Use of Narrative-Based Language Intervention With Children Who Have Specific Language Impairment Ten 7–8-year-old children with specific language impairment participated in a 6-week program of narrative-based language intervention (NBLI) in an effort to evaluate NBLI’s feasibility. Each intervention session targeted story content as well as story and sentence form using story retell and generation tasks. Eight children achieved the clinically significant improvement ... Research Article
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Research Article  |   May 01, 2005
Use of Narrative-Based Language Intervention With Children Who Have Specific Language Impairment
 
Author Affiliations & Notes
  • Lori A. Swanson
    University of Tennessee, Knoxville
  • Marc E. Fey
    University of Kansas Medical Center, Kansas City
  • Carrie E. Mills
    University of Tennessee, Knoxville
  • Lynn S. Hood
    National Health Care, Murfreesboro, TN
  • Contact author: Lori A. Swanson, University of Tennessee, Department of Audiology and Speech Pathology, 578 South Stadium Hall, Knoxville, TN 37996-0740. E-mail: lswanson@utk.edu
Article Information
Language Disorders / Specific Language Impairment / Research Articles
Research Article   |   May 01, 2005
Use of Narrative-Based Language Intervention With Children Who Have Specific Language Impairment
American Journal of Speech-Language Pathology, May 2005, Vol. 14, 131-141. doi:10.1044/1058-0360(2005/014)
History: Received December 18, 2003 , Accepted February 25, 2005
 
American Journal of Speech-Language Pathology, May 2005, Vol. 14, 131-141. doi:10.1044/1058-0360(2005/014)
History: Received December 18, 2003; Accepted February 25, 2005
Web of Science® Times Cited: 42

Ten 7–8-year-old children with specific language impairment participated in a 6-week program of narrative-based language intervention (NBLI) in an effort to evaluate NBLI’s feasibility. Each intervention session targeted story content as well as story and sentence form using story retell and generation tasks. Eight children achieved the clinically significant improvement criterion from pre- and posttest comparisons of at least 1.45 points on a narrative quality (NQ) rating (p < .013). Throughout the NBLI program, the children were informally observed to show increased self-confidence in their narrative production skills. Nearly all children preferred story generation activities over story retell tasks, while story retell tasks were favored over sentence imitation drills. Pre- and posttest comparisons for number of different words, developmental sentence score, and a sentence imitation task were nonsignificant. This indicated no further evidence of positive outcomes for NBLI. Based on the significant findings for NQ, NBLI is worthy of further investigation. Modifications to enhance its ability to produce positive gains are discussed.

Children with specific language impairment (SLI) are well known to be late in the acquisition of grammatical skills and to be slow in the processes of grammar development once they begin. For English-speaking children, these deficits are especially noteworthy on forms that mark tense and agreement on verbs (Leonard, 1998). Consequently, many children with SLI require intervention targeting grammatical comprehension and production (Fey, Long, & Finestack, 2003).
Problems in the language development of children with SLI are not limited to morphosyntax, however. It is ofspecial interest to us that these children also tend to produce narratives with fewer total words (e.g., Strong & Shaver, 1991), fewer different words (e.g., Klee, 1992), more syntactic errors (e.g., Gillam & Johnston, 1992), poorer use of cohesive devices (e.g., Liles, 1987), and less story grammar content (e.g., Gillam, McFadden, & van Kleeck, 1995; McFadden & Gillam, 1996; Montague, Maddus, & Dereshiwsky, 1990) than their typically developing peers. Although by second grade, many children with SLI appear to have recovered from their language deficits when assessed by standardized tests, their performance on narrative tasks may still be relatively weak (Fey, Catts, Proctor-Williams, Tomblin, & Zhang, 2004). For example, Fey and his colleagues found that children with language impairment in kindergarten who appeared to have recovered by second grade more closely resembled their typically developing peers than children with persistent language impairments on a narrative composition task. By fourth grade, however, this same group of children exhibited profiles of fictional narrative skills that made them look more like the children with persistent language problems. The authors concluded that, regardless of the reasons for this pattern of illusory recovery, school-age children with early histories of language impairment may need intervention focusing directly on their narrative abilities.
Several studies have sought to facilitate the production of complex, cohesive narratives in children with language impairments (Gillam et al., 1995; Hayward & Schneider, 2000; Hoffman, Norris, & Monjure, 1990; Klecan-Aker, 1993; Klecan-Aker, Flahive, & Fleming, 1997; Ukrainetz, 1998). While some of these studies (e.g., Gillam et al., 1995; Hoffman et al., 1990) also addressed the grammatical deficits of the participants indirectly, none have placed specific emphasis on grammar. The intervention approach utilized in the present study, which we refer to as narrative-based language intervention (NBLI), was developed to address both narrative and grammatical abilities directly. It was conceived, in large part, as a brief, 6-week adjunct to another intervention, Fast ForWord–Language (FFW–L; Scientific Learning Corporation, 1998), which targets the deficits in auditory processing exhibited by some children with language impairments. As part of our larger research program, we have hypothesized that if FFW–L results in improved auditory verbal-processing abilities, or even if it only fosters better auditory verbal attention in some children with language impairments, it may provide children with SLI with a stronger foundation from which they can respond more readily to conventional language intervention approaches, such as NBLI.
Before testing this hypothesis, however, it was important to evaluate the feasibility of NBLI. For example, we were interested in determining qualitatively whether children seemed to enjoy the materials and activities, whether they cooperated readily in all tasks, and whether all activities could be included within the time allotted. We also wanted to develop a manual for NBLI and to form impressions on the ease with which clinicians might be able to implement the procedures and teach them to others. Finally, although our study was not designed to evaluate the efficacy of the approach, we wanted to gain early insights into NBLI’s potential as a stand-alone language intervention. This information would be important not only to our development of NBLI as an intervention but also to our broader research program in which NBLI plays a complementary rather than a comprehensive role in language intervention.
The specific objectives of the present study were as follows:
  1. To refine the tasks and materials for a 6-week production-based intervention approach focusing on production of grammatical structure and narrative content and form.

  2. To determine, in a preliminary study, whether this approach warrants evaluation in larger, more rigorous, experimental trials.

  3. To determine the suitability of two measures of narrative ability, the narrative quality (NQ) rating of Fey et al. (2004)  and number of different words (NDW), as measures of the outcomes of NBLI.

  4. To evaluate developmental sentence score (DSS; Lee, 1974) as a measure of grammatical outcome, following NBLI.

  5. To study two additional outcome measures that appear to tap memory and other cognitive processes associated with SLI, sentence imitation (the Recalling Sentences [RS] subtest from the Clinical Evaluation of Language Fundamentals—Third Edition [CELF–3; Semel, Wiig, & Secord, 1995 ]) and nonword repetition (NWR; Dollaghan & Campbell, 1998; Ellis Weismer et al., 2000).

  6. To ascertain children’s acceptance of the approach and to develop hypotheses for ways to improve its ability to produce positive outcomes.

Method
Participants
Participants included 10 children age 6;11 (years;months) to 8;9 (M = 7;10) who resided in monolingual English-speaking homes. All children scored at least −1.5 SDs on the speaking composite and/or spoken language quotient of the Test of Language Development—Primary: Third Edition (TOLD–P:3; Newcomer & Hammill, 1997). Seven of the 10 children scored at least −.5 SD on the listening composite quotient of the TOLD–P:3, and the remaining 3 scored between −.5 and +1 SD. All children passed a hearing screening and an oral-motor screening, the Oral Speech Mechanism Screening Examination—Third Edition (OSMSE–3; St. Louis & Ruscello, 2000), scored between ±1 SD on the Matrices subtest of the Kaufman Brief Intelligence Test (K–BIT; Kaufman & Kaufman, 1990), and had no reported frank neurological or social-emotional disorders. (See Table 1 for entrance criteria test scores.) Six of the 10 children were receiving speech-language services at their public school at the time of the investigation. Three of the 4 remaining children were on summer break from their school-based services. The remaining child just missed qualifying for school-based services, and his parents were seeking alternative services.
TABLE 1.Standard scores of entrance criteria measures.
Standard scores of entrance criteria measures.×
Participant Sex Age Listening quotient Speaking quotient Spoken quotient K–BIT
1 M 8;2 88 70 75 88
2 M 8;9 91 76 82 88
3 M 8;7 112 76 82 111
4 M 6;11 91 70 85 99
5 F 6;11 85 82 77 110
6 M 7;2 100 88 76 86
7 M 7;8 88 76 70 87
8 F 8;3 88 91 72 106
9 M 8;5 94 64 68 92
10 M 7;1 94 76 83 86
Note. Age is listed in years;months. Listening, Speaking, and Spoken quotients are from the Test of Language Development—Primary: Third Edition. For all scores, M = 100, 1 SD =15. K–BIT = Kaufman Brief Intelligence Test.
Note. Age is listed in years;months. Listening, Speaking, and Spoken quotients are from the Test of Language Development—Primary: Third Edition. For all scores, M = 100, 1 SD =15. K–BIT = Kaufman Brief Intelligence Test.×
TABLE 1.Standard scores of entrance criteria measures.
Standard scores of entrance criteria measures.×
Participant Sex Age Listening quotient Speaking quotient Spoken quotient K–BIT
1 M 8;2 88 70 75 88
2 M 8;9 91 76 82 88
3 M 8;7 112 76 82 111
4 M 6;11 91 70 85 99
5 F 6;11 85 82 77 110
6 M 7;2 100 88 76 86
7 M 7;8 88 76 70 87
8 F 8;3 88 91 72 106
9 M 8;5 94 64 68 92
10 M 7;1 94 76 83 86
Note. Age is listed in years;months. Listening, Speaking, and Spoken quotients are from the Test of Language Development—Primary: Third Edition. For all scores, M = 100, 1 SD =15. K–BIT = Kaufman Brief Intelligence Test.
Note. Age is listed in years;months. Listening, Speaking, and Spoken quotients are from the Test of Language Development—Primary: Third Edition. For all scores, M = 100, 1 SD =15. K–BIT = Kaufman Brief Intelligence Test.×
×
Procedures
Preexperimental Sessions
Each child participated in two preexperimental sessions scheduled within 7 days of each other. These sessions were 1.5 hr long and were held at the Child Language Laboratory at the University of Tennessee or in a quiet room at the child’s school. During the first session, a clinician administered the entrance criteria measures, including the TOLD–P:3, the OSMSE–3, and the K–BIT. For children who qualified, pretreatment measures were obtained during a second preexperimental session. Children were required to generate two oral narratives based on two sets of pictures (“Blackie’s Apples” and “Hammie’s Big Night”; henceforth “Blackie” and “Hammie”), using the protocol of Fey et al. (2004) . For each story, a set of three laminated pictures was displayed. The first picture contained the characters and setting, the second showed the main character in a problem situation, and the third presented a climax, although the ultimate resolution was still uncertain. Before the child was asked to generate a story about each set of pictures, the examiner provided a model story about a similar set of pictures, titled “Rescue by the Lake,” for the child. Following the model, the child composed a novel story for each of the picture sequences (“Blackie” and “Hammie”). Story generation, as employed in this task, is known to be more challenging than story retelling (e.g., Merritt & Liles, 1987).1 
Outcome Measures
NQ and NDW were selected as our two outcome measures of narrative ability, and both of these measures were expected to increase in response to our brief course of NBLI. Fey et al. (2004)  developed NQ as a summary measure of children’s story organization, story content, and language sophistication (see Appendix A  for NQ scoring procedure). Thus, it is a direct measure of story quality. NDW typically serves as a measure of lexical diversity and, if the length of the stories is allowed to vary as it was in our study, as a measure of story length. NBLI does not target vocabulary diversity directly, but NDW has been shown to be highly correlated with measures of story quality (Fey et al., 2004; Graham & Harris, 1989), and it is much more easily and reliably calculated than is NQ. Thus, NDW was considered as a possibly useful index of overall narrative ability.
NQ and NDW were selected indices of children’s story composition abilities and response to intervention for three additional reasons. First, both measures distinguished the narratives of groups of second- and fourth-grade children with SLI and groups of their typically developing counterparts in the study by Fey et al. (2004) . Second, the children with SLI in the Fey et al. study showed positive but slow growth on these measures from second to fourth grade. Third, NDW was the only measure to show change in the narratives of children with SLI from second to fourth grade that was statistically reliably slower than that of their typically developing peers. While it is true that better stories are not always longer stories, there is considerable evidence that, as children get older and their story-telling skills develop, their stories tend to get longer. Thus, NDW was selected as a gross index of the quality of children’s stories, much like mean length of utterance is often selected as a gross metric of children’s grammatical skill.
In addition to the two measures of NQ, we chose DSS as a measure of grammatical outcomes. DSS was based on a 15-min conversational sample and a 15-min narrative sample collected using the guidelines of Leadholm and Miller (1992, pp. 20-21). For the narrative sample, the Leadholm and Miller procedures require the clinician to converse with the child, asking him or her to retell familiar stories, TV episodes, and favorite movies. DSS was not applied to the children’s story compositions described in the last section, because these stories typically were too short.
DSS provides a very rigorous test of the outcomes of NBLI. First, the intervention was very short, much shorter than other programs that have observed effects on DSS (Fey, Cleave, Long, & Hughes, 1993; Lee, Koenigsknecht, & Mulhern, 1975). Second, because the language samples consisted of relatively unstructured, spontaneous language, DSSs based on these samples may not have been sensitive to treatment-related changes in the children’s grammatical knowledge and skill. Third, the contexts of these samples differed significantly from the conditions found within NBLI. Nevertheless, improvements in DSSs based on spontaneous samples like those we collected have considerable ecological validity, and we would expect a 12-week intervention comprising a sequence of FFW–L and NBLI to lead to changes in this variable. Thus, we were interested in determining the amount of change expected following a 6-week stand-alone course of NBLI.
The fourth measure was the RS subtest of the CELF–3 (Semel et al., 1995). The RS subtest was chosen because many of its items contain syntactic structures similar to those targeted by NBLI. Furthermore, improvement was predicted for RS because NBLI provides imitative practice of sentence-level grammatical skills. These changes might be expected well before changes could be anticipated on DSS, as measured from spontaneous language.
The final measure of treatment outcomes was NWR. NBLI places no direct focus on skills associated specifically with the phonological working memory, which by most accounts is tested directly with NWR tasks (Baddeley, 2000, 2003; Montgomery, 2003). Therefore, there were no strong reasons to expect improvements on this measure. On the other hand, the phonological loop has been implicated in children’s lexical and syntactic development and could well be influenced by the intensive auditory discrimination and memory tasks found in some programs, such as FFW–L. NWR could be a useful index of improvement in phonological loop processes that might result from such an intervention. Our interest, then, was to determine the extent to which NWR might be sensitive to changes resulting from a more conventional intervention, such as NBLI, that relies to a large extent on children’s careful auditory-verbal attention and sentence imitation (SI) abilities.
Selection of Goals
Each child had a basic goal of increasing the frequency of use of complex grammatical forms often found in stories (see Fey, 1986, for discussion of goals). Three intermediate grammatical goals were selected based on each child’s conversational and narrative samples: one for every 2 weeks of the intervention program. Targeted goals included postmodification of nouns, subordinating conjunctions, coordinating conjunctions, and verb phrase elaboration. For each intermediate goal, multiple specific targets were identified for each child. For example, if the intermediate goal was postmodification of nouns, then the specific targets were relative clauses (who, that), prepositional phrases (in, with), and/or appositives (e.g., “John, the mailman”), based on the child’s abilities. Forms that were used infrequently or were frequently produced in error in the child’s language samples were selected.
Three specific narrative production goals also were formulated for each child: one for every 2 weeks of the intervention program. Story components that received limited credit on the NQ score were identified and targeted. For example, children who failed to include a setting and characters or an ending were encouraged to use these components. Children who included these components but merely utilized information from the stimulus picture were encouraged to create additional information not perceptually available (e.g., character and location names, character’s likes and dislikes). Similarly, children who did not produce complete problem-resolution pairs were encouraged to do so. Although special emphasis was placed on only three components, each child addressed all story grammar components in each session.
A horizontal/cyclical goal attack strategy was employed for each of the child’s goals (see Fey, 1986, for a discussion of goal attack strategies). That is, several specific goals associated with a single intermediate goal were targeted in each session for 2 weeks. Then, regardless of the child’s progress on these targets, a new intermediate goal was addressed during each subsequent 2-week period.
Materials for Novel Stories
Twenty-six novel stories were created to target upper level morphosyntactic/discourse targets (i.e., subordinating conjunctions, coordinating conjunctions, complex verbs, and postmodification of nouns). From the pool of 26 stories, 18 were used with each child with the exception of Participant 7 (1 story per session × 3 sessionsper week × 6 weeks) for the story retell-imitation task (see Appendix B  for an example). The specific stories selected for each child were determined by the child’s syntactic goals (6 stories per each of 3 goals = 18 stories). For Participant 7, 18 upper level stories were revised to target lower level morphosyntactic and discourse targets (i.e., negation, present progressive, and coordinating conjunctions). All stories contained a minimum of 10 examples of the child’s weekly morphosyntactic or discourse-based target form (e.g., postmodification of nouns). All stories contained each of the narrative components: setting, characters, problem, resolution, complication, and ending (Cleave & Fey, 1997; Fey et al., 2004), and specialized syntax characteristic of stories (e.g., direct quotes). When children had identical morphosyntactic or discourse-level goals, the same stories were used across children.
Systematic Analysis of Language Transcripts (SALT; Miller & Chapman, 2000) was used to determine the number of total words. The mean number of total words per story was 276.7 (SD = 45.3) for the lower level language stories and 305.6 (SD = 39.5) for the upper level stories. Each lower level language story contained between 10 and 12 syntactic targets, and each higher level language story contained 10 to 19 targets. Overall, approximately 90% of the stories involved real-life themes; the remaining 10% involved fantasy. Each story had three corresponding pictures created using a clip art program, Art Explosion (NOVA Development Corporation, 1995 –2001).
NBLI Intervention Sessions
Each child was seen individually for therapy at the location most convenient for the child’s parents (i.e., Child Language Lab, child’s school, or child’s home). Experimental sessions, each 50 min in length, were held three times per week for 6 weeks. The first and fourth authors, who are American Speech-Language-Hearing Association–certified, licensed speech-language pathologists, conducted the experimental sessions. All experimental sessions were recorded using a Marantz audiotape recorder and Sony tiepin microphones. During these sessions, the clinician provided motivators (verbal reinforcement, opportunity to play short games, snack at end of session) as needed. The children received a prize at the end of the postexperimental session.
NBLI Procedures
NBLI is a hybrid language intervention approach that combines skills-based and naturalistic (interactive, meaning-based) activities. Although the child’s specific target forms were included in the experimental stimuli and were recast and modeled during therapy activities (described below), the clinician also recast and/or modeled these forms during spontaneous interactions (task-related and natural). Specific target forms were highlighted approximately 15 times during spontaneous interactions in each session. The activities included in each session are described next.
Warm-up activity.
The child retold the story from the story retell-imitation task (see below) from the previous session. Because of previous exposures and practice, this story was very familiar to the child, allowing for immediate success. During the production of this story, the clinician refrained from making any corrections.
Story retell-imitation task.
In this task, the child was asked to retell a story that contained multiple examples of the morphosyntactic or discourse-level target form on a component-by-component basis (Hoffman et al., 1990). Prior to reading the story to the child, the clinician highlighted the story’s main theme to heighten the child’s interest and to activate the child’s prior knowledge of the story’s semantic details (e.g., “This story is about a boy who needed glasses. Do you know anyone who wears glasses?”). The clinician then read the story. While reading the story, the clinician used large inflectional modulations and a high emotional intensity level, again in an effort to maintain the child’s attention. The clinician then read the story again, one story component at a time, and the child was asked to retell the story on a component-by-component basis. As each story was retold, corresponding colored pictures were displayed. If an “optional” target form was not produced, or produced incorrectly, the clinician modeled the sentence or recast the child’s production. The clinician then recapped the child’s contributions, once again modeling the important semantic details and the target grammatical structures within a coherent story frame. As the child completed repeated retellings of the component parts, the clinician attempted to create reasons to retell.
The clinician then introduced a brief SI task. The short SI drill was designed to provide the child with intensive exposure to and production practice with his or her grammatical target and to require close attention to clinician models. During pilot work, the SI task preceded the story retell task. This seemed to suggest to the children that the story components had to be retold verbatim, similar to the requirements of SI task. Based on this observation, we moved this task to follow the story retell task to prevent the child from acquiring a mindset for verbatim imitation prior to the story-retell task. In the SI task, the child imitated 1012 sentence pairs. Each pair contained one model of the target form (e.g., a sentence taken from the story containing two clauses) and a model of the contrastive form (e.g., two sentences that could be combined to make a more complicated sentence). The child first imitated the contras-tive sentence(s) and then, if possible, the target sentence. After each sentence pair, the clinician had the option to present a prompt related to the sentence pair. These prompts were created to make the task more meaning-based and to increase the child’s willingness to attend. Use of these prompts varied across children (see Appendixes B  and C  for examples of SI task).
Story generation task.
For this task, the child selected a single picture from a choice of two or more that he or she found the most interesting. Each picture illustrated a scene without an obvious initiating event. First, the child was asked to describe the setting and characters, and then the clinician recapped the child’s introduction including all missing relevant information. The clinician then elicited an initiating event with a verbal prompt such as “Oh no! What do you think might happen in our story?” The child then stated a possible initiating event. The clinician highlighted the “problem” and then gave a verbal prompt to elicit a possible resolution. The child stated a resolution, and the clinician then recapped the problem and resolution pair. If the child failed to generate an initiating event, the clinician provided the child with options to allow for story co-construction (Merritt, Culatta, & Trostle, 1998). After the child’s first attempt at generating the story, the clinician (or child when possible) drew stick drawings of the events in a storybook. There is some evidence that “pictography” helps to increase the length and temporal complexity of children’s narratives (Ukrainetz, 1998). The child then retold the entire story to the examiner a second time using the storybook as a guide. To elicit the story the second time, the clinician first asked, “Let’s see, what do we have to say first?” The child then might have said, “We have to say who the story is about.” The clinician would have responded, “That’s right. We have to talk about the people/characters.” If at any step the child failed to identify the next component to discuss, the clinician attempted to prompt a correct response. As the child described each story component, the clinician “recapped” and then prompted for clarification, more events, and/or more elaborate syntax as in the retelling task (Hoffman et al., 1990). In story generation, the clinician recast the child’s grammatical, phonological, and semantic errors. The child’s weekly target story component (e.g., a complication in a problem-resolution pair) was given extra attention by stating how the child’s production of the target component contributed to the story plot. After the second retelling, the clinician recorded the child’s utterances (i.e., one or two sentences per illustration) in the storybook. These sentences were recorded after the second attempt so the child would produce multiple sentences per picture during the generation task (see Appendix C  for an example of the story generation task).
Repeated retellings.
At the end of the session, the child received a copy of the story and corresponding illustrations from the story retell-imitation task and the storybook from the story generation task to practice telling at home, preferably to someone who had never heard the stories.
Postexperimental Session
Each child was seen for a 1.5-hr postexperimental session to collect the following outcome measures: narrative (NDW, NQ), syntactic (DSS), and measures that tap working memory (RS, NWR). The individual who elicited the narrative samples (“Blackie” and “Hammie”) from each child was an unfamiliar adult who was never present during the NBLI procedures. Therefore, the narrative measures, which were based on “Blackie” and “Hammie,” were collected by a different person than the intervention agent. The other measures (DSS, RS, NWR) were collected by the same individual.
Transcription of Samples
Three of the authors and two trained graduate research assistants transcribed the conversational samples, narrative samples, and nonword productions. Conversational and narrative samples were scored at the completion of all intervention and testing sessions for all children by the second author using the DSS module of Computerized Profiling (Long, Fey, & Channell, 2002). This scorer was blind to all details of the children’s profiles and the session at which each sample was collected. Story narratives were transcribed using SALT (Miller & Chapman, 2000) conventions. The samples were scored for NQ rating and NDW. Finally, the online scoring of the RS subtest was verified by listening to the audiotape.
NBLI Training
The fourth author was trained in the administration of all assessment procedures. Prior to conducting preexperimental assessment sessions, she performed practice sessions on at least 3 children (chronological age = 6-9 years) with language impairments. She also was trained in the administration of all treatment procedures by the first author. Prior to conducting treatment sessions, the fourth author listened to three audiotaped NBLI treatment sessions. After listening to each tape, the first and fourth authors discussed the strengths and weaknesses of each session, and the latter then conducted six practice sessions with children (chronological age = 6–9 years) with language impairments. These sessions were videotaped and critiqued by the first author.
Reliability
The two graduate research assistants who helped transcribe the original samples randomly selected 20% of the total number of samples (4 conversational, 4 narrative, and 10 “Hammie” and “Blackie” story productions) to retranscribe for reliability purposes. All retranscriptions took place approximately 3 months after the samples were originally transcribed. The original and reliability transcripts were first compared on a word-byword basis. Percentage word agreement was calculated by dividing the total number of words in agreement by the total number of words in the original transcript. The percentage agreement ranges (means) for the conversational, narrative, and story samples were 76%–97.2% (90.1%), 88%–97.4% (93.2%), and 86%–100% (94%), respectively. The conversational sample marked at 76% agreement was attributed to the child’s poor intelligibility. The first author, who conducted the session and was familiar with the child’s articulation patterns, originally transcribed this conversational sample. When comparing the original and the reliability transcripts, it was clear that the original transcript was more accurate than the reliability transcript for each of the word discrepancies.
After the assistants transcribed all pre- and postexperi-mental samples, they de-identified them and reassigned a random number to reduce potential bias during analyses of all the narrative and conversational files. The second author used the DSS module of Computerized Profiling (Long et al., 2002) to perform a developmental sentence analysis (Lee, 1974) on all 40 files. The third author randomly selected and independently scored 8 (20%) of the files. The “compare DSS files” utility in Computerized Profiling was used to compute percentage agreement between the original and reliability files. This module scores all disagreements of point or category assignment as errors. In some cases, errors are double coded in this procedure. Output was checked to identify instances of double coding, and agreement scores were adjusted accordingly. These changes were always less than 1% of the total agreement. Agreement ranged from 91.6% to 98.6% (M= 97.25%).
The average absolute difference between means for scores of the two judges was 0.19 DSS points (SD = 0.10). Expressed as a proportion of the total score of the original scorer, this is an average difference of 2%.
The second author calculated the NQ rating of the “Hammie” and “Blackie” stories produced during pre- and postexperimental sessions. A graduate research assistant then randomly selected and independently calculated NQ ratings for 10 (20%) of the story samples. Correlation between the two NQ rating scores fell at r = .81. Differences between NQ ratings were discussed, and changes were made to the second author’s ratings, where necessary, while he was still blind to participant and time of sample. These adjusted ratings were then used for the final analyses.
Statistical Design
All participants took part in the intervention, and effects were measured by comparing the pre- and posttest data, using resampling techniques and randomization tests (see Lunneborg, 2000, 2002, for randomization procedures). Data from the study of Fey et al. (2004)  served as the basis for determining the clinically significant criterion levels, or a meaningful response to therapy, for NDW and NQ. In the study of Fey et al., narrative production was studied longitudinally from second to fourth grade in a group of children with SLI. The criterion for significant change for this study was based on the upper limit of the 95% confidence interval reached by children with SLI in the study of Fey et al. For NDW, this reflected a gain of 11.63 words and a gain of 1.45 points for NQ. Approximately 40% of the children with SLI in the study by Fey et al. achieved gains of this magnitude. Therefore, the probability of a single child achieving such a gain by chance was estimated at .4. The binomial probability of finding 7/10 children (or more) of meeting either criterion by chance was .055, and the probability of 8 children reaching the criterion was less than .014. Criterion-level gains by these numbers of children would add to clinical significance of statistically reliable group gains. No such criteria were set for the other measures.
Results
Eight of 10 children with SLI made the clinically significant improvement criterion of 1.45 points for NQ (binomial probability of chance occurrence, p < .014), while only 1 met the criterion of 11.63 words set for NDW. Across both stories, the average gain for NDW and NQ was 2.35 words (range = −0.5–5.5) and 2.7 points (range = −24.5–25.5), respectively. Using a resampling test, the probability associated with a value of 2.7 is p = .0126. Thus, a score of 2.7 is a very unlikely event. Pre- and posttest scores as well as pre-post gain for NQ and NDW scores for each participant are displayed in Figures 1 and 2, respectively.2 
Mean DSS pre- and posttest scores for conversational (M = 8.63, SD = 1.82, and M = 8.62, SD = 1.78, respectively) and narrative (M = 9.17, SD = 1.48, and M = 9.22, SD = 2.21, respectively) samples showed little to no positive change. Although gains in DSS were nonsignificant, the correlation between the pre-post narrative samples was .74. The same correlation for the conversational samples was .2. The relative stability of scores for the narrative samples suggests that they may be a reasonable choice for future work. Pretest and posttest narrative samples ranged from 57 to 140 (M = 89.9, SD = 26.02) and 54 to 195 (M =103.6, SD = 37.52) total utterances, respectively. All utterances could not be scored with DSS.
FIGURE 1.

Mean preexperimental, postexperimental, and pre-postgain in narrative quality (NQ) rating for each participant. NQ is a rating of narrative macrostructure developed by Fey et al. (2004) . Ratings are based on the participant’s production of two oral narratives collected during pre- and postexperimental sessions.

Mean preexperimental, postexperimental, and pre-postgain in narrative quality (NQ) rating for each participant. NQ is a rating of narrative macrostructure developed by Fey et al. (2004). Ratings are based on the participant’s production of two oral narratives collected during pre- and postexperimental sessions.
FIGURE 1.

Mean preexperimental, postexperimental, and pre-postgain in narrative quality (NQ) rating for each participant. NQ is a rating of narrative macrostructure developed by Fey et al. (2004) . Ratings are based on the participant’s production of two oral narratives collected during pre- and postexperimental sessions.

×
Sentence imitation scores indicated a slight positive gain (M = 1.22, SD = 1.56), but this gain is well within the standard error of measurement for this task and probably can be attributed to regression toward the mean. For the final measure (NWR), the children showed no gain (M = −0.33, SD = 7.4), as was predicted.
Discussion
The purpose of this study was to test the feasibility of NBLI and gain insights into the ability of NBLI to affect positive change. The design was nonexperimental, so conclusions regarding efficacy would be premature. For example, most of the children made clinically significant changes on the NQ outcome measure; however, it remains unclear whether these changes were the direct or indirect result of NBLI. Our intention was not to produce a definitive study of efficacy but to determine whether indications of positive outcomes were sufficient to warrant more rigorous experimental evaluation of the NBLI approach.
Gains in NQ
A primary finding was a statistically reliable change in the children’s NQ following intervention. Furthermore, 8 of 10 children exceeded the clinically significant improvement criterion for NQ following participation in NBLI. Finally, the average posttest scores of our participants were roughly equivalent to the estimated population mean for fourth-grade children in the study of Fey et al. (2004) . Thus, it appears reasonable to adopt an NQ performance criterion within the typical range as a future measure of the clinical significance of the effects of interventions such as NBLI for children such as those participating in this study. Following NBLI, participants in this study were capable of producing narratives that typically contained a setting with items that were not observable, characters with names, a simple plot, an ending that extended beyond the resolution, and emerging use of the language of literacy (as described in Appendix A). These gains are consistent with previous studies that found narrative- or literature-based intervention can be effective in enhancing the narrative skills of children with SLI (Gillam et al., 1995; Hayward & Schneider, 2000; Klecan-Aker, 1993; Klecan-Aker et al., 1997). With the use of adult prompts, all story grammar components were included in the participants’ retelling and story generation attempts. Most participants could spontaneously name which story component “came next” by session 10. A few children, however, nevermastered the names of some of the story grammar parts.
FIGURE 2.

Mean preexperimental, postexperimental, and pre-post gain in number of different words (NDW) for each participant. NDW is based on the participant’s production of two oral narratives collected during pre- and postexperimental sessions.

Mean preexperimental, postexperimental, and pre-post gain in number of different words (NDW) for each participant. NDW is based on the participant’s production of two oral narratives collected during pre- and postexperimental sessions.
FIGURE 2.

Mean preexperimental, postexperimental, and pre-post gain in number of different words (NDW) for each participant. NDW is based on the participant’s production of two oral narratives collected during pre- and postexperimental sessions.

×
No Gains in NDW
Nine of the 10 children failed to achieve the improvement criterion set for NDW. There are several explanations for the lack of group effect for NDW. First, during the pretest, the children engaged in a lot of descriptive behavior when asked to generate narratives, which resulted in an inflated NDW. In contrast, during posttesting, they attempted to generate a story, which resulted in a more representative, reduced NDW. For this reason, NDW may not be a sensitive measure of gains in narrative skill (see also Botvin & Sutton-Smith, 1977). Second, during posttesting, a couple of the children were more savvy test takers. These children seemed to tell short stories to have their work completed. Third, the picture sequences in the narrative task may have affected the children’s ability to be productive. The picture sequences do not involve familiar, everyday events, and in the case of “Hammie,” the problem-resolution pair is quite abstract, possibly resulting in a floor effect. Fourth, 1 child (S3) was ill during the postexperimental session and was noncompliant during the majority of the session. Unfortunately, his postnarratives were not indicative of his performance throughout the study. In future work, other measures from other story-telling procedures should be evaluated. For example, Gillam and Pearson (2004)  have introduced a standardized narrative battery with strong psychometric properties. The oral narration standard score from this battery may be more desirable as a pre-post measure than NDW.
No Gains in Syntactic and Working Memory Outcome Measures
Pre- and posttest comparisons indicated no significant gains for any of the nonnarrative outcome measures (DSS, RS, NWR). Recall that improvement was predicted for DSS and especially RS, but not for the NWR task. There are several possible reasons for the lack of significant gains for RS and DSS. The most straightforward explanation is that the children did not improve in grammar because the treatment was too short. There was no evidence of improvement in the children’s syntactic skills (RS, DSS). Another possibility is that DSS may have been affected by variability in the length of the language samples (conversational and narrative). On occasion, the length of the pre- and postconversational and narrative samples differed significantly within individual participants. Furthermore, for some children, the narrative samples barely met the minimum of 50 complete utterances for the DSS analysis. Both of these factors could have masked gains in syntactic complexity.
Third, DSS gains may have been affected by the content of the narrative samples, which seemed too difficult for our participants. The children were asked to tell about their favorite fairy tales, books, cartoons, TV shows, and movies. Although children could retell familiar fairy tales, they had difficulty retelling a movie plot or specific TV episode, as these items were often too abstract, complicated, or difficult to remember. When confronted with this task, children simply described each of the characters or one main event in the movie or TV show. This observation is consistent with that of Preece (1987), who found that retelling a narrative based on a visual media source is more difficult than retelling one based on a print source. When retelling a narrative based on visual media, the child must impose “structure, sequence and causation upon the visual images they had seen in order to tell others about them” (Preece, 1987, p. 361). Preece observed that children’s retelling of narratives based on visual media usually consists of highlighting something funny or scary. Other researchers also describe limitations in eliciting narratives from movies (Baggett, 1979) and TV episodes (Scott as cited by Scott, 1988). Typically developing children cannot retell an entire movie or TV show until 7 to 9 years of age (Abrams & Sutton-Smith as cited in Botvin & Sutton-Smith, 1977). In summary, it appears that despite its stability across testings, DSS based on fictional narrative samples following Leadholm and Miller’s (1992)  protocol is a less than optimal procedure for evaluating gains in grammatical expression.
The lack of gain on the NWR task was not unexpected. Although NBLI requires careful auditory-verbal attention and SI, it does not target phonological working memory skills directly. The minimal gain on the RS subtest, which probably reflects regression toward the mean, was a bit surprising. Evidently, our 6-week program was too short to capture gains in syntax or attention on the RS subtest.
Attention and Learning
During the course of NBLI, participants were confronted with “explicit” narrative targets and “implicit” grammatical targets. Although NBLI contains a short SI task, the bulk of grammatical learning is expected to occur incidentally. Given the limited processing capacity (e.g., see Leonard, 1998, for a review) of children with SLI, it is not surprising that our participants failed to make gains on the implicit grammatical targets infused in training and nontraining activities. Recall that both measures of syntax (DSS and RS) showed nonsignificant pre- and posttest comparisons. Participants’ attentional resources appeared to be focused on the explicit teaching of narrative structure as shown by the significant findings for NQ. They seemed to have few attentional resources for the incidental learning of grammatical targets (J. Montgomery, personal communication, December 20, 2004). These findings speak to usefulness of NBLI in teaching narrative structure but its current limitations with regard to syntax.
In a recent study, Marton and Schwartz (2003)  found that children with SLI have difficulty with simultaneous processing and attentional capacity. During their second Modified Listening task, participants were asked to listen to a sentence ending with a nonsense word. Participants were then asked to repeat the nonsense word and answer a question about the sentence. Children with SLI performed more poorly than their typically developing peers due to the simultaneous processing demands of the task. On their list recall task, children with SLI had difficulty suppressing irrelevant information as shown by their interference errors.
Results of the present study corroborate the findings of Marton and Schwartz (2003) . Children with SLI failed to master syntactic targets provided incidentally within the context of two “explicit” narrative tasks due to their limited processing resources. Future research is needed to determine whether children with SLI can master implicit grammatical targets during an extended period of NBLI (8-12 weeks) or a sequence of FFW–L (6 weeks) followed by NBLI (6 weeks). Perhaps NBLI will need to be modified to enhance the salience of the grammatical targets.
Feasibility and Acceptance of NBLI
Throughout the NBLI program, the children were informally observed to show increased self-confidence in their narrative production skills. Participants learned that they had “good ideas” and that their ideas would be valued. Participants also learned that they could be entertaining (i.e., produce scary or funny stories). As the children’s self-confidence increased, they also seemed to talk louder and use better eye contact. They showed an increased number of initiations during conversation and an increased willingness to share story plots. Finally, at least 2 of the participants were able to recognize when another person’s story lacked a problem, adequate characters, or some other element of story grammar. They were eager to tell the clinician when they had noted the error in a peer or a younger sibling and appeared excited to have learned and generalized this skill.
The children’s willingness to participate in the tasks (story retell-SI, story generation) was assessed throughout the study. Nearly all of the children enjoyed the story generation task more than the story retell task. They liked the story generation task because they could talk about their own experiences, knowledge, and interests. The story generation task also was less intimidating because the children did not have a specific story they were supposed to replicate. All of the participants “tolerated” the SI task. When they became bored with it, the prompts and extrinsic reinforcers (check marks and stickers) made the task more appealing to them. The repeated retellings worked very well during the story generation task. With each retelling the child’s story became more elaborate. The language produced during the story generation task was natural. Use of repeated retellings during the story retell task resulted in language that was a bit contrived. This is an obvious trade-off when using basalized stories.
Quality of Syntax Stories
Use of syntax stories allowed for low frequency, often optional, syntactic forms to occur with greater frequency during the intervention session. The number of targets per story (i.e., 10 to 19) seemed appropriate. Stories that captivated the children were those that focused on everyday events (e.g., bad haircut, and lack of “cool” clothes). After the clinician introduced a familiar theme, the children would frequently recall a similar personal experience (i.e., when they had a bad haircut). The few stories that appeared to be boring or confusing to the children, and those that contained vocabulary and figurative language terms that are outdated or too advanced, will be modified or replaced before future investigations.
Modified NBLI
Based on the present findings, the NBLI procedure will be modified in several ways. First, a couple of the NBLI stories, which did not maintain the children’s attention, will be modified. Second, the modified NBLI procedure will contain more reasons to retell the stories and more opportunities for reenactments (e.g., Merritt et al., 1998). Third, to facilitate recall of the story grammar components, each part of the story will be represented by an icon, which follows the general approach of the story grammar marker (Moreau & Fidrych, 1998). Finally, the most significant changes will be in the outcome measures. A narrative language abilities index will be derived from the Test of Narrative Language (Gillam & Pearson, 2004) and serve as one primary outcome measure. The production portion of this index is based on one story generated from a sequence of six pictures (“Late for School” sequence), a second story generated from a single illustration (“Aliens”), and a third story (“McDonald’s” story) that is retold by the child. DSS and NQ will be included as primary measures but will be based on fictional narrative samples generated completely from nonvisual media sources, rather than following the procedure of Leadholm and Miller (1992) . In this way, adequate samples will be collected for DSS and NQ analyses. Narrative samples appear to be better than conversation samples because of their test-retest stability, despite the difficulty in obtaining samples sufficiently long enough for syntactic analyses.
Limitations of Study
There are several limitations to the present study. First, the lack of a control group prevents any conclusions that can be made regarding the efficacy of this approach. We refer to this as a “feasibility study” with the full awareness that it provides an indication of positive outcomes that must be tested using more rigorous experimental procedures. It cannot stand alone as a definitive measure of the efficacy or effectiveness of NBLI. Consequently, this intervention approach is “not ready for prime time.” Second, the number of children in the “intervention group” was small (N = 10), and they were somewhat heterogeneous. Third, the intervention period (6 weeks) was short, and some of the children were receiving other speech-language services from their public school clinicians, which may have confounded the outcome. Given the intensity of the NBLI program compared with the limited services provided by the school clinicians, however, this case is very unlikely. Fourth, long-term follow-up data were not collected; such data might have shown subsequent gains made by the children. Finally, many psychometric properties of the Fey et al. (2004)  narrative task are unknown. In particular, information on the test-retest reliability of this instrument is needed to make accurate interpretations of the present data.
Conclusion
This study examined the feasibility of NBLI, which focuses on narrative content and form using skills-based and naturalistic (interactive, meaning-based) activities. Our findings indicate that NBLI is well accepted by second-grade children with language impairments. Participants made statistically and clinically significant changes in the NQ of their story compositions, which could be the result of their participation in NBLI. Experimental investigations must be undertaken to demonstrate this possibility. NDW, DSS, RS, and NWR scores did not change over the 6-week intervention period. Methods for enhancing the NBLI materials and procedures were discovered, as were possibilities for future outcome measures. Given the tremendous need for this type of intervention program, further study of NBLI is warranted.
Acknowledgments
This project was funded by the Bamford-Lahey Children’s Foundation. The authors thank Jim Montgomery, Teresa Ukrainetz, and an anonymous reviewer for their insightful comments. We thank Abigail Pfeiler and Stacey Walter for their assistance in creating the novel stories and conducting data analyses. We are grateful to Barbara Culatta for her many valuable contributions and Tim Meline for his statistical expertise. We also thank the following students who assisted in countless ways: Rebecca Ensminger, Jennifer Jones, Ashley Little, Cara Prall, Sarah Rice, Mary Katherine Shay, and Erin Tully. Finally, appreciation is extended to the children and their parents who made this study possible.
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Ukrainetz, T. A. (1998). Stickwriting stories: A quick and easy narrative representation strategy. Language, Speech, and Hearing Services in Schools, 29, 197–206. [Article]
Ukrainetz, T. A. (1998). Stickwriting stories: A quick and easy narrative representation strategy. Language, Speech, and Hearing Services in Schools, 29, 197–206. [Article] ×
Narrative Quality
Narrative quality is a rating of the characters, physical setting, plot development, ending, and language sophistication of a child’s narrative production. Each component is rated on a scale of 0–3, with the exception of plot development, which is on a scale of 0–6. Criteria for scoring “character” are based on the degree to which the character is defined (i.e., personality traits, family relations, etc.) and described in relation to the story’s plot. Criteria for scoring “setting” are based on the description of the time, place, location, or physical conditions in relation to the story’s problem or resolution. The “plot” of a story may contain no episodic structure (0–2 points), a single problem-resolution pair, with or without complications (3–4 points), or multiple problems and more complex organization (5–6 points). Ending scoring criteria are based on the degree to which the story concludes with a phrase, a summary of the plot, or the moral or future actions of characters in the story. Language sophistication reflects the degree to which a child successfully uses complex language (i.e., postmodification of nouns, clause initial adverbial phrases, appositives, repeated words for stylistic effects, quotations, idioms, metaphors, and similes). Scores from each component are added, yielding a total score from 0–18 points (see Fey et al., 2004). Scores calculated based on this procedure may reflect an ordinal scale.
Example of Novel Story and Sentence Imitation Task
“Bad Haircut”
Goal: subordinate clauses
Main idea: This story is about a boy who got a bad haircut.
Prompt: Have you ever had a bad haircut before?
Once there was a boy named Matt. Matt liked to be like everyone else. He wore the same clothes his friends wore. He talked like his friends talked. He even walked like his friends walked.
One day, Mart’s hair was getting very long, so he went to get a haircut. His old hair cutter was busy, so he got in the next chair. When the new hair cutter was finished, Matt looked in the mirror. He was shocked to see his new hairdo! It looked very funny, because it was spiked in the front and the back! Matt hated the haircut, because it was so different.
The next morning, Matt decided not to go to school. He was embarrassed by his hair, so he just wanted to hide. He said, “Mom, I’m sick, so I can’t go to school.” But Matt’s mother was not fooled. “Good,” she exclaimed. “If you stay home, you can help me clean the house.” Matt did not like to clean house, so he went on to school.
On the way to school, Matt got a great idea. “If I joke about my own hair, I can laugh along with the other kids.” And that’s just what he did. When Matt got to school, he walked right up to his friends in the hallway. Everyone seemed to stare at his hair. “Oh, you noticed my hair,” Matt said. “It went wild when I saw a ghost in my room last night. Now, I just can’t get it to go back to normal.” Everybody started to laugh, including Matt.
Then, one of Matt’s friends told him that he thought his hair was really different. He thought it was cool. So did everyone else. Everyone wanted to know who cut his hair! When Matt told them, they got their hair cut there, too. Soon, lots of kids had haircuts, just like Matt’s.
After that day, Matt never worried about being different. And he never worried about a bad haircut either. The End.
Examples from the Sentence Imitation Task Instructions: “That story had some long sentences that are kind of tricky. Let’s practice saying some of those sentences.” He talked. His friends talked.
He talked like his friends talked.
Prompt: How do you and your friends talk? What are some popular words right now?
(One day,) Matt’s hair was getting very long. He went to get a haircut.
(One day,) Matt’s hair was getting very long, so he went to get a haircut.
Prompt: Where do you get your haircut? How often do you go?
The new hair cutter was finished. Matt looked in the mirror.
When the new hair cutter was finished, Matt looked in the mirror.
Prompt: What did the haircutter do to Matt’s hair?
It looked very funny. It was spiked in the front and the back!
It looked very funny, because it was spiked in the front and the back!
Prompt: Where’s a guy’s hair supposed to be spiked?
He was embarrassed by his hair. He just wanted to hide.
He was embarrassed by his hair, so he just wanted to hide.
Prompt: Where do you like to hide?
Note. Story targets are in bold type. No additional stress or emphasis was placed on the story targets as they were presented to the participants.
Note. Story targets are in bold type. No additional stress or emphasis was placed on the story targets as they were presented to the participants.×
Examples from the Sentence Imitation Task Instructions: “That story had some long sentences that are kind of tricky. Let’s practice saying some of those sentences.” He talked. His friends talked.
He talked like his friends talked.
Prompt: How do you and your friends talk? What are some popular words right now?
(One day,) Matt’s hair was getting very long. He went to get a haircut.
(One day,) Matt’s hair was getting very long, so he went to get a haircut.
Prompt: Where do you get your haircut? How often do you go?
The new hair cutter was finished. Matt looked in the mirror.
When the new hair cutter was finished, Matt looked in the mirror.
Prompt: What did the haircutter do to Matt’s hair?
It looked very funny. It was spiked in the front and the back!
It looked very funny, because it was spiked in the front and the back!
Prompt: Where’s a guy’s hair supposed to be spiked?
He was embarrassed by his hair. He just wanted to hide.
He was embarrassed by his hair, so he just wanted to hide.
Prompt: Where do you like to hide?
Note. Story targets are in bold type. No additional stress or emphasis was placed on the story targets as they were presented to the participants.
Note. Story targets are in bold type. No additional stress or emphasis was placed on the story targets as they were presented to the participants.×
×
Example Dialogue for the Sentence Imitation and Story Generation Tasks
Sentence imitation task proceeds as in the following example:
Story generation task proceeds as in the following example:
Footnotes
1All story materials for this task can be obtained at http://www.ku.edu/%7Esplh/research/catts1.html.
All story materials for this task can be obtained at http://www.ku.edu/%7Esplh/research/catts1.html.×
2Throughout the program, Participant 10 had difficulty completing the intervention activities. Not surprisingly, this child was unable to complete several of the posttest tasks. Based on the “intention to treat” principle, this child’s pretest scores were entered as the posttest scores when posttest scores were unavailable. This procedure is very conservative, but it avoids selection bias that can be created by eliminating children who do not follow an intervention protocol as planned.
Throughout the program, Participant 10 had difficulty completing the intervention activities. Not surprisingly, this child was unable to complete several of the posttest tasks. Based on the “intention to treat” principle, this child’s pretest scores were entered as the posttest scores when posttest scores were unavailable. This procedure is very conservative, but it avoids selection bias that can be created by eliminating children who do not follow an intervention protocol as planned.×
FIGURE 1.

Mean preexperimental, postexperimental, and pre-postgain in narrative quality (NQ) rating for each participant. NQ is a rating of narrative macrostructure developed by Fey et al. (2004) . Ratings are based on the participant’s production of two oral narratives collected during pre- and postexperimental sessions.

Mean preexperimental, postexperimental, and pre-postgain in narrative quality (NQ) rating for each participant. NQ is a rating of narrative macrostructure developed by Fey et al. (2004). Ratings are based on the participant’s production of two oral narratives collected during pre- and postexperimental sessions.
FIGURE 1.

Mean preexperimental, postexperimental, and pre-postgain in narrative quality (NQ) rating for each participant. NQ is a rating of narrative macrostructure developed by Fey et al. (2004) . Ratings are based on the participant’s production of two oral narratives collected during pre- and postexperimental sessions.

×
FIGURE 2.

Mean preexperimental, postexperimental, and pre-post gain in number of different words (NDW) for each participant. NDW is based on the participant’s production of two oral narratives collected during pre- and postexperimental sessions.

Mean preexperimental, postexperimental, and pre-post gain in number of different words (NDW) for each participant. NDW is based on the participant’s production of two oral narratives collected during pre- and postexperimental sessions.
FIGURE 2.

Mean preexperimental, postexperimental, and pre-post gain in number of different words (NDW) for each participant. NDW is based on the participant’s production of two oral narratives collected during pre- and postexperimental sessions.

×
TABLE 1.Standard scores of entrance criteria measures.
Standard scores of entrance criteria measures.×
Participant Sex Age Listening quotient Speaking quotient Spoken quotient K–BIT
1 M 8;2 88 70 75 88
2 M 8;9 91 76 82 88
3 M 8;7 112 76 82 111
4 M 6;11 91 70 85 99
5 F 6;11 85 82 77 110
6 M 7;2 100 88 76 86
7 M 7;8 88 76 70 87
8 F 8;3 88 91 72 106
9 M 8;5 94 64 68 92
10 M 7;1 94 76 83 86
Note. Age is listed in years;months. Listening, Speaking, and Spoken quotients are from the Test of Language Development—Primary: Third Edition. For all scores, M = 100, 1 SD =15. K–BIT = Kaufman Brief Intelligence Test.
Note. Age is listed in years;months. Listening, Speaking, and Spoken quotients are from the Test of Language Development—Primary: Third Edition. For all scores, M = 100, 1 SD =15. K–BIT = Kaufman Brief Intelligence Test.×
TABLE 1.Standard scores of entrance criteria measures.
Standard scores of entrance criteria measures.×
Participant Sex Age Listening quotient Speaking quotient Spoken quotient K–BIT
1 M 8;2 88 70 75 88
2 M 8;9 91 76 82 88
3 M 8;7 112 76 82 111
4 M 6;11 91 70 85 99
5 F 6;11 85 82 77 110
6 M 7;2 100 88 76 86
7 M 7;8 88 76 70 87
8 F 8;3 88 91 72 106
9 M 8;5 94 64 68 92
10 M 7;1 94 76 83 86
Note. Age is listed in years;months. Listening, Speaking, and Spoken quotients are from the Test of Language Development—Primary: Third Edition. For all scores, M = 100, 1 SD =15. K–BIT = Kaufman Brief Intelligence Test.
Note. Age is listed in years;months. Listening, Speaking, and Spoken quotients are from the Test of Language Development—Primary: Third Edition. For all scores, M = 100, 1 SD =15. K–BIT = Kaufman Brief Intelligence Test.×
×
Examples from the Sentence Imitation Task Instructions: “That story had some long sentences that are kind of tricky. Let’s practice saying some of those sentences.” He talked. His friends talked.
He talked like his friends talked.
Prompt: How do you and your friends talk? What are some popular words right now?
(One day,) Matt’s hair was getting very long. He went to get a haircut.
(One day,) Matt’s hair was getting very long, so he went to get a haircut.
Prompt: Where do you get your haircut? How often do you go?
The new hair cutter was finished. Matt looked in the mirror.
When the new hair cutter was finished, Matt looked in the mirror.
Prompt: What did the haircutter do to Matt’s hair?
It looked very funny. It was spiked in the front and the back!
It looked very funny, because it was spiked in the front and the back!
Prompt: Where’s a guy’s hair supposed to be spiked?
He was embarrassed by his hair. He just wanted to hide.
He was embarrassed by his hair, so he just wanted to hide.
Prompt: Where do you like to hide?
Note. Story targets are in bold type. No additional stress or emphasis was placed on the story targets as they were presented to the participants.
Note. Story targets are in bold type. No additional stress or emphasis was placed on the story targets as they were presented to the participants.×
Examples from the Sentence Imitation Task Instructions: “That story had some long sentences that are kind of tricky. Let’s practice saying some of those sentences.” He talked. His friends talked.
He talked like his friends talked.
Prompt: How do you and your friends talk? What are some popular words right now?
(One day,) Matt’s hair was getting very long. He went to get a haircut.
(One day,) Matt’s hair was getting very long, so he went to get a haircut.
Prompt: Where do you get your haircut? How often do you go?
The new hair cutter was finished. Matt looked in the mirror.
When the new hair cutter was finished, Matt looked in the mirror.
Prompt: What did the haircutter do to Matt’s hair?
It looked very funny. It was spiked in the front and the back!
It looked very funny, because it was spiked in the front and the back!
Prompt: Where’s a guy’s hair supposed to be spiked?
He was embarrassed by his hair. He just wanted to hide.
He was embarrassed by his hair, so he just wanted to hide.
Prompt: Where do you like to hide?
Note. Story targets are in bold type. No additional stress or emphasis was placed on the story targets as they were presented to the participants.
Note. Story targets are in bold type. No additional stress or emphasis was placed on the story targets as they were presented to the participants.×
×