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(Justice, Swanson, & Buehler, 2008; Swanson, Fey, Mills, & Hood, 2005). Based
on the group results from the current study, school-aged children with mildto-moderate
HL do not show difficulties with most aspects of narrative production,
but they are not as effective in conveying relevant information to the
listener as their peers with TD. Assessment of higher level language skills
should thus be included in the monitoring of the academic performance of
children with mild-to-moderate HL. Narrative intervention should explicitly
target identification of relevant information and monitoring of listener reactions
in a variety of narrative contexts. Furthermore, intervention goals should
always be based on individual profiles of narrative performance, since a qualitative
analysis of narrative development is necessary for appropriate goals to
be formulated. Recent experimental research has shown that written narrative
tasks facilitate oral narrative production more than oral narrative facilitates
written narrative (Johansson, 2009). A focus on written narratives may thus
be the most beneficial approach in work with school-aged children with poor
narrative skills.
Methodological Considerations
Picture-elicited contexts may not be the best language elicitation tasks to
really explore language skills in school-aged children. A range of narrative
tasks should be used to obtain a full picture of a child’s narrative abilities.
A personal narrative can be used, although this is an elicitation context that
demands more active participation from the clinician (Walldén & Åkerlund,
2008). To really explore school-aged children’s higher level language skills, an
expository task may be used. Furthermore, expository tasks have been found
to elicit more grammatically complex story structures than other speaking
contexts (Nippold, Mansfield, Billow, & Tomblin, 2008).
Conclusion
This study was conducted to gain insight into whether narration is a vulnerable
area of language production in children with mild-to-moderate HL and,
if so, which aspects of narration appear to be vulnerable in this population.
Our results showed that a group of school-aged children with a HL diagnosed
during their preschool years produced narratives that were similar to those
produced by children with TD. One result indicated somewhat poorer development
of higher level language skills, however. Children with HL were less
effective in sharing crucial content information with the listener as compared
with children with TD. Children with mild-to-moderate HL should be monitored
and assessed at intervals by a SLP. Problems with higher level language
skills can easily go unnoticed, and tasks that tax the child’s language processing
skills, such as narratives or expository tasks, should be included during
assessment.
400 Reuterskiöld, Ibertsson, & Sahlén