Problems of language and communication in children; Identification and intervention

Barbro Bruce

Research output: ThesisDoctoral Thesis (compilation)


This thesis addresses identification and intervention of language and communication problems in children. The issue of identification is addressed in study I by investigating communicative ability in 18-month-old children, and in study II by exploring the prevalence of language and communication problems in children with complex problems, such as attention deficit hyperactivity disorder (ADHD). The issue of intervention is addressed in studies III and IV by analysing verbal interaction in conversations, in which one of the participants is a child with specific language impairment (SLI). Study III explores how dialogues between children with SLI and typically developing peers (TLD) representing the same age (age peers), and the same language level (language peers) respectively, differ with respect to responsiveness, assertiveness and reciprocity. Study IV investigates interactional style and elicitation strategies of speech/language pathologists (SLP) during intervention, and how these factors influence the child with SLI.

The results from study I show that receptive skills and symbolic play at 18 months of age are significantly associated with language ability three years later. Study II, in which language skills in children with ADHD were explored, indicates that language ability plays an important role for all other aspects of children's development and behaviour, with the exception of motor skills. Use of language and language comprehension caused these children many more problems than structural aspects of language production. Furthermore, reading and writing problems were found to be very frequent. Study III shows that dialogues between children with SLI and TLD age peers are characterized by more responsiveness and topic coherence than dialogues between children with SLI and TLD language peers. However, the children with SLI were more assertive, i.e., introduced more topics, in dialogues with language peers. Study IV indicates that the children with SLI talked more and had a higher mean length of utterance (MLU) in the free conversational context, whereas the individually selected grammatical targets occurred more often in the training context. In the conversational context the SLPs linked, i.e., attended, more to the child's focus and gave more feedback, while in the training context the individually selected grammatical targets occurred more often and the children were more frequently asked to follow instructions.

The results have important clinical implications. First; screening procedures at Child Health Care (CHC) centres should be recommended to focus on receptive language skills and play behaviour, and not only on size of vocabulary at 18 months of age. Second; language skills, in particular language comprehension, language use and literacy skills were found to cause children with ADHD problems, and should therefore be assessed. Third; it is of great value for children with SLI to be in mixed groups with peers representing different ages and language levels, and to avoid the risk of not being selected as playmates. Fourth; increased awareness of how interactional style and elicitation strategies influence the developing language skills in children with SLI can be used in intervention planning, depending on the goals of the specific intervention procedures for the individual child.
Original languageEnglish
Awarding Institution
  • Logopedics, Phoniatrics and Audiology
  • Nettelbladt, Ulrika, Supervisor
  • Hansson, Kristina, Supervisor
Award date2007 Feb 23
ISBN (Print)91-85559-83-0
Publication statusPublished - 2007

Bibliographical note

Defence details

Date: 2007-02-23
Time: 10:15
Place: Hörsalen, Språk- och litteraturcentrum, Helgonabacken 12, Lund

External reviewer(s)

Name: Eriksen Hagtvet, Bente
Title: Professor
Affiliation: Institutet för specialpedagogik, Oslo universitet, Norge


<div class="article_info">Barbro Bruce, Ragnhild Kornfält, Karl Radeborg, Kristina Hansson and Ulrika Nettelbladt. <span class="article_issue_date">2003</span>. <span class="article_title">Identifying children at risk for language impairment: screening of communication at 18 months</span> <span class="journal_volume">vol 92</span> <span class="journal_pages">pp 1090-1095</span>. <span class="journal_distributor">Taylor & Francis healthsciences Acta Paediatrica</span></div>
<div class="article_info">Barbro Bruce, Gunilla Thernlund and Ulrika Nettelbladt. <span class="article_issue_date">2006</span>. <span class="article_title">ADHD and language impairment. A study of the parent questionnaire FTF (Five to Fifteen)</span> <span class="journal_volume">vol 15</span> <span class="journal_pages">pp 52-60</span>. <span class="journal_distributor">Springer Science and Business Media European Journal of Child and Adolescent Psychiatry</span></div>
<div class="article_info">Barbro Bruce, Kristina Hansson and Ulrika Nettelbladt. <span class="article_issue_date">2007</span>. <span class="article_title">Interactional style, elicitation strategies and language production in professional language intervention.</span> <span class="journal_volume">vol 23 (2)</span> <span class="journal_distributor">Sage Publications Ltd, Copyright Sage Publications Child Language Teaching and Therapy</span> (accepted)</div>
<div class="article_info">Barbro Bruce, Kristina Hansson and Ulrika Nettelbladt. <span class="article_issue_date"></span>. <span class="article_title">Assertiveness, responsiveness and reciprocity in verbal interaction. Dialogues between children with SLI and peers with typical language development.</span> (submitted)</div>

Subject classification (UKÄ)

  • Other Medical Sciences not elsewhere specified
  • Otorhinolaryngology

Free keywords

  • auditive system and speech
  • Otorinolaryngologi
  • audiology
  • Medicin (människa och djur)
  • Otorhinolaryngology
  • Interaction
  • Medicine (human and vertebrates)
  • Intervention
  • Screening
  • Language and communication problems
  • audiologi
  • hörsel- och talorganen
  • ADHD
  • Identification


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