Morphology

As reviewed by Kamhi (2014), children with language disorders do not necessarily have difficulty with the acquisition of all of Brown’s 14 early-developing morphemes, yet many SLPs focus on these 14 morphemes as a matter of course. The present progressive -ing, plural -s, and prepositions in and on do not usually cause difficulty for children with language disorders. In contrast, children with language disorders do demonstrate difficulty acquiring morphemes reflecting tense and agreement, which include third person singular -s, past tense -ed, auxiliary do and copula and auxiliary forms of be. Clinicians need to focus intervention on the specific morphological forms with which a given client is displaying deficits. Ebbels and Nicoll (2021) provided a free resource to help determine morphosyntactic targets here.

Morphological knowledge is comprised of morphological awareness, or the conscious manipulation of words into their roots and affixes, and morphological processing, which is the comprehension and production of words without conscious thought to, but influenced by, the root and affixes (Meaux et al., 2020; Nagy et al., 2014). Targeting morphological knowledge results in growth in a number of language domains. In the phonological domain, spelling and decoding are improved because English orthography is partially based on morphology. In the semantic domain, morphological knowledge also helps with accessing, inferring, and remembering the meanings of words, especially Tier III academic terms. Knowledge of morphology also helps with inferring the word class, or part of speech, of a word and its syntactic function (Nagy et al., 2014). Given that SLPs receive extensive training in language, they have an important role in collaborating with teachers to address morphological awareness at multiple levels of multi-tiered systems of support (MTSS) frameworks. Given that some teachers have not had explicit education in morphology, SLPs can provide professional development to teachers addressing morphology (Meaux et al., 2020).

Tier 1 Activities for Targeting Morphological Awareness

In Tier 1 of MTSS, the SLP can provide whole-class instruction in morphology. One activity for this purpose that can be used with kindergarten students is Thumbs-Up Storybook Reading. In this strategy, the SLP explains to the class that they are going to listen for words that have a certain sound or group of sounds at the end/beginning that means [the morpheme’s meaning] and give a thumbs up when they hear it (Meaux et al., 2020).

A Tier 1 strategy targeting morphological awareness for second graders is Word Sort. This activity helps students attend to the orthography by sorting cards with printed words into groups by morphemes that are spelled the same but pronounced differently, such as past tense –ed or third person singular –s. Progress-monitoring can be done by the SLP and classroom teacher by reviewing students’ writing samples and their spellings of words containing inflectional suffixes (Meaux et al., 2020).

A strategy for working on morphological awareness with fourth grade students is Vocabulary Journals. The SLP and classroom teacher can team-teach “word study” lessons, which should focus on Latin and Greek roots, given their prevalence. Word Building can be used in these team-taught lessons. In this activity, students receive color-coded index cards with prefixes, Latin roots, Greek roots, and suffixes. Students can manipulate the cards to create real and novel words and reflect on the meanings of the words and their parts, then write the words and their meanings into their Vocabulary Journals. The SLP and the teacher should highlight the importance of keeping the spelling of each morpheme in the word (Meaux et al., 2020).

Tier 2 Activities for Targeting Morphological Awareness

Word Construction Sites can be a great small group rotation to work on morphological awareness with kindergarten students. This activity is similar to Word Building, described above, but leveled down for kindergarteners. Students use word cards with root words and affixes to make new words. They then identify the word, ascertain the meaning, and explain how the root word relates to the newly constructed word. Storybooks that contain example of words with multiple morphemes can be used along with this activity to find the target words to construct (Meaux et al., 2020).

At the second grade level, Word Sums can be used as a Tier 2 activity. Building on morphological spelling conventions taught during a Word Sort, described above, students write out the parts of of the word, as in [prefix] + [root] → [word]. Then the students discuss whether a group of words containing multiple morphemes are related (Meaux et al., 2020).

For fourth graders, Word Segmentation can be delivered in Tier 2. The teacher should encourage students to write unfamiliar words in their vocabulary journal as they encounter them. Then students can be guided by the teacher, SLP, or a paraprofessional to segment the words into their roots and affixes, with direct teaching of the meanings of the morphemes (Meaux et al., 2020).

Tier 3 Activities for Targeting Morphological Awareness

Children who do not make progress following Tier 2 support should receive individualized intervention in morphological awareness. In kindergarten, children can be Word Detectives. The SLP can provide the students a sheet with pictures and words containing two prefixes or suffixes. The SLP will directly teach the meanings of the affixes to the student. Next, the student will define each of the words on the sheet. The child and SLP can then go around the school and “spy” words from the list. When they find one, the child should state the affix and root word and define the word (Meaux et al., 2020).

Second graders needing Tier 3 instruction can use in Word Matrices, which also can be used in Tiers 1 and 2. A word matrix is a visual representation of a “word family.” Fourth graders needing Tier 3 can use the Word Relatives strategy, in which draws attention to Latin and Greek roots that are shared by multiple words. The SLP can discuss a root and it’s meaning, then provide examples of words that contain that root with that meaning. Once familiarity with the task is established, the SLP can provide counterexamples, words that have the same spelling but do not have that meaning, to highlight that words are relatives only if they share the same meaning and structure (Meaux et al., 2020).

The teaching of bound morphemes can be embedded into dialogic reading (Maul & Ambler, 2014).

Complex Syntax

Complex syntax, defined as utterances with one or more dependent clause, is produced by children as young as two years of age (Kamhi, 2014, Wisman Weil & Schuele, 2019). Children with language disorders tend to lag approximately two years behind typically developing peers in the development of complex syntax. Kamhi highlights the importance of targeting complex syntax during the preschool years, rather than waiting until grammatical morphemes have been mastered. Complex syntax should be targeted in a manner that focuses on the meaning or function conveyed by the syntax, rather than the syntactic constructions themselves. Relative clauses are one example. Like adjectives, the relative clause is used to clarify a noun. Thus, a clinician could have similar objects in front of a child, and ask the child to request an object using an adjective, and then turning the adjective into a relative clause. For example, “Give me the yellow block. Give me the block that is yellow.” Kamhi suggests focusing on mental states for teaching object clauses or complements. These exchanges can facilitate the use of object clauses:

“Would you like to have a big sister?

Yes, I wish I had a big sister.

Do you want a dog?

Yes, I hope I get a dog for my birthday.

Do you think it’s raining out?

Yeah, I think it is (p. 98).”

Conjoined and embedded clauses can be targeted by focusing on the meanings of coordinating and subordinating conjunctions, as well as conjunctive adverbs, such as then (Kamhi, 2014).

Complex Syntax Intervention (CSI; Balthazar & Scott, 2018) endeavors to help children aged 10 and older to develop the syntax necessary for academic success. This approach focuses on increasing syntactic complexity via use of adverbial, object complement, and relative clauses. Each session contains three parts. Sessions begin by defining the targeted clause type, describing how it could be used, and differentiating it from other types of clauses. Next, the clinician reads a one- or two-paragraph passage that includes several examples of the clause. The clinician then asks the client to repeat five sentences containing the target clause type. The second part of each session focuses on explicit metalinguistic instruction and guided practice. The activities in this part of the sessions include Sentence Identification, Sentence Deconstruction, Sentence Combining, and Sentence Generation. The third portion of the sessions focuses on the meaning and purpose of the clause type in context. This portion of the section includes Clause Hunt, Preference Production (given a choice of two similar sentences, the client identifies the one that makes more sense and explains why),  and Cloze Production. At the end of each session, probes were given for the client to complete a sentence combining activity.

Shape-coding  has been found to be an effective method for teaching grammatical concepts to children and adolescents with developmental language disorder (Ebbels, 2007; 2014). This method uses shapes to depict different types of phrases within a sentence (i.e., noun phrases, verb phrases, and prepositional phrases). Different parts of speech are depicted by different colors. Verb morphology is indicated by arrows. A demonstration of Shape Coding by Susan Ebbels can be viewed here:

A multimodal intervention program, MetaTaal, has also shown to improve complex syntax production in older school-age children This approach uses differently sized and colored Lego bricks to represent different parts of speech, which children use to build sentences. Five hours of MetaTaal resulted in improvement in relative clause production. (Zwisterlood et al., 2015).

CSI, shape-coding, and MetaTaal are different “packaged” interventions that share common principles (Balthazar et al., 2020). They all include metalinguistic instruction. This includes explicit descriptions, explanations and feedback that emphasize the forms, their meanings, and their uses. These methods focus on organizing stimuli in a manner that facilitates implicit learning. This is done via providing a higher density of the targeted forms than would be found in typical conversation embedded in a context that highlights the meaning of the form. Use of a variety of exemplars, rather than a limited number of stimuli, is a focus in order to promote generalization of the targeted forms. The three interventions also use multimodal representations of the targeted forms.

Interventions conducted in the context of storybook reading, conversation, or play that utilized modeling, recasting, expansion, and close procedures are more effective in improving the use of complex syntax than interventions using direct imitation (Wisman Weil & Schuele, 2019). Modeling refers to providing an example of the desired behavior (i.e., the desired syntactic construction). Recasting occurs when an adult repeats part or all of the child’s utterance. Recasts can add new semantic, syntactic, or phonological information. For example, if a child says, “Kitty fluffy,” the adult might say, “Is the kitty fluffy?” Cleave and colleagues (2015) found support for use of recasting in intervention programs for a variety of grammatical targets. Obtaining the child’s attention prior to recasting has been found to be efficacious (Meyers-Denman & Plante, 2016). A dosage of 24 recasts per session has been shown to be effective, whether the session lasts 15 minutes or 30, suggesting that this treatment method can be effective in a short session (Plante et al., 2019). Expansion is an utterance in which the adult uses the same sentence modality and adds syntactic or semantic information. For example, when the child says, “Kitty fluffy,” the adult might say, “The kitty is fluffy,” thereby changing the child’s two-word combination into a grammatically correct sentence. An expansion can also be non corrective, such as responding, “Black fluffy kitty” when the child says, “Kitty fluffy.” Cloze procedures are essentially “fill-in-the-blank” statements, made with rising intonation at the end to indicate that the child is to complete the adult’s utterance. Smith-Lock and colleagues (2015) found that both recasting and hierarchical cueing to elicit the correct response resulted in gains in morphosyntax; however, the group receiving hierarchical cueing had significantly higher gain scores than the children in the recast group. Spontaneous imitation of the correct targets in recast intervention often happens right before students make meaningful progress. Children who spontaneously imitate the correct productions of targets produce the targets more frequently during the course of treatment. Children who do this earlier and more frequently make the most progress in treatment. These imitations may serve as a self-scaffold. Keeping track of children’s spontaneous imitations can be useful in tracking progress throughout treatment (Nicholas et al., 2021).

Imitation training has long been used in the remediation of morphosyntax. Imitation training can benefit an individual by quickly teaching previously unproduced forms; however, once these forms are produced in imitation, moving them into discourse-based contexts is necessary for generalization (Eisenberg et al., 2020). Eisenberg et al. suggest that, rather than abruptly discontinuing imitation training, the level of support is gradually faded. Degree of match can begin with exact imitation, but should be faded to partial imitation. Timing of prompt should proceed from immediate to delayed imitation. Timing of model will be an antecedent model when intervention for a target is first initiated, but can fade to a consequent model as the child progresses. Density of models will begin with models prior to each attempt, and will move toward increasing the number of attempts between models. Contingency of model typically consists of models regardless of correctness when a new target is introduced, and moves to models being provided only when errors are produced. This scaffolding will facilitate better generalization of the forms obtained during imitation training.

Wh-Question Forms

Wh-questions are a particularly challenging language form for individuals with language impairment (Abou-Dahech & Diehm, 2019). Children with language impairment learn wh-questions in the same general order as their typically developing peers, but at a slower rate. That is, who, what-do, and where questions are answered accurately before why, when,  and how questions. Object wh-questions have found to be more challenging than subject wh-questions, perhaps due to more syntactic rearranging occurring with object wh-questions. For example, Where are you going requires more rearranging than Who is going. Length of the question also impacts performance, with more difficulty noted on questions containing more words. Wh-questions are important to target because they are necessary to function in both social and academic settings. Abou-Dahech and Diehm provided six recommendations for remediation of wh-questions.

1. Target wh-questions in the same order in which they develop in typically developing children
2. Be aware of how the length and structure of the question may impact performance.
3. Ask questions with viable answers in the immediate environment. Manipulating objects or performing actions may be helpful for increasing generalization.
4. Incorporate typically developing peers into the treatment to provide additional language models.
5. Use visual symbols to help teach parts of speech and syntactic movement.
6. Model the correct answer when the child answers incorrectly, and encourage the child to repeat the correct answer.

References