These are some of the tools and approaches I use in speech-language therapy with my students with developmental language disorder
*free downloads below*
It's estimated that roughly two kids in every classroom have developmental language disorder (DLD). That's a lot of kids. While some of those kids may not have been identified yet, many of them are already on our caseloads.
A few years ago, I had one of those insights that changed the way I think about a large portion of the kids I work with. While doing some continuing ed on DLD, I learned something I had already known intuitively to some extent, even though I had never fully appreciated it: If a child is exhibiting a language disorder after the age of about 5, and there is no other biomedical reason for that language disorder, it is very likely to be DLD. And it is, therefore, likely to be a lifelong condition for that child. While the expectation is that these kids can still make good progress in their language skills, especially with good intervention, they will never "catch up" to the language skills of their typically developing peers.
Until I had that insight, I had been operating under the assumption that much of what I was seeing in my students could still be considered a "delay" and that it was possible that they'd catch up to have age-expected language skills if I did my job right.
This realization that DLD is ubiquitous and lifelong has caused a real paradigm shift for me. For 6 important facts every SLP needs to know about DLD, see this post.
Language is such a complex system that it can be tough to know where to start when it comes to intervention with students with DLD in speech therapy -- I know I have struggled with this! And as kids get older, their language demands and challenges get more complex and permeate nearly every facet of school: comprehending lessons and other information given by teachers, explaining concepts and ideas, participating in group discussions, reading, writing, and even socializing. There's really not much at school that DLD doesn't impact.
While the research is ever-evolving on the best ways to support our DLD students, I have found some meaningful intervention strategies for the therapy I do with my own students, given what we know about the typical DLD language profile.
Developing Strategies for the Classroom for Students with DLD
Part of my work with students with DLD is helping them to understand what their strengths and limitations are; I like to foster an ongoing, age-appropriate discussion with them about what their teachers and other educators can do to help make the language in their classrooms more accessible. I let them know that I am a person in their life who gets it, and who is there to support them. I also make sure we celebrate their many strengths!
This free checklist from the website DLDandMe provides a great starting point for these types of conversations. My students can tell me what helps and what doesn't, and I can then pass this information on to the educational team.
Syntax Intervention for Students with DLD in Speech Therapy
Research shows that syntax is a source of difficulty for all kids with DLD; understanding and producing complex sentence structures can be especially hard.
Complex sentences are sentences that contain one or more subordinate clauses. If you need a refresher on clauses, I made a free Quick Guide to Clauses for SLPs -- you can get it on the free downloads page.
One way to support our students' ability to generate subordinate clauses is recast therapy. Check out this cool study where SLPs led science lessons for children with DLD. They focused on providing models and recasts to encourage students to generate complex sentences by combining mental state verbs (I observe, I remember, I notice, I predict, I wonder, etc.) with a clause beginning with a subordinating conjunction (that, what, why, when, how, where) to describe what occurred during the lesson.
I haven't had the opportunity for this kind of collaboration yet, but I imagine it'd be pretty cool to push-in to a science class and try this out! And I'm making a concerted effort to model and elicit these sentence types in my therapy sessions.
For some other ideas about how I work on syntax/grammar/complex language formulation with my students, check out this post.
Morphology Intervention for Students with DLD in Speech Therapy
Morphology is another source of difficulty for students with DLD. Regular readers of this blog will know that I'm a big fan of teaching morphology to kids.
I've written several posts already about how I teach it:
For an overview of what morphology is and why we should be teaching it in speech therapy, check out this post.
For a cool activity I use when I'm teaching morphological awareness, check out this post.
For a fun, free morphological awareness game I made, check out this post.
And for some insight into transparent and opaque words (an important factor when teaching about morphology), check out this post.
Vocabulary Intervention for Students with DLD in Speech Therapy
While kids with DLD may or may not have well-developed vocabularies, it is generally accepted that they need many more exposures to novel words before they integrate those words into their lexicon.
Kids with DLD need an average of 36 exposures to a new word before learning it. (https://doi.org/10.1044/lle22.4.131). Kids with typically-developing language need 12 or less. Given this need for many more exposures to new words, word learning happens much more slowly for kids with DLD. This often leads to lower vocabulary skills overall.
I've found that a combination of tier 2 vocabulary instruction and increased morphological awareness has positively impacted my students' vocabulary. Reading is a huge source of novel vocabulary for kids too.
Here's a video of how I teach tier 2 vocabulary to my students.
Putting it All Together
There is no question that if we can focus on these language components (syntax, morphology, vocabulary) directly with classroom material, we can have a tremendous impact on our students' language skills. Teacher collaboration is easier in some settings and harder in others. If you're able to push-in, science and ELA classes provide good opportunities to focus on these skills. As an alternative, if teachers can share their curriculum and/or lesson plans, we can tailor our therapy activities to the language around these topics.
Here's an example of one of my past therapy sessions with two of my students with DLD. Their science unit was about the solar system and our sessions provided them with some fun opportunities to practice the words and concepts they were learning in a different context, outside of their classroom. They put their space suits on (as you can see, they were pretty high-tech -- who knew astronauts wear the same latex gloves SLPs use!), watched a video of a rocket launching, and then we went on a mission to find planets in the hallway-- er, I mean solar system.
Not all the settings we work in allow for this kind of collaboration, however. Perhaps teachers cannot provide curricular information in advance, or perhaps your therapy groups consist of students from different classes or grades.
For these situations, StoryWhys book companions provide a systematic way to target many of the skills kids with DLD need:
comprehension and use of tier 2 vocabulary
critical thinking and higher-level language comprehension and expression (categories, cause & effect, compare/contrast, main idea & details, problems & solutions)
perspective-taking/social inferencing with specific feelings/emotions vocabulary
comprehension of figurative language
morphological awareness
complex/compound sentence building
sequencing and formulation of organized narratives
Want to try a StoryWhys book companion for free? Get a FREE, 71-page book companion for speech therapy on the free download page.
And explore all of the StoryWhys book companions for speech therapy in my store. You'll find comprehensive book companions that target many different language skills (there are now over 15 of them!) or Spotlight Series book companions that focus on one type of skill, all using high-quality, beloved storybooks that you can find in your school library!
LEVEL UP YOUR SPEECH THERAPY ACTIVITIES WITH STORYWHYS
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Have you heard? StoryWhys now offers the Speech and Spell series of resources. I am always trying to tie articulation work and spelling together in my therapy and I've never found any good resources out there to help me do this. So I made my own! Many more speech sounds and spelling rules to come. They'll be 50% off for 48 hours when new resources are added to the StoryWhys store. Find them here.
Enjoy!
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