Maille Coombs and Faculty Mentor: Martin Fujiki, Communication Disorders
The link between social communication and Language Impairment (LI) is an emerging topic in the field of speech pathology. It is known that children with LI struggle to produce and comprehend language, but it has recently been shown that these children also have notable difficulty communicating and interacting appropriately in social situations. A number of recent studies have documented that children with LI have deficits in emotion understanding (Fujiki, Spackman, Brinton & Illig, 2008). Children with LI struggle with affective theory of mind, recognizing and labeling facial expressions, and understanding emotion through prosody changes (Delaunay-el Allam, Guidetti, Chaix & Reilly, 2011). These deficits cause children with LI to experience negative social interactions and show decreased sociable behaviors (Hart, Fujiki, Brinton & Hart, 2004).
The purpose of this study was to investigate the efficacy of a social communication intervention to increase sociable behaviors children with Language Impairment. The project evaluated whether improvements in emotion understanding led to improved perceptions of sociable behaviors by classroom teachers.
Participants. Six children, ranging from 6 to 10 years of age, participated in the study. All six participants were identified as having LI through the administration of formal testing, and were already receiving services from the school Speech-Language Pathologist on a pull-out basis. The participants also exhibited social communication difficulties, but did not meet the criteria for Autism Spectrum Disorder.
Intervention. This study used a multiple baseline single subject design and participants attended therapy bi-weekly for twenty-minute sessions. The intervention program addressed the children’s social communication needs, as well as their language needs. The therapy activities were designed to specifically address affective theory of mind; in particular, a child’s ability to understand emotions and understand that others may feel emotions different from their own in a given situation. The intervention consisted of an expanded story enactment procedure in which the child and clinician read a book and talked about the feelings experienced by each character in the story and possible causes of these emotions. The next stage of enactment involved using stuffed animals and props to act out the story, where client and clinician narrated the perspectives and emotions of each character. At the end of each session, a journaling activity was used to help participants relate story events to their own experiences.
Assessment Instrument and Method of Analysis. This study examined teacher perceptions of sociable behavior in the children with LI before and after participation in the emotion understanding intervention. The Teacher Behavior Rating Scale (TBRS) was used to assess teacher perceptions of the behaviors in question. The TBRS is a 161-item questionnaire that has previously been used to evaluate the social skills of children with LI (Hart & Robinson, 1996). The TBRS focuses on several behavioral subtypes of sociable behavior that has been identified in the social psychology literature. The subtypes that were analyzed were impulse control/likability and prosocial behavior. Impulse control evaluates how the child handles anger and likability refers to the child being liked and accepted by peers. Prosocial behavior includes offering to help or share with others, and the ability to show sympathy and comfort to peers.
Results were obtained by calculating the mean score for items relating to sociability, as reported by teachers on the TBRS. The possible range is 0 (never observed) to 2 (observed very often). The table below contains the means for each child over an eight-month period and references typical means with standard deviations shown in parentheses. Higher means are positive, indicating greater levels of sociable behavior.
Although progress was variable, in general, the children showed improvement following intervention. Higher frequency of positive, prosocial behavior was seen in four of the five children. Less dramatic change was observed for items relating to likeability. Only two of the five children showed improvement, two children stayed the same, and one child regressed. Overall, each child made improvements in at least one area, if not both areas, following the social communication intervention.
The results of this study are highly encouraging and suggest the viability of language intervention approaches that facilitate social and emotional learning. Further data from this intervention program will be analyzed in the future as the study continues.
Delaunay-el Allam, M., Guidetti, M., Chaix, Y., & Reilly, J. (2011). Facial emotion labeling in language impaired children.Applied Psycholinguistics, 32(4), 781-798. doi:http://dx.doi.org/10.1017/S0142716411000063
Fujiki, M., Spackman, M. P., Brinton, B., & Illig, T. (2008). Ability of children with language impairment to understand emotion conveyed by prosody in a narrative passage. International journal of language & communication disorders, 43(3), 330-345.
Hart, C.H., & Robinson, C.C. (1996). Teacher Behavior Rating Scale. teacher questionnaire. Brigham Young University, Provo, UT.
Hart, K. I., Fujiki, M., Brinton, B., & Hart, C. H. (2004). The relationship between social behavior and severity of language impairment. Journal of Speech, Language, and Hearing Research, 47, 647–662.