Börn sem eru sein til máls: Áhrif þjálfunar á orðaforða barns á þriðja ári

Abstract

Tilgangur rannsóknarinnar var að skoða áhrif þjálfunar á orðaforða barns á þriðja ári, sem seint var til máls. Einn þátttakandi var í rannsókninni. Við upphaf rannsóknarinnar var hann 30 mánaða, notaði rúmlega 160 orð og var ekki farinn að tengja saman orð í setningar. Þátttakandinn var valinn af hentugleika. Þjálfunin var byggð á fyrirlögn fyrir fram ákveðinna markorða sem þjálfuð voru bæði á fjölbreyttan hátt og með ákefð. Einnig voru valin samanburðarorð sem ekki voru þjálfuð. Þjálfunin fór fram tvisvar í viku í leikskóla barnsins og voru þjálfunartímar 14 talsins. Niðurstöður leiddu í ljós að almennur orðaforði barnsins, sem mældur var með staðlaða málþroskaprófinu Orðaskil, jókst yfir þjálfunartímabilið umfram það sem vænta mátti vegna almenns þroska. Mælingar sýndu að barnið notaði markorðin meira en samanburðarorðin, bæði heima og í þjálfunartímum, og að notkun á orðunum jókst eftir því sem leið á þjálfunina. Sú aukning sem varð á orðaforða barnsins hélst mánuði eftir að íhlutun lauk. Mikilvægt er að bera kennsl á seinkun í málþroska eins snemma og kostur er. Þegar búið er að bera kennsl á barn sem seint er til máls þarf í framhaldi að veita því viðeigandi örvun eða íhlutun, en þessi rannsókn bendir til að slík þjálfun geti haft góð áhrif. Sambærileg rannsókn hefur ekki verið gerð áður á Íslandi.

Late talkers are children who have low expressive vocabulary and/or do not use two word sentences at the age of two years. Approximately 15% of children between 2 and 3 years of age are classified as late talkers and at risk of developing language disorder. Developmental language disorder (DLD) in children is characterized by problems with language that cannot be explained by neurological, cognitive, sensory or emotional factors. The prevalence of DLD in five year old children is approximately 7%. Around half of the children identified as late talkers will later acquire language within the normal range but approximately half of the others will later be diagnosed with language disorder. At the age of two years it is not known which children will later be diagnosed with DLD. Language disorders may cause social and learning problems later in life. Early intervention, where a child receives appropriate evidence based intervention, can have positive effects on language development. Almost all children in Iceland attend preschool between the ages of 2 and 3 and spend on average seven hours in school each day, five days a week. Preschool teachers play a key role in advising and educating parents on language development. However, they do not have an official role in systematically screening early language to identify children at risk of being late talkers. Additionally, early intervention for children under three years of age is not systematically organized. Intervention for this age group is limited in Iceland. Early intervention for young children needs to be defined and organized so that each child can be serviced according to his/her needs.The aim was to investigate whether a cross-situational learning method was successful to improve vocabulary knowledge in a late talker. The intervention was based on the presentation of a few predetermined target words administered with intensity using a different variable method. The subject heard the target words 64 times or more in each session. Control words were also chosen but not presented during therapy sessions. The intervention was delivered twice weekly by the first author within the child’s preschool for a total of fourteen sessions over a period of nine weeks. The duration of each treatment session was about 30 minutes. Increase in vocabulary was measured by the standardized language development test Orðaskil, which is the Icelandic version of the MacArthur Communicate Development Inventory. Results showed an increase beyond what is to be expected in a child with normal development. During the intervention period the mean increase of vocabulary was 17.4 words each week or 157 words over the nine weeks of intervention. Vocabulary knowledge changed from being two standard deviations from the mean of children at his age to being slightly below one standard deviation from the mean. Results from target and control word testing were not of significance. However, other measures showed that the child used target words more than control words, both at home and in intervention sessions. Words of one and two syllables were used more frequently than longer words. His use of the words in daily life also increased over the intervention period. The child further added 41 words to his vocabulary knowledge during the month after intervention which is approximately the same number of words as children add with typical language development at his age. These norms are based on the Orðaskil measure. This suggests that the child maintained vocabulary gains one month from intervention. It is important to identify delay in language development as early as possible. After identifying a late talker, appropriate stimulation or intervention needs to be applied. This study suggests that vocabulary intervention can be beneficial. This is the first time a study of this kind is implemented in Iceland.