#127: Strategies You Can Use: Grammar

Marisha: Hello there and welcome to the SLP Now Podcast, where we share practical therapy tips and ideas for busy speech language pathologists. Grab your favorite beverage and sit back as we dive into this week's episode.

Marisha: Hey there. It's Marisha and welcome to the SLP Now Podcast. This summer, we are doing a series called Strategies You Can Use, and we picked different goal areas. And we're going to do a blitz of three evidence-backed strategies that you can use when targeting those specific skills. These are mostly strategies that have come from the literature, and we're just pulling out the ones that are most practical that might help you if you're feeling stuck or just wanting to try some new strategies when targeting some of our most common goals. Without further ado, let's dive right in.

Marisha: This week, we are sharing strategies to target grammar goals. And I wanted to start with a bird's-eye view of what we're looking at. We are going to share a number of research studies. And they're really, really great references. They give some really great practical strategies. We're just going to touch on a few of them today. If you want to get easy access to the articles, head to the show notes. Those are at slpnow.com slash 127. S-L-P N-O-W.com slash 127. And just to get us started, Fey, Long, and Finestack, from 2013, have a really great article with a lot of different strategies for grammar intervention. So, if you're loving this podcast, definitely check out that article.

Marisha: But I love how they talk about grammatical intervention. They said that, "The basic goal of all grammatical intervention should be to help the child achieve greater facility in the comprehension and use of syntax and morphology."

Marisha: And so, that's a direct quote there. But the goal of grammar intervention is not to be able to complete a task and fill in blanks and sentences. We want them to be able to use these grammatical structures in conversation, when they're telling stories and when they're in the classroom, when there's talking with peers. This can have a really big impact on their ability to be understood and to communicate their thoughts and feelings. That's a little bit of the "why" behind that grammar intervention because I know that this is a topic that can get some groans from time to time. It's not always our favorite. And I love what Eisenberg says about authenticity. She says, quote, unquote, "Authenticity is crucial. Students must have a reason for doing the things that lead them to learn and use grammar, so that they can read, write, and speak better.

Marisha: So, we want to be using authentic context in our intervention. And we'll circle back to that. But first, we have a couple quick strategies that we can use when targeting these goals. We've got three of them for you today. The first strategy is to provide focused stimulation. Focused stimulation is when we provide students with frequent models and recaps in a variety of activities.

Marisha: A model is when we highlight the feature naturally in conversation. For example, if we're reading a book, and we know that the student has a goal to work on past tense verbs, or if we're working on auxiliary verbs, whatever it might be, we can highlight that naturally in conversation and maybe just place a little bit of emphasis on it. Then in a recast, we can correct what the child says or modify the modality. So, if the student says, "The dog run to the store," then we can say, "Yeah, the dog ran to the store."

Marisha: Or if we modify the modality, we can turn a statement into the question like, "Did the dog run to the store?" That is one strategy that can be really helpful. And at the end, I'll give a bonus tip on how to structure all of this. But there is support in the literature for using the focused stimulation as a strategy. And we can do this throughout. If you're using literacy-based therapy, there's plenty and plenty of opportunities to provide that focused stimulation throughout the unit.

Marisha: Then, our second strategy is to use a strategy called imitating contrasting sentences. And this is an older article, Connell, 1982. But it includes a lovely step-by-step training procedure that is free to access. So, I would highly recommend checking that out. And consider giving the strategy a try, especially if you're feeling stuck with a grammar goal, like if you've tried everything and the student just isn't making progress.

Marisha: What this is is we're imitating contrasting sentences. It's a lot like what it sounds, but the child imitates the target sentence as well as a contrasting sentence that's semantically or grammatically related. And we typically use picture cards with this. And like I said, the article lays out a really nice protocol on how we would do this, but we would give the student some picture cards or whatnot. And then we can say, "The boy is walking." And then, a contrasting form for that could be, "He is walking." So then the student imitates the target as well as the contrasting form. And it's a drill-based activity that gives us some great practice with imitation. And adding the contrast there is meant to be very helpful. An example with past tense verbs is we would have a picture: "He is eating." And then we have a picture where the boy is done. So we can say, "He ate. He is eating. He ate." That's that contrast. And that's a great way to work on past tense verbs or auxiliary verbs as well.

Marisha: Eisenberg 2007 says that, "The most effective timing of imitation drill is immediately prior to an activity that involves contextual use of that same structure." That brings us to step three: while it is super helpful, we need to teach the student these structures and give them some targeted practice, we want to be able to use these skills in context as quickly as possible.

Marisha: Because like we said, at the beginning, it doesn't matter if we can fill in blanks with grammatical structures with a hundred percent accuracy if we're not using those structures when we're telling our friends a story on the playground, for example. We need to be able to use the skill in context to really have an impact.

Marisha: There's a lot of different ways that we can provide that embedded practice. We can manipulate the context of the therapy session to create more opportunities for the student to use that target. We can do this by carefully selecting activities that we're using in therapy. We can use books, set up certain conversation topics. And then we can really provide embedded in practice using a huge variety of activities. We just need to take advantage of that opportunity and think about how we can do slight modifications to allow this to work for our students. Some great embedded activities are to work on describing pictures. We can select activities. If we're reading a book, we can describe the picture in the book and try to elicit the target structure in that way. We can ask strategic questions. And this is really great for mixed groups.

Marisha: The describing the picture activity, if we're reading a book and we're doing an extension activity with that book, we're looking at the pictures in the book. And student A is working on past tense verbs, so that student can make sentences telling what happened in the story. If another student is working on answering wh questions, we can ask the question, and the student can respond. If we're working on describing, the student can describe the attributes of the different objects in the book, for example. So, this one activity can be used to target a number of goals. And it can be really beneficial in working towards that embedded context. So it's a win-win-win scenario there. Those are our three tips; one providing focused stimulation, which we can do while reading a book or engaging in conversation, whatever language-rich activity we're using.

Marisha: Then the second strategy is to use a drill-based activity called imitating contrasting sentences. This gives us a little bit of an extra leg up in our progress. Just imitating sentences doesn't give us quite as much bang for our buck. But if we have those contrasting sentences, that can be a strategy to help students move the needle a little bit more quickly, leading to our third tip. We don't want to spend all of our time in drills, so we do want to provide students with that embedded practice.

Marisha: The bonus tip today is how we can strategically structure our practice. And this is from Eisenberg 2014. She did a really great article on what works in therapy for their thoughts on improving clinical practice for children with language disorders. That'll also be linked in the show notes, slpnow.com/127. But she says that different activity types can be used in a complimentary way within our therapy sessions.

Marisha: We're using high structure drill to highlight and prime those linguistic features. And then, we're immediately incorporating those features into embedded practice. We're imitating the contrasting sentences, and then we're diving into that activity where we're describing pictures in the book. And then, this is also from Eisenberg, but she says that, "The use of discrete skill instruction, without embedding the use of those newly acquired structures in a meaningful activity, is not recommended. So, if all we're doing is modeling or imitation, and we're not embedding those structures in a meaningful context, Dr. Eisenberg doesn't recommend that.

Marisha: And some other guidelines that she shares are that students should not imitate sentences until they've heard several examples of the grammar target. An ideal structure would be: we read the book. We give students lots and lots of models. And we maybe do some pre-story knowledge activation where the students have the opportunity to engage in conversation, and we're recasting those structures.

Marisha: They're given lots of models. They're hearing lots of recasts. They've heard several examples of the target. And then, they might be ready to imitate those sentences. They've gotten enough exposure. And this will be different for each student. There are some students who might need weeks of that modeling and recasting before it starts to click and they're ready to imitate. Some students might just need a few minutes, and then they'll be ready to imitate sentences. We get to use our clinical judgment here to decide what makes sense. But according to Dr. Eisenberg, she recommends first, modeling, recasting and then having students imitate. And doing that imitation or whatever type of drill before we jump into embedded practice. We want to give the students the opportunity to hear the target, then imitate the target, and then jump into that embedded practice where they use it in a meaningful context.

Marisha: Model, recast, then drill, then embedded practice. That is a wrap on our blitz of strategies for grammar. I'm looking forward to seeing you all next week, where we dive into strategies for syntax; working on compound and complex sentences, passive voice, relative clauses, all of that good stuff. Hope you have a great week, and we'll see you soon. Thanks for listening to the SLP Now Podcast. If you enjoyed this episode, please share with your SLP friends. And don't forget to subscribe to the podcast to get the latest episodes sent directly to you. See you next time.