Primary language comprehension difficulties in a school aged child: a pilot study to test the efficacy of metalinguistic intervention

Background: Current research investigating effective interventions for receptive language comprehension deficits in children with a Specific Language Impairment (SLI) is limited to date. Many of these studies focus on preschool or older school-aged children. Furthermore, research has shown that working memory deficits and processing limitations can have a detrimental effect on language learning. Objective: The current pilot study aimed to investigate the efficacy of a metalinguistic and metacognitive therapeutic approach when treating receptive language comprehension deficits. Method: A controlled single case study design was utilised in a child aged 7 years 2 months with a diagnosis of SLI. The current pilot study aimed to investigate the efficacy of a combined intervention approach through the implementation of (a) Shape Coding, to explicitly teach syntactic rules, and (b) metacognitive strategies; rehearsal strategies and comprehension monitoring techniques, to improve working memory deficits. Baseline standardised assessment results and criterion-referenced test scores were used to select therapy targets. Pre and post-test measures of treated and untreated grammatical targets, and an expressive control were used as measures of effect. Results: Although post therapy scores reveal no statistically significant gains, in-session data indicates improved comprehension of syntactic structures during therapy. Qualitative investigation of in-session data revealed improvements in the child’s awareness during communication breakdown, but poor application of rehearsal strategies. Conclusion: While findings were not statistically significant, in-session data revealed that Shape Coding and explicit instruction can be effective for younger school-aged children with SLI. Qualitative data revealed that, although the child failed to utilise the rehearsal strategies, comprehension monitoring techniques can be an effective tool in enhancing metacognitive awareness, as indicated by performance related assessment. These findings should encourage further studies involving children with similar profiles and provide useful qualitative information on the nature of oral language comprehension difficulties.