|Study Shows Variety of Approaches Help Children Overcome
Auditory Processing and Language Problems
For children who struggle to learn language, the choice between
various interventions may matter less than the intensity and format
of the intervention, a new study sponsored by the National Institute
on Deafness and Other Communication Disorders (NIDCD) suggests.
The study, led by Ronald B. Gillam, Ph.D., of Utah State University
is online in the February 2008 Journal of Speech, Language,
and Hearing Research. NIDCD is one of the National Institutes
The study compared four intervention strategies in children who
have unusual difficulty understanding and using language, and found
that all four methods resulted in significant, long-term improvements
in the children's language abilities. The aim of the study was
to assess whether children who used commercially available language
software program Fast ForWord-Language had greater improvement
in language skills than children using other methods. This program
was specifically designed to improve auditory processing deficits
which may underlie some language impairments. Children who have
auditory processing deficits can jumble the order of sounds that
are heard in close sequence. Researchers believe that this deficit
can interfere with vocabulary and grammar development.
"These results show that any of a number of intensive educational
approaches can make a tremendous difference for children whose
language and auditory processing skills are lagging," says
NIDCD director James F. Battey, Jr., M.D., Ph.D. "Even play
with peers seemed to support the improvements the children in this
"We had a very positive outcome," says Dr. Gillam. "Our
results tell us that a variety of intensive interventions that
we can provide kids will improve auditory processing and language
While most children are chattering easily by the time they are
toddlers, about 7 percent struggle to speak, read and understand
language despite having adequate hearing, intelligence and motor
skills. Children with language impairment have trouble learning
language or expressing their thoughts through language. They often
have difficulty learning new vocabulary words or sentence structures,
comprehending what's said to them, holding conversations, or telling
stories. These children tend to perform poorly on measures of auditory
processing and standardized tests of language development. Many
of these children are hindered academically throughout their formal
education, explains Dr. Gillam.
To address auditory processing problems, a different group of
language researchers developed the computer software package called
Fast ForWord-Language several years ago. The program uses slow
and exaggerated speech to improve a child's ability to process
spoken language. As children advance through the program, subsequent
language exercises use gradually faster and less exaggerated speech.
Dr. Gillam's team designed a study that would compare Fast ForWord-Language
to three other interventions. He and colleagues at the University
of Kansas, the University of Texas at Austin and the University
of Texas at Dallas enrolled 216 children in the trial. All were
between ages 6 and 9 and had been diagnosed with language impairment.
The children, from Northeast Kansas, Central Texas or North Texas,
were randomly assigned to receive one of four possible interventions.
In addition to Fast ForWord-Language, the trial included another
computer-assisted language intervention, an individual language
intervention with a speech-language pathologist, and a nonlanguage
academic enrichment intervention that focused only on math, science
The other computer-assisted language intervention, which used
Earobics and Laureate Learning Systems software, differed from
Fast ForWord-Language in not using slow or exaggerated speech.
Groups of children worked on the computer intervention exercises
at their own pace wearing headphones and supervised by a speech-language
Children assigned to the individual language intervention worked
one-on-one with a speech-language pathologist for the duration
of the trial. In their sessions, the children read picture books
that contained a variety of age-appropriate vocabulary words.
In the academic enrichment intervention, children worked on educational
computer games designed to teach math, science and geography. This
intervention was delivered in the same way as the language-focused
computer interventions. It served as a comparison group against
which the researchers could measure the results of the language
All of the interventions were delivered in an intensive, six-week,
summer program that also included day camp activities such as arts
and crafts, outdoor games, board games and snack time. The children
attended the program five days per week for three and a half hours
per day. They practiced their assigned interventions for an hour
and forty minutes each day. The children took a standard language
test — the Comprehensive Test of Spoken Language — and
completed a variety of auditory processing measures at the beginning
and end of the program as well as three and six months afterward.
The children in all four groups demonstrated statistically significant
improvement on the auditory processing measures and the language
measures immediately after their six-week program.
The children showed even greater improvement when their language
skills were tested again six months later. Even a subgroup of children
with very poor auditory processing skills made improvements on
the auditory processing tasks and the language measures. About
74 percent of children in the Fast ForWord-Language group made
large improvements on the language measures. Sixty-three percent
of children in the computer-assisted language intervention group
made large improvements. Of those who worked with a speech-language
pathologist, 80 percent made large gains, and in the general academic
enrichment group, almost 69 percent made large gains. These gains
are much larger than the improvements that have been reported in
long-term studies of children who have received language therapy
in public school settings.
The researchers were surprised that such a large percentage of
the children who worked on the math, science and geography computer
games improved their auditory processing and language skills. They
speculate that all the children may have benefited from the opportunities
to listen carefully, to decide on an appropriate response based
on what they heard, and to practice language skills with each other.
The recreation and play time built into each day of the six-week
program gave the children the chance to form friendships with peers
who were functioning at similar language levels.
The intensive delivery of the interventions — 500 minutes
per week — may also have benefited kids in every intervention
group. In comparison, school systems typically offer speech-language
pathology services to students with language impairment for 30
minutes twice per week.
"I urge speech-language pathologists to engage children with
auditory processing problems and language impairments in activities
in which they have to listen carefully, attend closely and respond
quickly, and to do it in an intense manner," says Dr. Gillam. "And
clinicians should provide children with ample opportunity to converse,
socialize and interact with kids at their same developmental level."
The language intervention trial was also supported by a grant
from the National Institute of Child Health and Human Development
(NICHD) to the Kansas Mental Retardation and Developmental Disabilities
Research Center at the University of Kansas. NICHD is also part
of the National Institutes of Health.
The NIDCD supports and conducts research and research training
on the normal and disordered processes of hearing, balance, smell,
taste, voice, speech and language and provides health information,
based upon scientific discovery, to the public. For more information
about NIDCD programs, see the Web site at www.nidcd.nih.gov.
The National Institutes of Health (NIH) — The Nation's
Medical Research Agency — includes 27 Institutes and
Centers and is a component of the U.S. Department of Health and
Human Services. It is the primary federal agency for conducting
and supporting basic, clinical and translational medical research,
and it investigates the causes, treatments, and cures for both
common and rare diseases. For more information about NIH and
its programs, visit www.nih.gov.