'Better Conversations With Developmental Language Disorder': Designing a Novel Intervention for School-Aged Children and Their Main Carers.

Abstract

Background: Children with developmental language disorder (DLD) experience difficulties with receptive and expressive language, which can affect their participation in everyday interactions with others. This, in turn, can impact their ongoing language development and ability to form and maintain friendships. This paper describes the development of a complex intervention, 'Better Conversations with Developmental Language Disorder' (BCDLD), designed with and for school-aged children with DLD and their main carers.

Methods: Medical Research Council guidelines for developing complex interventions were used to inform the design and early-stage evaluation of BCDLD, including consultation with key interest holders at each stage of the project; appraisal of relevant literature and articulation of programme theory.

Results: A review of the evidence for communication partner training revealed a gap in the research and clinical practice for school-aged children with DLD. Research with other clinical groups suggests potential for enhancing everyday interactions through work with conversation partners. Theory underpinning the proposed intervention, which was identified from the review, included social interactionist and constructivist accounts of child language acquisition, behaviour change theory and applied conversation analysis. Children and parents with experience of living with DLD identified barriers to their everyday conversation to inform intervention content and delivery. Speech and Language Therapists gave feedback on the draft intervention protocol and advised on how BCDLD could be implemented in clinical practice.

Conclusion: This paper reports the development of a theoretically-informed, conversation-based intervention for children with DLD and their conversation partners, which aims to improve the content and flow of their everyday interactions, whilst supporting children's language development. Synthesising knowledge from the literature, input from children living with DLD, parents and professionals in the field enabled the design and early-stage evaluation of BCDLD.

What this paper adds: What is already known about this subject There is a gap in the literature and clinical practice for a conversation-based intervention, designed for school-aged children with DLD and their parents or carers. What this paper adds to existing knowledge This project followed Medical Research Council guidelines for early development of a novel intervention, 'Better Conversations with Developmental Language Disorder'. What are the potential or actual clinical implications of this work? The programme is ready to progress to the next stage of development, including manualisation and training, leading to feasibility studies within NHS and education settings.