Investigation of meta-linguistic and meta-cognitive intervention to improve comprehension of coordinating conjunctions

Background: There is a limited evidence base available in the area of oral language comprehension for children with primary language comprehension difficulties, with existing research which demonstrates treatment effectiveness largely focusing on pre-school or older school age children. Objectives: This pilot study aims to investigate the efficacy of individually-tailored intervention and strategies to improve the oral comprehension skills of a child with primary language impairment aged 7 years 11 months. Methodology: This intervention centred on a meta-linguistic approach with strategies tailored to match deficits of the individual participating in the study. A single case study design was chosen due to the heterogeneity of the population under investigation, allowing specific grammatical targets to be identified and treated using shapes and colours (Shape Coding, Ebbels 2007) to make the grammatical rules of English explicit. Rehearsal and visualisation strategies were employed to help the participant with working memory challenges. Comprehension monitoring strategies were explicitly taught to facilitate the participant to recognise when and how to ask for help. Results: Non-parametric analysis comparing the child’s performance on pre and post assessment of treated and untreated measures demonstrated a statistically significant improvement (p=.008* 2-tailed) in comprehension of treated coordinating conjunction ‘neither/nor’ with no significant change in untreated structures. Spontaneous use of comprehension monitoring, and rehearsal and visualisation strategies were evident toward the end of therapy. Comprehension: These findings provide preliminary evidence to support the use of a two-pronged approach in treating oral comprehension of younger school-aged children with primary language impairment.