From a functionalist framework, language use, or pragmatics, is the overall organizing system of language (Owens, 2012). There is debate regarding the causal direction of the relation between pragmatics and the other aspects of language, form (syntax, morphology, and phonology) and content (semantics) (Gerber et al., 2012). Regardless of the cause of the pragmatic deficits observed in children with developmental language disorder (DLD), it is clear that children with DLD do, at times, experience negative social outcomes; thus, it is critical to develop interventions to facilitate social success for these children. Direct instruction on topic initiation and group entry behaviors has been found to be successful for children with deficits in these areas (Cirrin & Gillam, 2008).

A Bibliotherapeutic Approach

Brinton and Fuijiki (2019) define social communication as as the integration of language processing, pragmatics, and social and emotional learning (SEL). Language processing includes vocabulary and morphosyntactic skills. Pragmatics involves communicative intent and the use of conversational rules. SEL, termed social interaction by some, involves knowledge of the social and emotional context of communication. Given the need for children to integrate these constructs when interacting with others, Brinton and Fujiki advocate for targeting all three of the areas simultaneously. They highlight the importance of providing intervention in an authentic context, which has the following components.

• A real connection is formed between participants
• Real information is shared
• Language processing, pragmatics, and SEL are integrated
• The activity could happen in a typical day for the child

One authentic context in which to provide intervention is the context of story sharing. Brinton and Fujiki (2019), noting that many school-based SLPs see children for 20-minute sessions, suggest a plan-do-review format for sessions. The plan portion of the session can take 1-3 minutes, the do portion can be provided in 12-16 minutes, and the review can be completed in 3-4 minutes. The plan consists of an overview of session activities and goals, and may refer back to concepts explored during a previous session. The do portion is the story-sharing activity. During the review segment, the clinician facilities the child’s completion of a journal entry about the new concepts learned in the story-sharing. The clinician can write this to dictation if needed, but the child should add words or drawings as well.

Storybooks should be developmentally appropriate for the child, and should contain language that the child can understand. The books should emphasize emotion knowledge with characters experiencing and managing emotion in familiar situations and contexts. Engaging illustrations, interesting plots, and clear story structure help keep the child’s attention.

Once a book has been selected, the SLP identifies the social-emotional, pragmatic, and language concepts incorporated in the story. Lesson plans for several storybooks have been provided here.

These plans are meant to be used as a guide, rather than rigidly followed. Following the story-sharing using the prompts described in the lesson plans, or using similar self-designed prompts, children enact the stories. The enactment is followed by the review journaling.

Narrative Production Approaches

Narratives are important for both academic and social success (Westby & Culatta, 2016). Narration has been incorporated into the Common Core State Standards (CCSS; National Governors Association, 2010). Intervention targeting narratives, particularly those focusing on repeated story retellings and narrative macrostructure, facilitate improvement in narrative macrostructure and microstructure (Petersen, 2011). Microstructure of a narrative refers to the morphosyntactic and semantic elements of a story, such as use of bound morphemes, complex syntax, and lexical diversity. Macrostructure of a narrative refers to organization, cohesion, and genre-specific elements.

A number of programs have been designed for narrative intervention. One such program is Supporting Knowledge in Language and Literacy (SKILL; Gillam & Gillam, 2017). This intervention is based on the premise that the cognitive-linguistic structures that underlie narration are important for improving the ability to recall key information from text, create stories with cohesive and coherent complex structures, and use metacognitive skills to integrate text with prior knowledge. SKILL is delivered in three phases: Phase I: Explicit instruction of Story Elements and Causal Connections, Phase II: Elaboration, and Phase III: Independent Storytelling.

During Phase I of SKILL, the story grammar elements are introduced in the context of wordless picture books. Next, each story grammar element becomes the focus of an individual lesson. Lessons on before and after are also included. Following the individual lessons, the students retell stores with and without cognitive supports, which include verbal supports, icons, pictures, and graphic organizers. During the next lessons, the students create, retell, and edit their own stories with the same cognitive supports. This is termed parallel storytelling. Pictographic supports, which consist of drawing stick pictures to aid in the retelling, created and put into a graphic organizer, called a storyboard, which includes all of the elements of story grammar in sequential order. Next, literature is used containing the story grammar elements that were learned. Students focus on vocabulary, parallel storytelling, and retelling of the literature. Phase I concludes with students answering factual and inferential questions about a story without cognitive supports. In order to graduate to Phase II, children must pass an exit test that demonstrates their ability to identify, define, and give examples of each of the story grammar elements; create their own story using all of the story grammar elements; and answer comprehension questions about the story grammar elements after hearing a story.

Phase II of SKILL is comprised of 16 lessons targeting the skills needed for developing elaborate, cohesive, complex stories. Lessons cover coordinate and subordinate clauses, metacognitive and metalinguistic verbs, causal language, adverbs, and elaborated noun phrases. Dialogue is introduced during this phase. Inclusion of a complicating event, which interferes with the character’s achievement of a goal, is highlighted to promote the inclusion of multiple events within the story to increase story complexity. As in Phase I, the concepts of focus in Phase II are first targeted in wordless picture books, and literature is used at the end of the phase. Exit testing is conducted to assess students’ ability to generate stories with clear causal referents between story grammar elements and use complex language, which includes metalinguistic or metacognitive verbs, adverbs, and elaborated noun phrases.

The aim of Phase III of SKILL is to develop the metacognitive skills required for independent storytelling and narration, including understanding and using causation, as in if-then statements is a focus of Phase III, and students are taught to use the an editing rubric.

Story Champs (Spencer & Petersen, 2016) is another narrative intervention program that has been shown to be effective for the development of narratives. This program consists of icons representing the following aspects of story grammar: character, setting, problem, feeling, action, ending, and end feeling. The clinician first models telling the story, placing the icon representing the story grammar element on the picture containing that element. Students are then given 1-2 icons each, and tell the part of the story that is represented by their icons. Next, children individually retell the story while the other children play “story games” in which they indicate the story grammar element as it is produced. Next, students are asked to tell a personal story related to the story. Finally, students work together to generate a fictional story containing all of the story grammar elements. The clinician draws the story in stick figures on the board, and then when the whole story has been generated the children take turns retelling it. In addition to being an effective intervention method for oral narration, the use of Story Champs, delivered orally, has been effective for improving students’ writing (Spencer & Petersen, 2018). As noted in the introduction to the intervention section of this book, Story Champs is an effective intervention to use in RtI or MTSS frameworks.

The following videos demonstrate the use of Story Champs in a small group. 

The following video demonstrates the use of Story Champs in a large group.

Westby and Culatta (2016) highlight the importance of telling personal narratives for social interaction. They focus on two types of personal narratives: personal event narratives and life stories. Personal event narratives are stories about one’s own experiences. Life stories refer to integrated combinations of personal event narratives that form a cohesive whole. Westby and Culatta recommend the following strategies to facilitate development of personal event narratives. First, encourage reminiscing. It is important that the SLP has shared in the experience with the child so that the SLP can scaffold the story and assess accuracy. For school-based SLPs, this could include school-wide activities, such as field day or an assembly. Past therapy activities are also topics about which the SLP and student can reminisce together, as they have a shared experience. Westby and Culatta also recommend using the movie Inside Out. In the following YouTube clip of the movie, one character explains another character’s core memories, which are represented by balls with different colors depicting different emotions. Clinicians can explain the concept of core memories to parents of their students, and request pictures representing the students’ memories. SLPs can purchase clear plastic balls that can be opened, place the pictures inside the balls, and have the children decorate the balls and share their memories with other children.

When students have demonstrated the ability to produce personal event narratives, SLPs can begin to facilitate the development of life stories. Westby and Culatta suggest four foci for helping students generate life stories. First, focus on physical and psychological traits of characters, and consider how these traits influence characters’ thoughts and behaviors. Westby and Culatta suggest that African animal stories by Mwenye Hadithi are good stories to use for this purpose, as these stories do describe the physical and psychological traits of the animal characters, and the traits clearly influence the thoughts and behaviors of the characters. Next, model turning points in books. Third, analyze and capitalize on thematic connections in books. Fourth, call attention to threads in biographies. For young children, the thread may be a temporal sequence. Older children may study biographies that depict the relation between a person’s nature and the course of the person’s life. 

For both personal event narratives and life stories, Westby and Culatta highlight the importance of focusing on functioning. All children, regardless of cultural background, need to be able to produce the type of narrative structure encountered in school, although cultural differences should be acknowledged and appreciated. SLPs also should address the processes that underlie narrative production. These include reminiscing, reflecting, establishing coherence, and conveying the plot structure. Finally, SLPs can support narrative performance by evoking and embedding personal narratives into conversations; involving the child’s parents; having the child tell stories that the SLP has scaffolded to others, such as a peer; and using authentic model texts.

Summary

Providing intervention for language use must be done in collaboration with the clients themselves, their families, and relevant others, including teachers. Naturalistic contexts, such as conversation, shared book-reading, or narration, are ideal for remediating difficulty with pragmatics.

References

Brinton, B., & Fujiki, M. (2019). Facilitating social communication in children with developmental language disorder: A bibliotherapeutic approach. Perspectives of the ASHA Special Interest Groups, 4(3), 532-537.

Cirrin, F.M., & Gillam, R.B. (2008). Language intervention practices for school-age children with spoken language disorders: A systematic review. Language, Speech, and Hearing Services in Schools, 39, S110-S137.

Gerber, S., Brice, A., Capone, N., Fujiki, M., & Timler, G. (2012). Language use in social interactions of school-age children with language impairments: An evidence-based systematic review of treatment.

Gillam, S.L., & Gillam, R. B. (2016). Narrative discourse intervention for for school-aged children with language impairment: Supporting knowledge in language and literacy. Topics in Language Disorders, 36, 20-34.

Spencer, T. D., & Petersen, D. B. (2016). Story Champs 2.0: A multi-tiered language intervention program. Laramie, WY: Language Dynamics Group. Retrieved from http://www.languagedynamicsgroup.com

Spencer, T. D., & Petersen, D. B. (2018). Bridging oral and written language: An oral narrative language intervention study with writing outcomes. Language, Speech, and Hearing Services in Schools, 49, 569-581.

Westby, C., & Culatta, B. (2016). Telling tales: Personal Event Narratives and Life Stories. Language, Speech, and Hearing Services in Schools,