Too young for meta? The use of shape coding, rehearsal and comprehension monitoring to treat oral comprehension deficits in a young school age child: a pilot study

Background: Previous studies have highlighted the resistance of receptive language impairment (RLI) to intervention. This is especially evident where interventions aim to treat oral comprehension deficits in children in the younger school age population. Current theories of oral comprehension impairments centre on deficits in underlying linguistic knowledge and/or deficits of specific or general processing. Objectives: The aim of this study was to identify the nature of oral comprehension deficits in 1 child with RLI (6:6, female) and to tailor an intervention package to treat those specific deficits. Methodology: A two-pronged treatment approach was used, that combined both metalinguistic interventions such as Shape Coding and metacognitive interventions such as Rehearsal strategies. The child was also taught to use Comprehension Monitoring strategies. A single case study design was employed, which compared treated and untreated targets pre/post therapy; with MLU scores pre/post therapy compared as a further control measure. Results: While outcome measures showed considerable improvement in the comprehension of treated targets within sessions, statistical analysis of pre/post-therapy assessment results did not yield statistically significant results. MLU and untreated controls remained unchanged. Qualitative data showed successful use of comprehension monitoring and rehearsal strategies within sessions, but these strategies were not observed to have generalized in situations outside of therapy. Conclusion: Although findings were not statistically significant, it was clear that gains were made on treated targets and strategies within sessions. A more in-depth study is required to understand why these gains did not generalize post therapy.