulties (CLD) group, and Control Language Normal

    (CLN) group. The CLN group was included to allow comparison of the ELD and CLD groups

    results with those of a normally developing group over the four months of intervention; thus,

    Time 1, pre-testing and Time 2, post-testing. Parents of the children in the CLD and CLN

    groups were given the option of being trained in the intervention strategies upon completion of

    the research.

    Every child was tested by one of two assessors, with pre- and post-testing of all children.ANCOVA analyses were conducted using difference scores. To investigate where the group differ-

    ences lay, further post-hoc analyses, specifically using the StudentNewmanKeuls (SNK) test,

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    Colmar 85

    were performed to determine which groups differed from each other. The SNK analyses are post-

    hoc pairwise comparisons that are conducted in one follow-up procedure (thus obviating the need

    for piecemeal post-hoc tests). All alpha levels were set atp< 0.05. A separate measure of effect size

    was calculated using Cohens d.

    III Results

    1 Effectiveness of the intervention

    An ANCOVA was performed on difference scores, together with a StudentNewmanKeuls post-

    hoc analysis. The ANCOVA analyses for the Experimental Language Difficulties (ELD) groups

    difference scores, compared with the Control Language Difficulties (CLD) and the Control

    Language Normal (CLN) groups difference scores as a function of group membership, were com-

    pleted on measures of expressive language (TELD3,F(2, 33) = 9.37,p= .001), receptive language

    (TELD3,F(2, 33) = 13.81,p= .001, PPVT3,F(2, 33) = 5.29,p= .010), and the spoken language

    quotient (TELD3,F(2, 33) = 18.49,p= .001). The results from the StudentNewmanKeuls post-hoc analysis (p< .05) were that the ELD group scored significantly higher than the CLD and CLN

    groups following the intervention, confirming that the differences occurred in favour of the ELD

    group, with no significant changes in the CLD and CLN groups. Therefore, Hypothesis 1 was

    proven for all measures.

    Hypothesis 2 predicted that the effect size for the ELD group of children would be over .50

    (medium) on all measures following the intervention. As is evident in Table 2, this hypothesis was

    upheld. For expressive, receptive and the spoken language quotients, effect sizes were large (.80

    and above) to very large, with 1.50 for expressive language, 1.67 for receptive language (TELD3),

    .80 for receptive language (PPVT3) and 1.73 for the overall spoken language quotient.

    Finally data from the parent interviews was positive, with parents enjoying the book-readingintervention and generally maintaining the use of the strategies for the four-month experimental

    period. Many provided anecdotal evidence of positive interactions with their child and observed

    progress, particularly the childs use of specific vocabulary.

    2 Summary of the findings

    In summary, hypotheses predicted that the language of children in the Experimental Language

    Difficulties (ELD) group would improve across key areas following parental implementation of

    the intervention strategies. Significant differences and medium to large effect sizes were achieved

    for the ELD group compared with the Control Language Difficulties (CLD) group, and the ControlLanguage Normal (CLN) group. Further, the results for the CLD and CLN groups of children

    showed no significant change during the four-month intervention period.

    IV Discussion

    The study explored the impact of training the parents of young children with language difficulties.

    Parents intervened using simple strategies within a book-reading context to facilitate their childs

    use of language. Changing the pattern of adultchild language interactions led to positive signifi-

    cant gains, with large to very large effect sizes in child language in the Experimental Language

    Difficulties (ELD) group. Importantly no change was observed in either of the Control groups(CLD and CLN) during the four-month intervention phase. Given that there were no differences

    between the ELD and CLD groups of children observed at pre-test, and the pretesting scores were

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    86 Child Language Teaching and Therapy 30(1)

    used as a covariate, it is reasonable to attribute the significant gains with large effect sizes observed

    in the ELD group at post-testing to the intervention program. The findings are important and

    unique, demonstrating that the gap between children making poor progress in learning language

    skills can be closed, particularly as the typically developing children in the Language Normal

    group made age typical, but not accelerated progress during the same time period. Only one previ-

    ous study has been published combining elements of naturalistic milieu teaching within a book-

    reading context (Colmar, 2011) with standardized child language measures; thus, there is little

    prior research to link to the present interventions effectiveness.It is important to consider the intervention in terms of the relative simplicity of the strategies

    and the consultative nature of the training. Clearly a combination of the powerfulness of pausing

    to provide the child with an opportunity to initiate talk on a topic of their own interest (their chosen

    focus of attention), and responsive questioning, coupled with the advantages of book reading and

    using naturally occurring opportunities to communicate, was highly successful in facilitating the

    childrens language progress. From qualitative comments gathered, parental motivation to help

    their own child was high. Further, the simplicity of the strategies ensured parents could implement

    the program and that, as they observed the positive changes in their childrens language use and

    understanding, they were further encouraged to keep using the strategies. However, as it was not

    practicable to collect treatment fidelity data, only parental report and records, it is the robustnessof the design controlling for the covariates and the full results presented, that suggest parents actu-

    ally did implement the intervention following training.

    Pausing and questioning are both single behaviours and easily described, possibly making it

    easier to train than the more complex full milieu strategies (Colmar, 1999; McNeill and Fowler,

    1999). It is also likely that the structured book-reading context, with pausing specified to occur

    when using the books at the start of a session and at every page turn, both of which were readily

    observable opportunities, made it easy to implement. However, pausing implicitly involves the

    inhibition of high levels of adult talk, and this could have been initially difficult, particularly as an

    inappropriate pattern of communication with children with language difficulties including talking

    fairly constantly in a book-reading context, can be adopted (Colmar, 1999). Similarly, questioningwas simpler within the book-reading context as child language was generally clearly understood

    with pictorial cues available to enhance the supportive context.

    Table 2. ANCOVA difference scores results for experimental (LD) group versus control groups.

    Languagequotients

    Group Numbers Difference scoresM (SD)

    Difference scoressignificance

    Effect sizeCohens d

    ELQ Experimental (LD) 11 12.18 (6.82) .001 1.50

    Control (LD) 12 4.75 (9.79)Control (LN) 13 1.00 (5.03)

    RLQ Experimental (LD) 11 24.55 (11.20) .000 1.67

    Control (LD) 12 5.17 (12.08)

    Control (LN) 13 2.62 (9.58)

    SLQ Experimental (LD) 11 22.18 (8.12) .000 1.73

    Control (LD) 12 5.58 (9.60)

    Control (LN) 13 2.00 (7.76)

    PPVT3 Experimental (LD) 11 13.64 (17.97) .010 0.80

    Control (LD) 12 0.25 (8.01)

    Control (LN) 13 0.62 (7.30)

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    Colmar 87

    The book-reading context functioned as an intervention and additionally as a practice time,

    both for the parent to learn the technique in a semi-structured setting and for the child to talk on a

    personally chosen topic in an enjoyable, emotionally warm context. Parents in the present study

    confirmed this became a special time with their child that was mutually enjoyable. In addition,

    books are an excellent source of conversational topics with the advantage of picture stimuli

    (Barachetti and Lavelli, 2011), potentially a range of new and varied vocabulary, contextualization,

    and a storyline to enhance conversation building. Importantly, the effectiveness of book reading

    per se cannot be separated out from the parents use of the specifically prescribed strategies, given

    that the program was presented as an intervention package with multiple elements, and specific

    treatment integrity data was not gathered. However, parents reported using the same principles of

    pausing and contingent questioning in response to child initiations within naturalistic contexts to

    develop turn-taking conversations; thus the intervention went beyond book reading.

    Much of the research has focused on the impact of book reading on future literacy success, not

    the immediate impact on language itself. In the present study, parental post-intervention interviews

    suggested that the pausing and use of the open questioning were helpful in the book-reading con-

    text in encouraging the childs engaged participation and conversational turn-taking. Importantly,

    the parents use of contingent open questioning based on the childs initiated topic may have been

    particularly useful, as the childs meaning then becomes the focus rather than reading the print.

    Research does support the relevance of assisting the child to develop meaning, which will ulti-

    mately facilitate literacy comprehension (Schickedanz and McGee, 2010).

    The findings of the present research could be further explored by including an additional Control

    group whose parents could be asked to read books more, thus clarifying if the training in the strate-

    gies resulted in the effectiveness of the intervention or if providing books with no instructions would

    be effective. An acknowledged limitation of the study is that the two assessors of the childrens

    language at all stages of testing were aware of the group to which each child had been allocated; thus

    assessor bias could have occurred. Future research or replication could ensure blind testing occurred.

    In summary, the parents capacity to learn and successfully use a set of simple new strategies

    confirms the importance of direct parent involvement in child learning. When trained to pause,

    listen and interact as a facilitator, parents allowed opportunities for child initiations and child-led

    conversations, with open questioning providing the child with further opportunities to respond

    using language and to develop a conversation about a topic of their own choice. Generalization of

    the technique and opportunities for more conversations were created when the parents in the study

    used pausing and open questioning as often as possible in their everyday conversations with their

    child, as well as engaging regularly in the book-reading program.

    Changing book reading from an adult controlled activity to a child centred one, with child

    choice and opportunities to both initiate and respond using language ensuring child attention and

    motivation, achieved significant positive changes, with medium to large effect sizes, in child lan-

    guage skills, vital skill enhancement for children with serious language difficulties.

    Acknowledgements

    I acknowledge the invaluable assistance with the data collection of Louise Davey, Psychology Student from

    the University of Bath, UK, and the generous assistance with statistical procedures and explanations from

    Andrew Martin, University of Sydney, Australia.

    Declaration of conflicting interest

    The author declares that there is no conflict of interest.

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    88 Child Language Teaching and Therapy 30(1)

    Funding

    This research received no specific grant from any funding agency in the public, commercial, or not-for-profit

    sectors.

    References

    Aarts R, Demir S, and Vallen T (2011) Characteristics of academic language register occurring in care-

    taker-child interaction: Development and validation of a coding scheme. Language Learning 61:

    11731221.

    Alpert C and Kaiser A (1992) Training parents as milieu language teachers. Journal of Early Intervention

    16: 3152.

    Ard LM and Beverly BL (2004) Preschool word learning during joint book reading: Effect of adult questions

    and comments. Communication Disorders Quarterly26: 1728.

    Barachetti C and Lavelli M (2011) Responsiveness of children with specific language impairment and mater-

    nal repairs during shared book reading.International Journal of Language Communication Disorders

    46: 57991.Bishop D and Leonard LB (2000) Speech and language impairments in children: Causes, characteristics,

    intervention and outcome, Hove: Psychology Press.

    Butz AM, Crocetti RE, Thompson RE and Lipkin PH (2009) Promoting reading in children: Do reading prac-

    tices differ in children with developmental problems. Clinical Pediatrics48: 27583.

    Colmar S (1999) Language intervention for children with language delays using pausing and incidental teach-

    ing strategies. Unpublished doctoral thesis, Macquarie University, Sydney, Australia.

    Colmar S (2011) A book reading intervention with mothers of children with language difficulties.Australasian

    Journal of Early Childhood36: 10412.

    Dunn L and Dunn L (1997) Peabody Picture Vocabulary Test: 3rd edition (PPVT3). Pines Circle, MN:

    American Guidance Service.

    Elias G, Hay I, Homel R and Freiberg K (2006) Enhancing parent-child book reading in a disadvantaged com-munity.Australian Journal of Early Childhood31: 2025.

    Fletcher KL, Cross JR, Tanney AL, Schneider M and Finch WH (2008) Predicting language development

    in children at risk: The effects of quality and frequency of caregiver reading. Early Education and

    Development19: 89111.

    Halle JW, Baer DM, and Spradlin JE (1981) Teachers generalized use of delay as a stimulus control pro-

    cedure to increase language use in handicapped children. Journal of Applied Behavior Analysis 14:

    389409.

    Hancock T and Kaiser A (2002) The effects of trainer-implemented enhanced Milieu Teaching on the social

    communication of children with autism. Topics in Early Childhood Special Education22: 3954.

    Hart B and Risley T (1974) Using preschool materials to modify the language of disadvantaged children.

    Journal of Applied Behavior Analysis7: 24356.Hart B and Risley T (1980) In vivo language interventions: Unanticipated general effects.Journal of Applied

    Behavior Analysis13: 40732.

    Hart B and Risley T (1995)Meaningful differences in the everyday experiences of young American children,

    Baltimore, MD: Brookes.

    Hart B and Risley T (1999) The social world of children learning to talk. Baltimore, MD: Brookes.

    Hockenberger EH, Goldstein H, and Haas LS (1999) Effects of commenting during joint book reading by

    mothers with low SES. Topics in Early Childhood Special Education19: 1527.

    Hoff E and Tian C (2005) Socioeconomic status and cultural influences on language.Journal of Communication

    Disorders38: 27178.

    Hresko W, Reid D, and Hammill D (1999) Test of Early Language Development: 3rd edition (TELD-3).

    Austin, TX: ProEd.Institute of Education Sciences (2007)Interactive shared book reading. Princeton, NJ: Institute of Education

    Sciences.

  • 7/24/2019 Problemas de Lenguaje y Estrategias de Intervencin

    11/13

    Colmar 89

    Justice LM and Pence KL (2004) Addressing the language and literacy needs of vulnerable children:

    Innovative strategies in the context of evidence-based practice. Communication Disorders Quarterly

    25: 17379.

    Justice LM and Pullen PC (2003) Promising interventions for promoting emergent literacy skills: Three evi-

    dence-based approaches. Topics in Early Childhood Special Education23: 99113.

    Kaiser A and Roberts M (2011) Advances in early communication and language intervention. Journal ofEarly Intervention33: 298309.

    Kang J, Kim Y, and Pan BA (2009) Five-year-olds book talk and story retelling: Contributions of mother

    child joint bookreading.First Language29: 24365.

    Law J, Garrett Z, and Nye C (2004) The efficacy of treatment for children with developmental speech and

    language delay/disorder: A meta-analysis. Journal of Speech, Language, and Hearing Research 47:

    92443.

    Law J, Plunkett C, and Stringer H (2012) Communication interventions and their impact on behaviour in the

    young child: A systematic review Child Language Teaching and Therapy28: 723.

    McNeill J and Fowler S (1999) Lets talk: Encouraging mother-child conversations during story reading.

    Journal of Early Intervention22: 5170.

    Pennington L, Thomson K, James P, Martin L and McNally R (2009) Effects of it takes two to talk: TheHanen program for parents of preschool children with cerebral palsy: Findings from an exploratory

    study.Journal of Speech and Hearing Disorders52: 112138.

    Reese E, Sparks A, and Leyva D (2010) A review of parent interventions for preschool childrens language

    and emergent literacy.Journal of Early Childhood Literacy10: 97117.

    Roberts JE, Jurgens J, and Burchinal M (2005) The role of home literacy practices in preschool chil-

    drens language and emergent literacy skills. Journal of Speech Language and Hearing Research

    48: 34559.

    Rodriguez B, Hines R, and Montiel M (2009) Mexican American mothers of low and middle socioeconomic

    status: Communication behaviors and interactive strategies during shared book reading. Language

    Speech and Hearing Services in Schools40: 27182.

    Schickedanz JA and McGee LM (2010) The NELP report on shared story reading interventions (Chapter 4):Extending the story.Educational Researcher39: 32329.

    Schooling T, Venediktov R, and Leech H (2010)Evidence-based systematic review: Effects of service deliv-

    ery on the speech and language skills of children from birth to 5 years of age. Rockville, MD: National

    Center for Evidence-Based Practice in Communication Disorders.

    Senechal M and LeFevre J-A (2001) Storybook reading and parent teaching: Links to language and literacy

    development. In: Britto PR and Brooks-Gunn J (eds) The role of family literacy environments in promot-

    ing young childrens emerging literacy skills: New directions for child and adolescent development. San

    Francisco, CA: Jossey-Bass, 3952.

    van Kleeck A, Schwarz AL, Fey M, Kaiser A, Miller J and Weitzman E (2010) Should we use telegraphic or

    grammatical input in the early stages of language development with children who have language impair-

    ments? A meta-analysis of the research and expert opinion. American Journal of Speech-LanguagePathology19: 321.

    Vilaseca RM and Del Rio M-J (2004) Language acquisition by children with Down syndrome: A natu-

    ralistic approach to assisting language acquisition. Child Language Teaching and Therapy 20:

    16380.

    Vinson T (2006) The education and care of our children: Good beginnings. Public Education Day: 18 May:

    122.

    Wasik BA, Bond MA, and Hindman A (2006) The effects of a language and literacy intervention on Head

    Start children and teachers.Journal of Educational Psychology98: 6374.

    Weiss AL and Theadore G (2011) Involving parents in teaching social communication skills to young chil-

    dren. Topics in Language Disorders31: 195209

    White PJ, OReilly M, Streusand W, et al. (2011) Best practices for teaching joint attention: A systematicreview of the intervention literature.Research in Autism Spectrum Disorders5: 128395.

  • 7/24/2019 Problemas de Lenguaje y Estrategias de Intervencin

    12/13

    90 Child Language Teaching and Therapy 30(1)

    Whitehurst G, Falco F, Lonigan C, Fischel J, DeBaryshe B, Valdez-Menchaca M and Caulfield M (1988)

    Accelerating language development through picture book reading. Developmental Psychology 24:

    55259.

    Yoder PJ and Warren SF (1999) Facilitating self-initiated proto-declaratives and proto-imperatives in prelin-

    guistic children with developmental disabilities.Journal of Early Intervention22: 33754.

    Young-Suk K, Kang JY, and Pan BA (2011) The relationship between childrens spontaneous utterances dur-ing joint bookreading and their retellings.Journal of Early Childhood Literacy11: 40222.

    Zevenbergen AA, Whitehurst GJ, and Zevenbergen JA (2003) Effects of a shared-reading intervention on the

    inclusion of evaluative devices in narratives of children from low-income families.Journal of Applied

    Developmental Psychology24: 115.

  • 7/24/2019 Problemas de Lenguaje y Estrategias de Intervencin

    13/13

    C o p y r i g h t o f C h i l d L a n g u a g e T e a c h i n g & T h e r a p y i s t h e p r o p e r t y o f S a g e P u b l i c a t i o n s , L t d .

    a n d i t s c o n t e n t m a y n o t b e c o p i e d o r e m a i l e d t o m u l t i p l e s i t e s o r p o s t e d t o a l i s t s e r v w i t h o u t

    t h e c o p y r i g h t h o l d e r ' s e x p r e s s w r i t t e n p e r m i s s i o n . H o w e v e r , u s e r s m a y p r i n t , d o w n l o a d , o r

    e m a i l a r t i c l e s f o r i n d i v i d u a l u s e .