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LSHSS
Clinical Forum
Language and Communication Disorders in Adolescents
Training Secondary School Teachers in
Instructional Language Modification
Techniques to Support Adolescents
With Language Impairment: A
Randomized Controlled Trial
Julia Starling,
a
Natalie Munro,
a
Leanne Togher,
a
and Joanne Arciuli
a
Purpose: This study evaluated the efficacy of a collaborative
intervention where a speech-language pathologist (SLP) trained
mainstream secondary school teachers to make modifications
to their oral and written instructional language. The trained
teachers’uptake of techniques in their whole-class teaching
practices and the impact this had on the language abilities of
students with language impairment (LI) were evaluated.
Method: Two secondary schools were randomly assigned to
either a trained or a control condition. A cohort of 13 teachers
(7 trained and 6 control) and 43 Year 8 students with LI (21 trained
and 22 control) were tested at pre, post, and follow-up times—
teachers by structured interview and students by standardized
spoken and written language assessments.
Results: Significantly increased use of the language modifica-
tion techniques by the trained teachers was observed when
compared to the control group of untrained teachers, with this
increased use maintained over time. Results from the trained
group of students showed a significant improvement in written
expression and listening comprehension relative to the control
group of students.
Conclusion: This randomized controlled trial is one of the first
investigations to evaluate a collaborative intervention that links
changes in mainstream secondary teachers’instructional lan-
guage practices with improvements in the language abilities
of adolescents with LI.
Key Words: secondary schools, adolescent language
impairment, teachers, training, collaborative intervention,
oral and written language
The concept of inclusive education is gathering mo-
mentum internationally, driven by legislation and
policy that highlight the need for schools to pro-
vide equal educational opportunities to all children, includ-
ing those who are at risk for educational disadvantage and
marginalization (United Nations Educational, Scientific
and Cultural Organization, 1994; U.S. Department of Edu-
cation, 2002). Inclusive education theory supports teachers
in ensuring that all students, regardless of their learning
needs, have equal opportunities for accessing the curriculum
and for working to their academic potential (Horn & Banerjee,
2009; Shaddock, 2007). The removal of barriers to learn-
ing for young people with language and communication
needs is a specific recommendation of a recent national re-
view of speech-language pathology services (Bercow, 2008).
Similarly, the Response to Intervention (RTI) model has been
adopted by many school districts in the United States as a
way to provide support to students with additional learning
needs (Fuchs, Mock, Morgan, & Young, 2003). Following
this tiered intervention model, high-quality core instruction
to support students with diverse learning needs in main-
stream classes was identified as a high priority at the primary
a
The University of Sydney, Australia
Correspondence to Julia Starling: Julia.Starling@sydney.edu.au
Editor: Marilyn Nippold
Associate Editor: Shari Robertson
Received August 31, 2011
Revision received January 20, 2012
Accepted January 27, 2012
DOI: 10.1044/0161-1461(2012/11-0066)
LANGUAGE,SPEECH,AND HEARING SERVICES IN SCHOOLS •Vol. 43 •474–495 •October 2012 *American Speech-Language-Hearing Association474
intervention level (National Centre on Response to Interven-
tion, 2011).
In this climate of inclusive education policy, however,
teachers often report feeling undersupported in professional
development on how to adapt their instructional practices
to accommodate students with additional learning needs,
including students with language impairment (LI) (Dockrell
& Lindsay, 2001; Forlin, 2001; Pearce & Forlin, 2005). LI, a
difficulty with the understanding and/or use of language in
both oral and written domains (Leonard, 1991), has a prev-
alence rate of between 7% and 16% (McLeod & McKinnon,
2007; Tomblin, Records, Buckwalter, Zhang, Smith, &
O’Brien, 1997) and a high persistence rate into adolescence
(Clegg, Hollis, Mawhood, & Rutter, 2005; Johnson et al.,
1999; Stothard, Snowling, Bishop, Chipchase, & Kaplan,
1998). Poor academic progress and disengagement in learn-
ing experienced by adolescents with LI (Dockrell & Lindsay,
2007) are risk factors for social, emotional, and behavioral
problems (Clegg, Stackhouse, Finch, Murphy, & Nicholls,
2009; Durkin & Conti-Ramsden, 2010; Law, Rush, Schoon,
& Parsons, 2009; Snow & Powell, 2004). These findings
highlight the need to be proactive in supporting secondary
school students with LI. Despite the identification of support
needs, there is a significant gap in applicable evidence-based
practice (Ebbels, van der Lely, & Dockrell, 2007; Nippold,
2010). Cirrin and Gillam (2008), in their systematic review
of the literature on evidence-based studies of children and
adolescents with disorders of spoken language, reported
that only two out of a total of 21 studies reviewed involved
secondary school-age populations.
The current study was designed to address this gap in
communication disorder research in the field of adolescent
LI and to meet the challenge of providing effective and col-
laborative speech-language pathology service delivery at the
secondary school level. We present the findings of a ran-
domized controlled trial (RCT) of a training-based collab-
oration between a speech-language pathologist (SLP) and
a group of mainstream secondary school teachers. In this
program, the SLP trained the teachers over a period of
10 weeks in the use of a set of instructional language
modification techniques. We define “instructional language”
as teachers’oral and written language that is used in the
classroom to instruct their students (Cazden, 2001), and
“modification techniques”as strategies that facilitate a
change in individuals’behaviors or practices (Kazdin, 2001).
Applying these terms to the program evaluated in this study,
the intervention aimed to effect a change in the language-
based instructional practices of mainstream secondary school
teachers, thereby creating a more supportive learning envi-
ronment for students with LI in their classes.
The Language Environment of Secondary
School Classrooms
Language forms the basis of secondary school teachers’
instructional teaching practices (Baumann & Graves, 2010).
Teachers use oral and written language to provide instruc-
tion, present and analyze language and literary features,
instruct in classroom procedures, and convey curriculum
content (Nelson, 1989). An increased emphasis by teachers
on written language occurs during secondary education,
for example, in their use of subject textbooks and in their
production of information, work, and assignment resources
(Whitmire, 2000). There is also an increased expectation for
students to present their understanding of new knowledge
through written work, for example, in their production of a
range of writing genres and in written responses for assign-
ments, tests, and exams (Kiuhara, Graham, & Hawken,
2009; Larson & McKinley, 1995). Secondary school teachers
across all subject areas regularly introduce specific vocab-
ulary items and terminologies for each new curricular topic.
Such vocabulary is often new and unfamiliar to the students,
and must be processed and retained so that they can develop
and demonstrate at least a rudimentary knowledge of each
topic (Beck, McKeown, & Lucan, 2002).
The oral and written language used by teachers in main-
stream secondary classrooms can be complex, creating
barriers to learning for students with LI (Larson & McKinley,
1995; Montgomery & Levine, 1995; Norris, 1997). In her
reference to the complexities of instructional language within
upper primary and secondary school classrooms, Simon
(1998) stated, “School language consists of a barrage of new
information presented at a rapid rate in unfamiliar vocabulary
and language structure”(p. 259). Children and adolescents
with LI are known to have persistent difficulty with oral
and written language comprehension (Bishop & Snowling,
2004), oral expression (Wetherell, Botting, & Conti-Ramsden,
2007), written expression (Culatta, Blank, & Black, 2010;
Dockrell, Lindsay, & Connelly, 2009), new word learning
(Nash & Donaldson, 2005), and short-term and working
memory (Archibald & Gathercole, 2006; Leonard et al.,
2007). Language difficulties on the part of the adolescent, in
combination with teachers’use of complex language, could
make general learning tasks such as processing, retaining,
and applying new information challenging for students with
LI. Facing these obstacles on a regular basis may contribute
to associated problems such as poor academic progress
and the potential for disengagement in the learning process
(Larson & McKinley, 1995).
In addition to explicit academic expectations that students
will learn and demonstrate their understanding of large
amounts of curriculum content, secondary school teachers
also create a set of behavioral expectations for their students.
This has been previously described as the “hidden curric-
ulum”(Hoover & Patton, 1997, following Jackson, 1968)
and refers to implicit behavioral and academic conformities
required of students by different teachers. For secondary
school students, these conformities include expectations to
attend consistently to information that is presented orally and
in written form, to ask and answer questions verbally, to copy
efficiently from the board and write notes, and to contribute
Starling et al.: Training Secondary Teachers 475
verbally to whole-class and small-group discussions (Larson
& McKinley, 1995; Nelson, 1998).
Secondary school students with LI often experience addi-
tional and significant difficulty with meeting these behav-
ioral expectations (Clegg et al., 2009). This may also
contribute to the development of unhelpful acting-out or
withdrawal behaviors (Starling, Munro, Togher, & Arciuli,
2011). Such psychosocial issues, combined with long-term
language difficulties, conspire to interfere with the academic
progress of students with LI, compounding the many factors
already causing them to fall behind their peers in language
development and literacy-based learning (Brinton, Fujiki, &
Baldridge, 2010; Law et al., 2009). Of additional concern
is the knowledge that these students’negative behaviors may
be misinterpreted and that the underlying LI can remain
unidentified and unaddressed (Clegg et al., 2009; Ripley &
Yuill, 2005).
The Challenge of Supporting Secondary
School Students With LI
Historically, SLPs have found it challenging to provide
effective supports for caseloads of students with LI during
adolescence, when service provision can be limited com-
pared to that for younger populations with LI (Dockrell,
Lindsay, Letchford, & Mackie, 2006; Hollands, van
Kraayenoord, & McMahon, 2005; Law et al., 2000). There
are many service delivery issues existing within the sec-
ondary school setting itself. For example, even though class
withdrawal for individual or group therapy sessions can be
effective (e.g., Ehren, 2002), the secondary school timetable
is complex and creates difficulties for scheduling additional
activities (Dohan & Schulz, 1998). Therapy progress can
be restricted by having few opportunities for the direct
application of therapy goals, due, for example, to a lack
of time for SLPs to conduct a sustained and consistent
integrated service delivery (Gordon Pershey & Rapking,
2002) and for mainstream teachers to commit to supporting
students individually (Larson & McKinley, 2003b; Prelock,
2000). In addition, missed class work can have a negative
impact on the academic progress of students with additional
learning needs. This may exacerbate an existing problem
where secondary school students with LI are already delayed
in their academic progress (Bercow, 2008; Smart, Prior,
Sanson, & Oberklaid, 2005; Stothard et al., 1998).
An alternative model of service delivery could be
the provision of inclusive, classroom-based support. The
secondary-level academic environment creates particular
challenges for the effective provision of inclusive education
for students with additional learning needs, including LI
(Shaddock, 2007). For example, mainstream secondary
school teachers are pressured to cover curriculum content
for groups of students with diverse learning abilities and
needs. However, teachers are reported to have little to no
training in the awareness and potential impact of learning
disabilities, as well as little to no training in teaching ap-
proaches that address these students’additional learning
needs (Forlin, 2001; Pearce & Forlin, 2005).
Encouraging findings on the benefits of teachers’pro-
fessional development can be found in recent general edu-
cation literature. For example, in a large-scale synthesis of
evidence-based professional development research, Guskey
and Yoon (2009) concluded that sustained, rather than one-
off, and site-based professional development activities for
teachers that are presented by experts in the relevant field
resulted in the most positive effects on student outcomes.
It has also been suggested that professional development
for teachers should target three major goals to be effective:
“Change in the classroom practice of teachers, change in
their attitudes and beliefs, and change in the learning out-
comes of their students”(Guskey, 2002, p. 383).
Building on these suggestions for fundamental ap-
proaches to general student support, we turn to the litera-
ture on best practice approaches for whole-class support of
students with learning disabilities. Vaughn, Gersten, and
Chard (2000), in their review of evidence-based studies in
this field, identified some common principles of effective
classroom teaching practices. These included making in-
struction visible and explicit, for example, by teaching
the steps of the writing process and frameworks for different
writing genres (Gersten & Baker, 2001); moderating task
difficulty by, for example, monitoring the order and se-
quence of presentation of curriculum content (Keogh, 1982);
and explicitly teaching procedural facilitators and strategies
to assist students with planning and executing their work
(Harris & Pressley, 1991).
Teachers’inclusive support of students with additional
learning needs through the use of direct vocabulary in-
struction has also received attention (Beck et al., 2002; Bos
& Anders, 1990; Graves, 2000; Joffe, 2006; Mastropieri,
Scruggs, & Mushinski Fulk, 1990; Throneburg, Calvert,
Sturm, Paramboukas, & Paul, 2000; Wilson, Nash, &
Earl, 2010). Highlighted is the effectiveness of targeting
essential curriculum vocabulary for content mastery and
teaching explicit strategies for independent word learning. In
summary, there is evidence to support mainstream teachers’
increased use of instructional language modification tech-
niques for students with learning disabilities, but to date, this
has yet to be systematically examined for students with LI.
Caseload management in the secondary school context
also involves deciding on the most efficacious model of
service delivery, and SLPs could consider adopting a
systems-based approach. Paul (2007) refers to the systems
model, where the interactive environment is the focus of
change, and where taking a systems-based perspective
“means that we do not assume that all of the communication
problems are ‘in’the child but, rather, are in the relationship
between the communication partners”(Paul, 2007, p. 12).
This conceptual approach underlines recommendations to
support whole populations of adolescents with additional
476 LANGUAGE,SPEECH,AND HEARING SERVICES IN SCHOOLS •Vol. 43 •474–495 •October 2012
learning needs, including LI, within their learning environ-
ment through interdisciplinary collaborations and integrated
service delivery opportunities (American Speech-Language-
Hearing Association, 1991; Law et al., 2002; Shaddock,
2007). Moreover, collaborations between SLPs and teachers
have been reported to facilitate a useful exchange of ideas
and expertise that have resulted in the improvement of lan-
guage skills in students with LI (Throneburg et al., 2000).
The need to situate interventions within the classroom has
been advocated (Gordon Pershey & Rapking, 2002), with
some authors recommending a specific emphasis on mod-
ifying teaching and learning contexts to support the needs
of students with LI (e.g., Dockrell, Lindsay, & Palikara,
2011).
The RCT presented in this article builds on a pilot study
that was carried out in Sydney, Australia. The pilot was
developed and implemented at a secondary school in re-
sponse to a request for sustained mainstream teacher pro-
fessional development that would impact whole populations
of secondary students with LI who were attending the school.
The first author provided 10 weeks of training to 13 teachers
who taught students in Years 7, 8, and 9 (which are equiv-
alent to Grades 7, 8, and 9 in the United States). The pilot
was evaluated by teacher questionnaire at mid and end points
of the program. All teachers provided positive and useful
feedback about aspects of the program, such as raising
teachers’awareness of the nature and impact of LI in sec-
ondary student populations, and the benefits of working
collaboratively with an SLP. Nine teachers reported that they
had observed students with LI benefitting from the language
modifications made to teaching materials, for example, by
these students becoming more engaged in classroom activ-
ities (Starling, 2007). The constructive teacher feedback
from the pilot study was encouraging and provided the
impetus for a more robust evaluation of the intervention.
The Current Study
The current study set out to evaluate the hypothesis that,
by facilitating changes to mainstream secondary school
teachers’oral and written instructional language by means of
a sustained on-site training program, SLPs can provide
effective support to whole populations of adolescents with
LI. Indeed, SLPs’training of secondary school teachers
in instructional language modification techniques is a
frequently recommended approach to collaborative inter-
vention (Ehren, 2002; Nippold, 2010; Norris, 1997; Prelock,
1997; Simon, 1998). However, to the authors’knowledge,
the efficacy of this approach has not previously been exam-
ined. It is not yet clear whether mainstream secondary school
teachers will find value in adopting instructional language
modification techniques and incorporating them into their
regular teaching practices to support students with LI in
their classes. Neither is it clear whether teachers trained
in these techniques will sustain their use of the techniques
without continued support from an SLP. Also, it is not known
whether teachers’changes in their language-based whole-
class teaching practices will have a significantly positive
impact on the oral and written language abilities of students
with LI in their classes.
A priority for the current study was to observe and
measure the degree to which teachers would adopt and
use innovative techniques that were presented to them in a
training program. For this purpose, we turned to the Concerns-
Based Adoption Model (CBAM; Hord, Rutherford, Huling-
Austin, & Hall, 2006). This instrument provides a conceptual
framework for measuring the process of change when
learners (such as teachers) are asked to adopt and implement
new ideas within their teaching practices. The CBAM
has undergone rigorous validation (Hord et al., 2006) and has
been used to evaluate a range of teacher professional
development innovations, including the use of computer
technology as an instructional tool (Gershner & Snider,
1999; Newhouse, 2001; Schiller, 2003), the implementation
of a new curriculum (Christou, Eliophotou-Menon, &
Philippou, 2004), and preservice teacher training programs
(Ward, West, & Isaak, 2002). The Levels of Use (LoU; Hall,
Dirksen, & George, 2006) is one of three diagnostic tools
that form the CBAM. It was selected for this study to mea-
sure the participating teachers’change in their levels of
use of the instructional language modification techniques
before training, immediately after training, and then one
school term with no further training.
We conducted the RCT to answer the following research
questions:
&Do mainstream secondary school teachers who have
been trained in the use of instructional language
modification techniques by an SLP demonstrate the
use of these techniques in their classroom teaching
practices in comparison to a control group of teachers
who have not been trained?
&Can trained teachers’use of instructional language
modification techniques be sustained over a period of
time in the absence of further direct support from the
SLP?
&Do secondary school students with LI who have been
taught by teachers who used the instructional language
modification techniques demonstrate significant im-
provements in their oral and written language ability
in comparison to a control group of students with LI
whose teachers have not received the training?
&If improvements in the students’oral and written
language skills are observed pre–post teacher training,
are these improvements maintained after a period of
time when the trained teachers have no further support
from the trainer (the SLP)?
We predicted that the teachers would take up and maintain
their use of language modification techniques after receiv-
ing training from an SLP in a sustained, interactive, and
Starling et al.: Training Secondary Teachers 477
professionally collaborative approach. We were more cau-
tious about our predictions for improvement in the students’
oral and written language abilities. Adolescent LI is en-
trenched by nature and is known to persist in the long term
(Clegg et al., 2005; Law et al., 2009), even when stud-
ents are supported over time with regular language therapy
(Durkin & Conti-Ramsden, 2010). The impact on students
with LI of an intervention targeting changes to the language
of instruction in secondary teachers’whole-class teaching
practices is not known. Our hypothesis was that, by directly
training teachers in instructional language modification tech-
niques for use in the students’naturalistic language envi-
ronment, these changes could have a positive impact on the
oral and written language abilities of the students with LI
in the teachers’classes.
METHOD
Design
We chose to use an RCT using area sampling (Portnoy &
Watkins, 2009), with blinding of assessors and raters. We
approached an administrator of government schools, inde-
pendent of the current study, who located a group of demo-
graphically similar secondary schools in metropolitan Sydney,
Australia. A short list of schools was identified by the admin-
istrator, and two secondary schools agreed to participate in
the study.
A concealed randomization process occurred following
identification of a cohort of teacher and student participants
across the two schools. Whole schools were randomly as-
signed to the treatment or control condition by means of
sealed envelopes chosen by a person independent of the
study. The treatment condition school received a school term
of training; the control condition school was placed in a wait
condition and received the treatment (i.e., the training pro-
gram) after a wait period of one school term. The primary
cohort of participants across the two schools included
13 mainstream secondary school teachers; the secondary
cohort of participants included 43 Year 8 students who had
been identified with LI. These students attended classes
taught by the participating teachers.
The intervention was administered to the group of teachers
at the treatment-condition school over the period of an entire
school term (10 weeks). Following the posttraining tests,
the intervention was administered to the cohort of teachers at
the wait-condition school. Throughout this paper, the cohort
of teachers attending the treatment-condition school will
be referred to as the “trained group,”and the cohort of teachers
attending the wait-condition school will be referred to as the
“control group.”The first author, an experienced and certified
SLP, administered the training program. All assessments,
scorings, and ratings were carried out by research assistants
(RAs) who were blinded to the nature of the intervention, the
trained/control condition of the cohorts, and the test phases of
the study. Intention to treat analysis was used in this study.
The trained group of teachers and students were assessed
at three phases of the study: pre/testing time 1, post/testing
time 2, and follow-up post/testing time 3. Due to their de-
layed treatment condition, the control group of teachers and
students participated in two pretraining testing phases of the
study (delayed pre/testing time 1 and pre/testing time 2)
and were again assessed at post/testing time 3 and follow-up
post/testing time 4. There was a period of È12 weeks be-
tween each phase of testing, representing a 2-week school
holiday plus one 10-week school term. Table 1 summarizes
the training and testing timetable.
Participants
Ethical approval was obtained from the University of
Sydney, and permission to conduct the research study was
obtained from the New South Wales (NSW) Department of
Education and Training. Two large, urban, coeducational
government secondary schools in metropolitan Sydney,
Australia, were recruited for the study. Approximately 85%
of the total student population at both schools was from
culturally diverse backgrounds, with English as their primary
language. The students attended the second year of sec-
ondary education, Year 8, which is the equivalent of middle
school Grade 8 in the United States.
Teacher participants.Following identification of the
cohort of Year 8 students with LI, all teachers at both schools
who had at least one student in one of their regular classes
were invited by the school executive to participate in the
study. Seventeen teachers originally agreed to participate;
however, four withdrew before the study commenced due
to personal reasons. Thus, there was a total of 13 teacher
participants in the final cohort: seven teachers in the trained
group, and six in the control group. These teachers were from
a range of teaching disciplines: math; history/geography;
Table 1. Time line of study.
Testing time 1 Testing time 2 Testing time 3 Testing time 4
Trained group Pre Training Post No training Follow-up
Control group Delayed pre No training Pre Training Post No training Follow-up
478 LANGUAGE,SPEECH,AND HEARING SERVICES IN SCHOOLS •Vol. 43 •474–495 •October 2012
visual arts; personal development, health, and physical edu-
cation (PDHPE); English; science; and agriculture. None of
the teachers was participating in other professional devel-
opment programs on language and literacy during their
participation in this study. A summary of the teachers’demo-
graphic profiles is presented in Table 2.
Student participants. Teaching staff at the two schools
were asked to identify a cohort of Year 8 students with
known or suspected LI, according to standard exclusion
criteria, including the absence of sensory deficits or devel-
opmental disabilities (Tomblin, Zhang, Buckwalter, & O’Brien,
2003). Because both schools had a high percentage of stu-
dents from culturally diverse backgrounds, students were
excluded from the study if they were assessed by the schools
as being either first- or second-phase English as a Second
Language (ESL) learners (NSW Department of Education
and Training, 2004). Sixty-six students were identified
across the two schools, representing 16.5% (34/206) of the
Year 8 students in one school and 17% (32/185) in the other.
Consent was sought from the students’parents for inclusion
in the study, as a result of which, 47 of the 66 identified
students were screened (22 at one school, 25 at the other).
One identified student was expelled from school just as the
screening program started.
Verbal language screening consisted of five subtests of the
Comprehensive Assessment of Spoken Language (CASL;
Carrow-Woolfolk, 1999) to obtain a core language score.
Nonverbal abilities were assessed using the Test of Non-
verbal Intelligence—3 (TONI–3; Brown, Sherbenou, &
Johnsen, 1997). The criterion for inclusion in the study was
a core language score indicating LI, being either a specific
language impairment (SLI) or a nonspecific language im-
pairment (NLI). Consistent with previous literature, an SLI
was defined as a verbal score of ≤standard score (SS)
85 (i.e., at least 1 SD below the norm) and a nonverbal
score of ≥SS 85 (Plante, 1998; Stark & Tallal, 1981).
An NLI was defined as a verbal score of ≤1SD below the
norm and a nonverbal score between 1 and 2 SDs below
the norm (SS 70–85) (Tomblin et al., 2003). The NLI
nonverbal cutoff was based on the diagnostic criterion for
intellectual and developmental disability as stated in the
Diagnostic and Statistical Manual of Mental Disorders,
4th Edition-Text Revision (DSM-IV-TR; American Psychi-
atric Association, 2000), being a nonverbal IQ < SS 70.
Of the 47 students screened, 43 met the criteria of an LI,
21 (17 males: 4 females) in the trained school group and
22 (16 males: 6 females) in the control school group. Interes-
tingly, the male to female ratio of adolescents with LI
identified in this study (3.3m: 1f) reflects the findings of
other larger scale prevalence studies. For example, a follow-
up study at ages 16–17 of Bishop and Edmundson’s (1987)
initial cohort of preschool children identified with speech-
language impairment reported a 3m: 1f ratio of adolescents
with persistent LI (Snowling, Adams, Bishop, & Stothard,
2001). Similarly, the Manchester Language Study (Conti-
Ramsden & Botting, 1999) reported a 3.3m: 1f ratio for the
initial cohort of 242 7- and 8-year-olds with LI.
There were no significant differences between the groups
in terms of age (trained school student age range in months
155–168, M
age
= 158; control group age range 151–171,
M
age
= 160 months; p= .246). The students’ethnic back-
grounds were as follows: Caucasian (trained school: 5, con-
trol school: 4), Asian (trained school: 12, control school:
15), African (trained school: 3, control school: 2), and Arabic
(trained school: 1, control school: 1). As previously iden-
tified in the LI inclusion/exclusion criteria, all student
participants were proficient English speakers.
Table 3 presents the screening test results of the trained and
control student groups. There were no significant differences
Table 2. Teacher demographics.
Trained group
(n=7)
Control group
(n=6)
Years of teaching
1–320
4–621
7–910
10–20 2 1
20+ 0 4
Highest qualification
Diploma/certificate 3 2
Bachelor of Arts degree 4 4
Course in learning difficulties
None 5 3
Diploma in special education 0 1
Stand-alone course 2 2
Age range
20–29 3 1
30–39 2 1
40–49 1 4
50–60 1 0
Gender 1m/6f 0m/6f
Table 3. Screening test standard scores (mean and standard
deviation) of Year 8 student participants.
Screening test
standard score
Trained
school
n=21
Control
school
n=22
tvalue pvalue
M SD M SD
CASL core
language score
73.6 9.6 74 9.5 –.329 .744
TONI–3 93.5 10.7 99.6 14.9 –1.431 .160
Note. CASL = Comprehensive Assessment of Spoken Language
(Carrow-Woolfolk, 1999). TONI–3 = Test of Nonverbal Intelli-
gence, Third Edition (Brown, Sherbenou, & Johnsen, 1997).
Starling et al.: Training Secondary Teachers 479
between the groups’verbal and nonverbal screening test
standard scores. There were no regular speech-language
pathology services available at either school, and none of
the participating students was accessing speech-language
pathology services in the private sector.
Participant flow. All seven trained group and six control
group teachers participated in all phases of the study. For
the 21 students in the trained group, all 21 were retested
at post, but one student was absent for the follow-up tests
(n= 20). For the 22 students in the control group, retention
rates were similar, with all 22 students tested at the delayed
pre and pre times, and one student absent for the posttest
(n= 21).
The Program
Program content. The following paragraphs summarize
the four types of instructional language modification tech-
niques that were presented in the program:
&Teachers’written language. Examples included mod-
ifying the language used on a teacher-prepared work-
sheet by breaking down large amounts of information
into smaller, visually distinct sections; adding graphics
and visual icons; providing descriptions for instruc-
tional vocabulary; and ensuring that questions were on
the same page as the text for easier reference.
&Teachers’oral language. Examples included ensuring
that instructions were explicit rather than inferred,
allowing time for students’processing and verbal
responses, repeating and rephrasing key information
and instructions, and facing the class when delivering
important information.
&Information processing. Examples included ensuring a
whole-of-class involvement in the deconstruction of
complex texts, for instance, by creating a mind map on
the board that summarized “discussed and agreed”key
points and associated facts; providing a visual planner
on the board; outlining the sequence of tasks to be
covered during the lesson; and involving the whole
class in creating visual aids such as charts and posters to
assist information processing and retention.
&Direct vocabulary instruction. Examples included
prioritizing vocabulary when starting each new curric-
ular topic, based on the three-tier vocabulary system
(Beck et al., 2002); embedding vocabulary in the
students’learning through activities such as creating
visual symbols to assist with word meanings and
retention; and conducting whole-class interactive mor-
phemic analysis that included identifying root words,
prefixes, and suffixes for better understanding of
unfamiliar vocabulary.
Appendices A and B provide examples of some of the
techniques that were used to modify teachers’instructional
language, taken from the program implementation.
Program delivery. The training program was delivered by
means of individual or small-group interactive meetings
between the SLP and the teachers. The meetings occurred at
the school during a 50-min out-of-class period once a week
for the duration of a school term (10 meetings). When nec-
essary, teachers were provided with a substitute teacher so
they could have class release time. In addition, the SLP at-
tended a minimum of three lessons per teacher to observe the
teachers’use and application of the trained techniques in situ.
The meetings between the teachers and the SLP served
various purposes, including the introduction, explanation,
and modeling of the oral and written instructional language
modification techniques, as well as discussion of ideas for
the application of these techniques to general classroom
scenarios. The meetings were also used for follow-up dis-
cussion of issues arising from implementation of the ideas as
observed by the SLP or reported by the teachers. At a later
stage of the program, teachers were encouraged to generate
their own ideas and modify resources without direct input
from the SLP, and application of these modifications was
also observed and discussed. The intention was that all
teachers would reach a stage of independent initiation and
application of instructional language modifications by the
end of the training program.
Program fidelity. Program fidelity was addressed in the
following ways. First, at the start of the training program,
all participating teachers were provided with the same
program manual (Starling, 2008). This manual presented
an overview of the program, including background rationale,
and an outline of the training program, including the four
phases of the program (i.e., overview and planning, instruc-
tion, learning and application, and assessment). Hypothetical
scenarios were provided for each instruction and learning
phase. To ensure consistency, a meeting protocol as outlined
in the manual was also used. The program contents (instruc-
tional language modification techniques) were presented
in the manual, with examples of applications.
Second, observation of the teachers’use of the trained
techniques occurred at least three times per teacher over the
course of the training program. Two rating forms were de-
veloped as an explicit protocol to guide and record the
trainer’s observations and the teachers’self-evaluations.
The forms were adapted from Larson and McKinley’s pro
forma for the evaluation of teachers’language (Larson &
McKinley, 2003a, p. 447), one targeting teachers’spoken
language and the other targeting teachers’written language.
The forms used a grid of eight areas evaluated on a 5-point
rating scale. An example of a spoken language evaluation
was “volume of voice,”with the five rating points being on a
scale from very quiet to very loud. An example of a written
language evaluation was “use of visual aids to support
written text,”with the five rating points being on a scale
from minimal use to highly used.
The completed forms were used as the basis of discussion
at the training meetings, so that comparisons could be made
480 LANGUAGE,SPEECH,AND HEARING SERVICES IN SCHOOLS •Vol. 43 •474–495 •October 2012
between the trainer’s observations and the teachers’self-
perceptions. These discussions facilitated identification
of teachers’individual goals for developing instructional
language modifications and the subsequent monitoring of
progress in meeting these specific goals. For example, a
science teacher identified, in consultation with the trainer,
that her lessons were very disorganized, that she tended to
talk at great length, and that subsequently she did not
cover the required curriculum content. The teacher was
previously unaware of the challenge she was imposing on
the students in her classes who had LI with associated
auditory processing and retention difficulties. This teacher
made two particular changes to her language-based in-
structional language practices. First, she wrote a visual
planner on the board at the start of each lesson, outlining the
topics and activities that she planned to cover. This list
would be referred to by both the teacher and her students
as the lesson progressed. Second, the trainer and teacher
worked collaboratively to develop a set of written resources
covering curriculum content information handouts and
worksheets that were then applied in the teacher’s whole-
class teaching practices.
As a third way of addressing program fidelity, modified
written resources that were developed collaboratively by
the SLP and teachers were collected over the course of
the training. A randomly selected sample of 20 such re-
sources (at least two for each trained teacher) identified a
90% rate of use by the teachers in their classroom teaching
practices, confirmed by teacher report or SLP observation.
By the end of the training program, all of the trained
teachers were observed to self-generate and use at least
10 language modification ideas in the classroom (at least
one per teacher).
Lastly, to ensure that the direct vocabulary instruction
component of the training program was being implemented,
whole classes were given pre- and posttopic instruction vo-
cabulary tests. Students were tested on their knowledge of
10 curricular words that had been identified and described by
each teacher, in collaboration with the SLP, as being of the
highest priority to the learning of a specific topic. Each de-
scription included one or two key words that were thought to
be contextually appropriate and important for the students’
demonstration of an understanding of the curricular word.
For example, the history teacher chose mobility as an es-
sential curricular word for the topic of indigenous peoples,
with the description “Mobility is the ability to move freely
from place to place,”and the key word being move. Trained
teachers gave the preinstruction tests to all students in their
Year 8 classes before the introduction of a new curricular
topic; the postinstruction tests were administered to the same
students at the completion of instruction in that topic. In most
cases, the postinstruction tests coincided with completion
of the 10-week training program. The use of the pre- and
postvocabulary tests by all participating teachers reinforced
the program’s fidelity.
Testing Tools and Procedures
Teachers’use of instructional language modification
techniques. As introduced earlier, the LoU tool (Hall et al.,
2006) from the CBAM (Hord et al., 2006) was used to
evaluate the teachers’changes in their use of the program
techniques over time. The LoU tool required a structured
face-to-face interview. The interview was audio-recorded
and then transcribed, and the teachers’responses were coded
according to their individual movement along a continuum
of change in relation to a set of seven distinct behavioral
parameters.
The LoU tool does not code nonuse or use of an inter-
vention as a discrete binary option. Instead, there are three
levels of nonuse: Level 0 (Nonuse), Level I (Orientation),
and Level II (Preparation); and five levels of use: Level III
(Mechanical Use), Level IVA (Routine), Level IVB (Refine-
ment), Level V (Integration), and Level VI (Renewal). The
five user levels are subgrouped as follows: Levels III, IVA,
and IVB being user: self-focused; and Levels V and VI being
user: impact-focused. These eight levels are described in
detail in Table 4.
These levels of use therefore demonstrate a continuum
of change from being a nonuser to a user of an intervention.
Levels are measured in relation to seven behavioral param-
eters: Knowledge, Acquiring Information, Sharing, Assess-
ing, Planning, Status Reporting, and Performing. Table 5
provides descriptions of each parameter.
In the context of this study, a teacher who was not using
the techniques included in the training program was con-
sidered to be at the “nonuser”level. In contrast, a teacher
who was in the process of learning and using the techniques
in the classroom but was not sharing ideas and resources with
colleagues was considered to be at a “user: self-focused”
level. At a “user: impact-focused”level, teachers indicated
active sharing of ideas and resources with others such as
teaching colleagues and school administrators.
The structured interview was conducted by independent
RAs at all testing points in the study, for both the trained and
control teacher groups. Teachers’audio-recorded and tran-
scribed responses were then coded by independent raters
who were blinded to the nature and testing phases of the
study. The interviewers were blinded to the specific contents
and purpose of the program, the trained/control condition
of the participants, and the testing phases of the study. All
RAs had a professional qualification relevant to the study,
such as speech-language pathology or teaching, and all
received training in the interview protocol (Hall et al., 2006)
by the principal researcher.
The LoU interview protocol uses the term “innovation”to
describe a new program. In our study, the term “innovation”
was replaced with the more familiar term “intervention. ”
To orient the teachers to the intervention, RAs qualified this
term by adding the phrase “language modification tech-
niques”at the start of the interview.
Starling et al.: Training Secondary Teachers 481
RAs adhered to the interview protocol by using a standard
written script (Hall et al., 2006, Appendix A). This script is
organized around a series of decision points that allow the
interviewer to make decisions about which questions to ask.
For example, if it was decided early in the interview that the
interviewee was not aware of, or was not using, the inter-
vention, the interview would follow a particular, and limited,
pathway of questioning. However, if it was found that the
interviewee was at a certain stage of using the intervention,
then the interviewer would continue with appropriate ques-
tions to gain more in-depth information. At all levels of
questioning, information was sought for each of the seven
behavioral parameters.
The following are examples of questions that were asked
as part of the interview protocol:
&At an initial stage of the interview: “Are you using the
ideas targeted in the intervention?”“Are you currently
looking for information about the intervention? ”
&Questions asked once it was ascertained that the inter-
viewee was using the ideas introduced in the inter-
vention: “Have you made any changes recently in how
you use the intervention?”“What do you see as the
strengths and weaknesses of the intervention in your
situation?”“Do you ever talk with others about the
intervention?”
In this way, each teacher’s levels of use could be quan-
tified over the time of the study according to a set of dis-
tinct behaviors. For example, a control group teacher who
responded to the question, “Have you made a decision to use
the intervention in the future?”with “I haven’t read it so I
don’t know how I can use it”for the behavioral category of
planning would be coded 0 (Nonuse). This indicates a level of
nonuse that aligns itself with the definition, “Individuals. . .
schedule no time and specify no steps for the study or use
of the innovation (intervention)”(Hall et al., 2006, Appen-
dix E). In contrast, if a teacher responded “Definitely I’ll use
it (the intervention), actually I’ll have a Year 7 learning
difficulties class (next year), so I’m definitely looking into
adjusting my worksheets and work that I used this year,”this
response would be coded at a self-focused level of use (IVB,
Refinement). In relation to the parameter Planning, this
response is consistent with individuals who “develop
intermediate and long-range plans that anticipate possible
and needed steps, resources and events designed to enhance
client outcomes”(Hall et al., 2006, Appendix E). Similarly,
in relation to Status Reporting, a question is asked: “Have you
Table 4. The eight Levels of Use (LoU) of an intervention (Hall, Dirksen, & George, 2006).
LoU Level name Subcategory Description
0 (0) Nonuse Nonuse State in which the user has little or no knowledge of the intervention, has no
involvement with the intervention, and is doing nothing toward becoming
involved.
1 (I) Orientation Nonuse State in which the user has acquired or is acquiring information about the
intervention and/or has explored or is exploring its value orientation
and its demands upon the user and the user system.
2 (II) Preparation Nonuse State in which the user is preparing for the first use of the intervention.
3 (III) Mechanical Use User: Self-focused State in which the user focuses the most effort on the short-term, day-to-day
use of the intervention with little time for reflection. Changes in use are
made more to meet user needs than client needs. The user is primarily
engaged in a stepwise attempt to master the tasks required to use the
intervention, often resulting in disjointed and superficial use.
4(IVA) Routine User: Self-focused Use of the intervention is stabilized. Few if any changes are being made in
ongoing use. Little preparation or thought is being given to improving
intervention use or its consequences.
5 (IVB) Refinement User: Self-focused State in which the user varies the use of the intervention to increase the
impact on clients within his or her immediate sphere of influence.
Variations are based on knowledge of both short- and long-term
consequences for clients.
6 (V) Integration User: Impact focused State in which the user is combining own efforts to use the intervention with
the related activities of colleagues to achieve a collective impact on clients
within their common sphere of influence.
7 (VI) Renewal User: Impact focused State in which the user reevaluates the quality of the use of the intervention,
seeks major modifications or alternatives to the present intervention to
achieve increased impact on clients, examines new developments in the
field, and explores new goals for self and the system.
Note. For column one, the original LoU numbering system is included in parentheses. For data analysis and interpretation, the numbering of
the levels is also shown. From Measuring Implementation in Schools: Levels of Use (p. 5), by G. E. Hall, D. J. Dirksen, and A. A. George,
2006, Austin, TX: Southwest Educational Development Laboratory (SEDL). Copyright 2006 by SEDL. Adapted with permission.
482 LANGUAGE,SPEECH,AND HEARING SERVICES IN SCHOOLS •Vol. 43 •474–495 •October 2012
made any changes in how you’re using the intervention?”
A teacher’s response such as “I made adjustments for every-
one, and then I had further activities for those that finished
faster, they had further challenges while I targeted those who
couldn’t do so much”would also be coded as a self-focused
user level of IVB (Refinement). At this level, in relation to
the parameter Status Reporting, a user “Reports varying use
of the innovation (intervention) in order to change client
outcomes”(Hall et al., 2006, Appendix E).
Interrater reliability between blinded assessors and the
first author for 25% of the LoU coded data, randomly
selected, was 94%.
Student testing. To evaluate the potential impact of the
teachers’use of instructional language modification tech-
niques on the cohort of students’language-based learning
abilities, four subtests of the Wechsler Individual Achieve-
ment Test—Second Edition, Australian Standardised Edition
(WIAT–II; Wechsler, 2007) were used: Reading Compre-
hension, Written Expression, Listening Comprehension, and
Oral Expression. This assessment tool was chosen due to its
provision of (a) subtests that assess both oral and written
language, (b) Australian population normative data, (c) Aus-
tralian language adaptations, and (d) robust content validity
in relation to Australian curriculum content (Wechsler, 2007).
For the Reading Comprehension subtest, students read
a series of short and longer passages and then verbally
answered questions related to the texts. For the Written
Expression subtest, students completed (a) a written word
fluency task, (b) a sentence-writing task, and (c) an expos-
itory essay-writing task. The Listening Comprehension
subtest involved receptive vocabulary, sentence compre-
hension, and answering questions such as “Tell me the word
that means ‘to break loose or free.”’ The Oral Expression
subtest involved an oral word fluency task, a visual passage
retell, and giving oral directions for two procedures.
Students were tested, and the responses scored, by trained
RAs who were blinded to the nature, the trained/control
condition, and the testing phases of the study.
Interrater reliability testing between the first RAs and a
second set of RAs was carried out for a random sample of
25% of the tests, with 92% reliability. An additional set of
reliability tests was carried out for two of the four subtests
of the WIAT–II, Written Expression and Oral Expression, as
these required more response interpretation than Reading Com-
prehension and Oral Comprehension. Interrater reliability
for scoring the Written Expression and Oral Expression
subtests for 25% of randomly selected test data was 90%.
Data Analysis
Teacher cohort. To evaluate the trained group of teachers
relative to the control group of teachers, data were compared
at time points relevant to when the trained teachers were first
tested. This meant that the efficacy of the training was
measured at pre and post conditions for the trained group
relative to the delayed pre and pre conditions of the control
group. For ease of presentation, the results will be anchored
to the terms pre (time 1) and post (time 2). Recall that the
coded LoU teacher data could reflect the effects of pro-
fessional development by an individual’s movement along
a continuum of change, that is, from being a nonuser of an
intervention to being a self-focused user and, ultimately,
to being an impact-focused user. The data as such could
range from Level 0 (Nonuse), Level 1 (Orientation), Level II
(Preparation), Level 111 (Mechanical Use), Level IVA
(Routine), Level IVB (Refinement), Level V (Integration),
and finally, Level VI (Renewal), where Levels 0–II indicate a
nonuser of an intervention, Levels III–IVB reflect a self-
focused user of an intervention, and Levels V and VI reflect
an impact-focused user (Hall et al., 2006).
To account for the ordinal nature of these data, we needed
to change Level IVA (Routine) and Level IVB (Refinement).
To do this, we recoded Level IVA data as scores of 4 and
Level IVB data as scores of 5. This meant that Level V
(Integration) data were then changed to 6 and Level VI
(Renewal) data to 7. Thus, the range of levels of use for our
analysis became a score from 0–7 (nonuser: Levels 0–2,
user: self-focused: Levels 3–5, and user: impact-focused:
Levels 6–7).
Table 5. Behavioral parameters for the LoU.
Category Description
Knowledge That which the user knows about characteristics of
the intervention, how to use it, and consequences
of its use.
Acquiring
Information
Solicits information about the intervention in a
variety of ways, including questioning resource
persons, corresponding with resource agencies,
reviewing printed materials, and making visits.
Sharing Discusses the intervention with others. Shares
plans, ideas, resources, outcomes, and problems
related to use of the intervention.
Assessing Examines the potential or actual use of the inter-
vention or some aspect of it. This can be a
mental assessment or can involve actual
collection and analysis of data.
Planning Designs and outlines short- and long-range steps
to be taken during the process of intervention
adoption (e.g., aligns resources, schedules, and
activities) and meets with others to organize
and/or coordinate use of the intervention.
Status
Reporting
Describes personal stand at the present time in
relation to use of the intervention.
Performing Carries out the actions and activities entailed in
operationalizing the intervention.
Note. From Measuring Implementation in Schools: Levels of Use
(Appendix E, pp. 79–81), by G. E. Hall, D. J. Dirksen, and A. A.
George, 2006, Austin, TX: Southwest Educational Development
Laboratory (SEDL). Copyright 2006 by SEDL. Adapted with
permission.
Starling et al.: Training Secondary Teachers 483
Inspection of the LoU data revealed that it was not nor-
mally distributed. As such, standard repeated measures anal-
yses of variance (ANOVAs) using the raw LoU data were not
pursued. Instead, we used aligned rank procedures for testing
multivariate interactions. Such procedures are known to bet-
ter control for Type 1 error rates for nonnormal data (Beasley,
2002). To do this, LoU scores for each dependent variable
were first ranked. To specifically investigate potential main
effects of time and group, the ranks of the original scores
were subjected to 2 ×2 repeated measures ANOVAs. Then,
to investigate possible interactions, aligned scores were cal-
culated by subtracting the main effect means from each in-
dividual unranked score. This produced the aligned scores
for each dependent variable that were then analyzed via 2 ×2
repeated measures ANOVAs, ignoring the main effects and
this time specifically looking for Time ×Group interactions.
Effect sizes are reported where h
p
2
values of 0.0099 refer to a
small effect size, 0.0588 to a medium effect size, and 0.1379
to a large effect size (Cohen, 1969; Richardson, 2011).
For ease of presentation, the statistical output is reported,
but with median and interquartile ranges displayed. The data
can thus be interpreted against the parameters of the LoU
instrument, where teachers ranged from being nonusers of
the techniques to being self- and impact-focused users (i.e.,
with scores from 0–7). To answer whether trained teachers
were able to sustain their use of the instructional language
modification techniques over time without any further
instructional support, separate Wilcoxon signed-ranks tests
were conducted from post to follow-up testing conditions
using the original data.
Student cohort . To evaluate the students whose teachers
had received the training compared to those in the control
group, data were compared at time points relevant to when
the students from the trained school were first tested. This
meant that the potential effects of the teacher training on
the students’written and oral language performance were
measured at pre and post conditions for the trained group
relative to the delayed pre and pre conditions for the control
group. Consistent with the teacher data, these results will
continue to be anchored to the terms pre (time 1) and post
(time 2). The student data were normally distributed and so
were analyzed by repeated measures ANOVAs. Effect size
benchmarks are reported as per the teacher cohort. To
observe longer term student outcomes once their teachers
were trained, separate paired ttests were conducted from
post to follow-up testing conditions.
RESULTS
Teacher Outcomes
Pre and post training. There are seven behavioral pa-
rameters within the LoU instrument. These are Knowledge,
Acquiring Information, Sharing, Assessing, Planning, Status
Reporting, and Performing. Table 6 presents the median,
minimum, maximum, and interquartile ranges of the seven
parameters of the LoU pre and post training for the trained
teachers and the control teachers.
To interpret these data, a score from 0–7 reflects a group’s
movement along a continuum from being a nonuser of
an intervention (scores 0–2) to being a self-focused user
(scores from 3–5) to being an impact-focused user (scores
of 6 and 7). Table 6 reveals that across all of the behavioral
parameters of the LoU, the groups were equivalent in their
nonuse of the intervention when they were interviewed
before the trained group received training; that is, neither
group reported the use of language modification techniques
in their regular teaching practices.
After training, the teachers showed increased scores that
reflected being a user of the intervention. The median scores
post training for the trained teachers indicated that these
Table 6. Descriptive results (median, minimum, maximum,
and interquartile range) of the seven behavioral parameters of
the LoU pre and post training for the trained teachers versus the
control teachers.
LOU
parameter
Trained
teachers’
pretraining
scores
Trained
teachers’
posttraining
scores
Control
teachers’
pre
scores
Control
teachers’
post
scores
Knowledge
Median 0 4 0 0
Min/Max 0–13–600–1
25%–75% 0–14–500–.25
Acquiring
Information
Median 0 4 0 0
Min/Max 0–14–600–1
25%–75% 0–14–500–1
Sharing
Median 0 5 0 0
Min/Max 0 4–600–1
25%–75% 0 4–600–1
Assessing
Median 0 4 0 0
Min/Max 0–14–50–10–1
25%–75% 0–14–50–10–1
Planning
Median 0 5 0 0
Min/Max 0 3–600–1
25%–75% 0 4–500–1
Status Reporting
Median 0 4 0 0
Min/Max 0–13–600–1
25%–75% 0 4–500–1
Performing
Median 0 4 0 0
Min/Max 0 3–500
25%–75% 0 3–500
Note. Score of 3 = Mechanical Use of an intervention, 4 = Routine
use, 5 = Refinement, and 6 = Integration.
484 LANGUAGE,SPEECH,AND HEARING SERVICES IN SCHOOLS •Vol. 43 •474–495 •October 2012
teachers were now self-focused users of the intervention (scores
from 3–5) across five of the behavioral parameters, indicating
routine useof the intervention (median score of 4 for Knowledge,
Acquiring Information, Assessing, Status Reporting, and
Performing). Two parameters (Sharing and Planning) had a
median score of 5, indicating refinement of the intervention.
Table 6 also identifies the range of scores post training as
some teachers moved from being a nonuser of the inter-
vention to being an impact-focused user (i.e., having a score
of 6 across five of the behavioral parameters, including
Knowledge, Acquiring Information, Sharing, Planning, and
Status Reporting). Table 7 presents frequency data of the
trained teachers’levels of use post training. This identifies
that out of the seven teachers, one teacher scored a 6 for four
parameters (i.e., Acquiring Information, Sharing, Planning,
and Status Reporting), one scored a 6 for Knowledge and
Sharing, and one scored a 6 for Sharing.
Significant main effects for time and group were observed
for the following parameters: Knowledge, Sharing, Assessing,
Planning, Status Reporting, and Performing. These were
qualified by significant Time ×Group interactions: Knowl-
edge, F(1, 11) = 35.419, p= .0001, h
p
2
= .763; Sharing,
F(1, 11) = 18.494, p=.001, h
p
2
= .627; Assessing, F(1, 11) =
48.656, p=.0001, h
p
2
= .816; Planning, F(1, 11) = 9.489,
p=.01,h
p
2
=.463;Status Reporting,F(1, 11) = 8.323, p=.02,
h
p
2
= .431; and Performing, F(1, 11) = 38.259, p= .0001, h
p
2
=
.777. With respect to the parameter Acquiring Informa-
tion, a significant main effect was found for time, F(1, 11) =
34.181, p=.0001, h
p
2
= .757, and for group, F(1, 11) =
26.274, p=.0001, h
p
2
= .705, but only a marginal Time ×
Group interaction was observed, F(1, 11) = 3.999, p=.071,
h
p
2
= .267.
Post training to follow-up. To investigate whether trained
teachers were able to sustain their use of the instructional
language modification techniques over time, Wilcoxon
signed-ranks tests were conducted using the raw data from
post to follow-up testing conditions for each LoU behav-
ioral parameter. These tests revealed no significant differ-
ences between post and follow-up conditions for the trained
teacher group on all behavioral parameters of the LoU:
Knowledge (follow-up median score = 4, interquartile
range 4–5, Z= 7.500, asymptomatic (two tailed) = .1000);
Acquiring Information, (follow-up median score = 4,
interquartile range 4–4, Z= 1.500, asymptomatic (two
tailed) = .414); Sharing (follow-up median score = 4, inter-
quartile range 4–5, Z= <.001, asymptomatic (two tailed) =
.059); Assessing, (follow-up median score = 4, interquartile
range 4–5, Z= 1.500, asymptomatic (two tailed) = 1.000);
Planning (follow-up median score = 4, interquartile range
4–5, Z= 1.500, asymptomatic (two tailed) = 1.000); Status
Reporting (follow-up median score = 4, interquartile range
3–5, Z= 7.000, asymptomatic (two tailed) = .414); and
Performing (follow-up median score = 4, interquartile range
3–5, Z= 7.500, asymptomatic (two tailed) = 1.000).
Student Outcomes
Pre and post training. The students from the trained and
control groups were tested pre and post training on the
WIAT–II subtests of Listening Comprehension, Written
Expression, Reading Comprehension, and Oral Expression.
Figure 1 identifies standard scores for all four subtests of the
students with LI whose teachers had (trained group) or had
not (control group) received the training.
WIAT–II: Written Expression. A significant main effect
was found for time, F(1, 41) = 4.174, p=.05, h
p
2
= .092, but
not for group, F(1, 41) = 3.05, p=.08, h
p
2
= .069. There was
a significant Time ×Group interaction, F(1, 41) = 11.338,
p=.002, h
p
2
= .217, where the students whose teachers had
received the training significantly improved from pre to post
testing compared to the students whose teachers had not
received the training.
WIAT–II: Listening Comprehension. A significant main
effect was found for time, F(1, 41) = 10.581, p=.002,h
p
2
=
.205, and a marginal effect was observed for group, F(1, 41) =
3.517, p= .068, h
p
2
= .079. This was qualified by a signif-
icant Time ×Group interaction, F(1, 41) = 4.859, p=.033,
h
p
2
= .106. Consistent with the Written Expression results, the
students taught by the trained teachers improved significantly
from pre–post times when compared to the control group
of students.
WIAT–II: Oral Expression. Figure 1 identifies that the
students’Oral Expression standard scores did not improve
pre–post teacher training. There were no main effects ob-
served for time,F(1, 41) = .116, p= .735, h
p
2
= .003, or
group, F(1, 41) = .0843, p= .364, h
p
2
= .020, and there was
no significant Time ×Group interaction, F(1, 41) = .637,
p= .429, h
p
2
= .015.
WIAT–II: Reading Comprehension. For Reading Com-
prehension, a significant main effect of time was observed,
F(1, 41) = 6.562, p= .014, h
p
2
= .138, but there was no main
effect for group, F(1, 41) = 2.344, p= .133, h
p
2
= .054.
Similar to the Oral Expression subtest results, there was
no significant Time ×Group interaction, F(1, 41) = .045,
p=.833,h
p
2
=.01.
Table 7. Frequency table of the trained teachers’(n= 7)
posttraining scores across the LoU behavioral parameters.
Parameter
LoU score
3456
Knowledge 1 3 2 1
Acquiring Information 5 1 1
Sharing 2 2 3
Assessing 5 2
Planning 1 2 3 1
Status Reporting 1 3 2 1
Performing 2 2 3
Starling et al.: Training Secondary Teachers 485
Post training to follow-up. Paired ttests (post to follow-up)
were conducted on each of the four WIAT–II subtests that
were administered to the students in the trained group. Aver-
age standard scores remained stable over the 12-week period
between the tests. There was no significant difference in
performance between post to follow-up tests on Reading Com-
prehension, postintervention mean = 80.62, SD =5.5,follow-up
mean = 80.1, SD = 6.2, t(19) = .447, p=.660;Listening
Comprehension, postintervention mean = 82.4, SD = 14.5,
follow-up mean = 82.4, SD = 12.8, t(19) = .0001, p= 1.00;
Oral Expression, postintervention mean = 87.48, SD = 10.0,
follow-up mean = 87.8, SD = 8.6, t(19) = .214, p= .833; or
Written Expression, postintervention mean = 92.2, SD =12.9,
follow-up mean = 92.5, SD =13.0,t(19) = .117, p=.908.
DISCUSSION
This study evaluated the efficacy of a training-based
collaboration between an SLP and a group of mainstream
secondary school teachers. The purpose of the training was
to facilitate changes to teachers’oral and written instruc-
tional language and to observe the impact this had on the
language abilities of students with LI in their classes. Our
first hypothesis was that the teachers who were trained over a
period of time by the SLP in the use of a set of instruc-
tional language modification techniques would adopt these
techniques and apply them to their regular whole-class
teaching practices. An additional hypothesis was that, as a
carryover benefit, the use and application of the tech-
niques by the teachers would lead to improvements in
the language abilities of the students with LI in their
classes.
The findings of the present study support these hypoth-
eses. Results indicated that the trained teachers significantly
moved along a continuum of change in their levels of use of
the techniques, to at least a self-focused level and, in some
cases, to an impact-focused level of use. In contrast, no
change was seen in the levels of use of the intervention by
the control group who had not yet received the training.
Similarly, positive outcomes were observed in the group of
Figure 1. Wechsler Individual Achievement Test, Second Edition, Australian Standardised Edition (Wechsler, 2007) subtest results at
pre and post training for Year 8 students with language impairment in the trained school versus the control school.
486 LANGUAGE,SPEECH,AND HEARING SERVICES IN SCHOOLS •Vol. 43 •474–495 •October 2012
secondary school students with LI who were taught by
the trained teachers, relative to those students in the control
condition school. For the students who were instructed
by teachers who underwent training, we found significant
improvements in two of the WIAT–II subtests, namely,
Written Expression and Listening Comprehension, assessed
pre and post teacher training.
To the authors’knowledge, this RCT study is among
the first of its kind to evaluate a systems-based approach
to the treatment of LI in adolescence that links changes in
mainstream secondary school classroom teachers’instruc-
tional language practices with the language abilities of whole
populations of secondary school students with LI. The study
makes a significant contribution to the body of evidence
for supporting adolescents with LI, as it validates a treatment
approach that enables regular classroom teachers to create
a more supportive and information-accessible language
environment for the students with LI in their classes.
Teachers’Use of Instructional Language
Modification Techniques
Our key question was whether a group of across-subject
mainstream secondary school teachers would demonstrate
the use and application of the ideas that were presented in the
training program. To address this, we used a measurement
tool that demonstrated changes in the teachers’behavior
across time as it related to their involvement in the program.
We were primarily interested in the general movement of
the teachers along a continuum of change from being non-
users of the intervention to being active users at progres-
sively self- and impact-focused levels.
We found that all of the trained teachers changed from
being nonusers of the techniques introduced in the program
to being users at, at least, self-focused levels, and in some
cases, at an impact-focused level of use. In contrast, the
control group of untrained teachers remained at the nonuser
level. Additionally, the trained teachers sustained their use
of the intervention over a period of time following com-
pletion of the training when there was no further input from,
or support by, the SLP.
Specifically, the trained teachers significantly improved
over time in the levels of use for six of the seven parameters
relative to the control group. These included Knowledge,
Sharing, Assessing, Planning, Status Reporting, and Perform-
ing. Only a marginal Time ×Group interaction was observed
for Acquiring Information. This parameter involves an in-
dividual’s seeking of information about a new intervention
by, for example, conducting Internet research or asking
colleagues for information. The lack of a significant Time ×
Group interaction for this parameter may have been in-
fluenced by two teachers in the wait-condition control group
whose responses moved from Level 0 (Nonuse: little or no
knowledge of, or interest in, the intervention) to Level I
(Orientation: still at a nonuse stage, however has sought
information about the intervention). It may be that these
teachers, by being interviewed, became curious about the
impending program and its contents and so independently
sought information about the nature of adolescent LI.
According to the LoU tool, to be assessed as a self-
focused user of an intervention means that individuals dem-
onstrate regular instances of use and application of new
ideas in their day-to-day practices, with an emphasis on mas-
tering the steps needed to implement these ideas (Level III:
Mechanical Use), to the next level where the ideas are be-
coming more routinely established in their regular teaching
practices (Level IVA: Routine). The third level of se lf-focused
use (Level IVB: Refinement) is attained when individuals
become more involved in the generalization of basic con-
cepts introduced in the training and in the creation of their
own resources based on the presented techniques (i.e.,
without direct input from the trainer). By moving into
this area of independent use, the ideas and resources (in this
case, the instructional language modifications) become of
greater usefulness to their specific teaching needs and are
more appropriate for their students and specific subject
content.
Of interest was the movement of the teachers from the
routine to the refinement level of use. By the completion of
the training, all seven trained teachers had reached Level IVA
(Routine) for most of the parameters, and five of the seven
had reached the next level, Level IVB (Refinement), for five
of the seven parameters (Knowledge, Acquiring Information,
Sharing, Planning, and Status Reporting). For instance, one
teacher who was at Level IVB at the posttraining phase
for the parameter of Knowledge reported: “I actually used
some of the [ideas] on my Year 10s, especially with that
brainstorm summary. . . . . and now it ’s given them ideas.
They knew it, they had the knowledge but they didn’t know
how to express it.”This illustrates how the teacher gen-
eralized techniques learned from the training program to a
different student group.
At the self-focused levels of use, the focus is not only
on the teachers themselves, but also on the impact of the
intervention on the students within their “immediate sphere
of influence”(Hall et al., 2006, p. 5). For example, one
teacher described the impact of her use of vocabulary in-
struction techniques on students in the following way: “It
takes away that big fear of ‘Oh, such a big word,’then they
switch off, but with [the SLP] showing me how to break
them [the words] down and teach them in the way that she
explained, they aren’t that scared any more.”Another
teacher, talking about the modifications made to a set of
written resources, stated,
I thought that some students weren’t listening properly
or that the problems were for other reasons. Now I have
identified that a lot of the problems are based on maybe a
lack of understanding of vocabulary or maybe I’m just using
too many words that they’re not familiar with, or presenting
them with too much written information, and then they’re
Starling et al.: Training Secondary Teachers 487
not even going to attempt to try and understand it or do the
work. So it’s [the intervention’s] helped me gain a lot of skills
to present materials in different ways.
By the completion of the training, three teachers had
progressed to the impact-focused level of use for three of
the parameters (Knowledge, Planning, and Sharing). To be
assessed at this level, the teachers needed to demonstrate
that they were looking beyond their classes to the whole-
of-school environment as well as to broader issues of
professional development. One trained teacher at this
impact-focused level of use stated, “We have a couple of
prac [pre-service] teachers at the moment, and they’ve come
up with a couple of really good worksheets. So I’m going
to incorporate my process of presenting information into
their worksheets. That way they’re getting a little bit [of a]
wider view.”School management infrastructures were in
place that supported the sharing of information and resources
between teachers and departments, including monthly inter-
and intradepartmental meetings of all departmental staff.
One trained teacher presented an overview of the program at
one of these meetings; another shared information in a more
spontaneous manner at an interschool curricular planning
meeting.
One of the major contributions of this study is the finding
that trained teachers were able to sustain their use of the
intervention in the longer term with no further support by
the SLP. Follow-up testing 3 months after completion of the
training revealed that there were no significant changes in the
levels of the teachers’use of the techniques. This indicates
that the trained teachers perceived the ideas embedded in
the program as holding value for them—a concept consid-
ered critical for the uptake and application of ideas presented
through teachers’professional development (Guskey, 2002).
All of the fundamental language modification tech-
niques included in the program were presented to all teachers
during their 10 weeks of training. It is important to note,
though, that the techniques in and of themselves were flex-
ible enough to accommodate individual classroom needs
across a range of teachers and their subject disciplines. For
example, visual aids were already commonplace in some
teachers’instructional practices. However, a visual arts
teacher identified the need to strengthen the links between
the presentation of visual and written information. As a
result, the teacher and the SLP worked collaboratively to
modify a set of written information, assignment, and test
sheets to improve the accessibility of the information for
students and to strengthen the links between words and
graphics. This teacher noted, “They [the students] can draw
the answers, but they have difficulty putting it into words.”
Similarly, a physical education teacher whose teaching
style was highly verbal and physical noted that her students
had problems retaining information. In this case, the col-
laboration included the development of reinforcing written
resources and revision sheets for all students in her classes.
Additionally, a history teacher found a text breakdown
strategy useful as many of her students were overwhelmed
by information that was presented in multiparagraph print
form. This was resulting in poor levels of engagement,
processing, and retention of the information that was em-
bedded in the texts. The specific language modification
technique adopted and used regularly by this teacher in-
volved a whole-class discussion with a board-based mind-
map type activity. The teacher found that, along with the
increased engagement of more students with the activity and
therefore the learning process, she was able to build on
students’improved interaction with the text by then devel-
oping a range of other interactive tasks. These reported
instances complement the teacher interview data; however,
a tally of individual teachers’use of specific techniques was
deemed to be outside the scope of this study.
Future studies could complement the LoU structured
interview by observing and recording individual teachers’
use of language modification techniques in the classroom,
pre–post and follow-up post intervention. For our study,
permission to use video and audio recording of the teachers
within their classrooms was not granted. An additional
consideration for future research could be whether differ-
ences in teaching qualifications and/or years of teaching
experience impact teachers’adoption of these language mod-
ification techniques. It could be that teachers who have more
years of teaching experience (relative to new teachers) are
less amenable to training content and/or collaboration.
However, the reverse may also be true. Given our sample
characteristics, it was not possible to evaluate such issues
comprehensively.
One final consideration in relation to the teachers’data
was that although the LoU tool was able to capture teachers’
use of an intervention, it is not entirely known whether
teachers were using language modification techniques before
the training but did not refer to them as such. It is there-
fore possible that reported nonuse of the intervention at the
pretraining interview for some teachers in both groups could
have been from a lack of familiarity with the term “language
modification techniques.”What we do know is that over
the course of the study, the trained teachers knew more and
expressed more about these techniques in their interviews
whereas the control group of untrained teachers did not.
The Impact of Teacher Training
on Students With LI
To address the question of whether secondary school
students with LI would show improvements in their oral and
written language abilities as a result of the change in teachers’
instructional language practices, we chose a standardized
measure of oral and written language that provided a robust
measure of change in students’language abilities over
time. The four specific language areas tested were oral and
written expression and listening and reading comprehension,
all of which have significant relevance to academic skills
488 LANGUAGE,SPEECH,AND HEARING SERVICES IN SCHOOLS •Vol. 43 •474–495 •October 2012
in the secondary school environment (Nippold, 2007). These
language skills also reflect contemporary assessment and
intervention practices for adolescents with LI (Larson &
McKinley, 2003a). Our study found that the students whose
teachers had received the training showed significant im-
provements in the Written Expression and Listening Com-
prehension subtests of the WIAT–II relative to the students in
the control group. This was encouraging considering the
entrenched nature of long-term LI (e.g., Clegg et al., 2005).
We suggest that the improvements in the written expres-
sion abilities of the trained group of students were related to
the trained teachers’increased use of language techniques
targeting written language. The intervention included train-
ing in strategies such as textdeconstructionandrecon-
struction, visual scaffolds, and explicit teaching of writing
genre structures. In addition, the teachers were trained in
strategies for modifying their own written resources, such as
worksheets and information summaries. The intention of
training teachers in these techniques was to make informa-
tion such as instructions and curriculum content more readily
accessible and easier to process for all students in their
classes. By the teachers’application of these techniques
across whole classes, thereby modeling good practice in
written expression, we conclude that the students with LI in
these classes became more engaged in independently pro-
cessing written information. Also, by being exposed to
these replicable written structures and procedures, the
students were able to generalize techniques to their own
written work. This was evidenced not only in the students’
improved WIAT–II scores, but also by teachers’anecdotal
comments about changes in the amount and quality of written
work produced by students with LI in their classes. For exam-
ple, a math teacher stated, “They love to write now. I just
couldn’t believe it! It’samathlessonandtheyactually
enjoy writing about the specific terms and what they know.”
Similarly, improvements noted in the Written Expression
and Listening Comprehension subtests of the WIAT–II
post teacher training could be related to the program’s
emphasis on direct vocabulary instruction. The training
introduced techniques to teachers that facilitated identifying
and providing direct and interactive instruction in essential
curricular vocabulary. For instance, teachers identified
core curricular vocabulary and used student-generated
definitions and visual symbols to encourage vocabulary
growth. In these ways, students were more directly involved
in the processes of understanding and gaining an expanded
knowledge of core vocabulary, increasing the possibility
that they could then apply these strategies independently
when faced with additional new and unfamiliar words. By
involving all students in a range of procedures for new word
learning, we conjecture that the students with LI in these
classes became more engaged in the process and were able to
generalize these skills to develop improved listening com-
prehension abilities, skills that involve the understanding of
a range of individual words as well as vocabulary in context.
A growth in students’vocabulary knowledge and use could
also have been reflected in improved and more expansive
written expression, as observed in the WIAT–II results of the
trained group of students, as well as from teachers’anecdotal
observations.
In a study that examined the predictors of academic out-
come for adolescents with a history of LI, listening com-
prehension served as a significant and unique predictor
(Dockrell et al., 2011). The researchers posit that oral lan-
guage comprehension is important for the learning outcomes
of students with LI. Our training study also supports this
notion but crucially identifies how classroom teachers can
assist and improve this important language skill.
Other spoken and written language abilities, however, did
not show significant trained group improvements from pre to
post training. Standard scores for reading comprehension
significantly improved for both trained and control groups
over time, suggestive of maturational effects rather than
effects related to the teacher training. Even though the cur-
rent literature on supporting reading comprehension diffi-
culties in adolescence informed the program content, it may
be that, in comparison to the written expression and vocab-
ulary instruction techniques embedded in the program,
specific strategies for reading comprehension per se were not
addressed as directly and systematically. There is a known
correlation between reading disorders and LI (Snowling,
Bishop, & Stothard, 2003), with an often widening gap
between levels of reading ability for students with reading
difficulties and required reading materials once they reach
secondary school (Mastropieri, Scruggs, & Graetz, 2003). It
may be that specific support for reading comprehension
during adolescence necessitates specialist and often intensive
intervention (Biancarosa & Snow, 2006; Ehren, 2009; Kamil
et al., 2008). Future research could consider extending the
existing program to include more specific and systematic
teacher support for students’reading comprehension needs.
No significant improvements were observed in either
group of students for the Oral Expression subtest of the
WIAT–II. The intransigent nature of the participating stu-
dents’difficulties with oral expression presents a quandary
for SLPs’traditional intervention focus on oral language.
There is an increased use of written language in the secondary
school academic environment and added expectations of
students’written language competencies for assessment
through assignments, tests, and internal and external exams
(Gordon Pershey, 2003; Schumaker & Deshler, 2003). This
direction was reflected in the greater emphasis on both
teachers’and students’written language in the training pro-
gram. It is possible that there is a corresponding decrease
in focus on the importance of oral language in secondary
classrooms. A valuable area of future research could be an
investigation into the nature of academic discourse in sec-
ondary schools as it relates to both written and oral language,
and how this impacts populations of secondary school
students with LI.
Starling et al.: Training Secondary Teachers 489
As with the trained teachers, we were interested to know
if the students maintained any improvements in their lan-
guage abilities in the longer term. To answer this question,
students in the trained group were retested at the same
follow-up time as the trained teachers (i.e., a period of time
after completion of the training program when there had been
no further support by the SLP for the trained teachers). No
significant differences were found for the four language
domains tested between post to follow-up. Instead, the
students in the trained group maintained their scores over
this time period. We contend that the training program does
have immediate carryover benefits to students with LI, as
witnessed by significant improvements in their written
expression and listening comprehension pre to post teacher
training. Perhaps though, the lack of significant continued
improvement post to follow up suggests that these students
require additional support to achieve further gains in the
longer term. The data here suggest that the use of a systems-
based approach may not be sufficient on its own to shift
the long-term trajectory of adolescent LI. Additional in-
formation about the impact of a systems-based intervention
on the long-term academic progress of students with LI
would be useful. Future studies could also examine students’
academic progress as a means of measuring improved access
to language-based curricular information.
Theoretical and Clinical Implications
The results of this study validate a systems-based ap-
proach to supporting secondary school students with LI
through the use of a professionally collaborative interven-
tion, one that embeds a process of change in the individuals’
key learning environment: the mainstream classroom. The
training program provided to teachers supports their efforts
with inclusive education practices. Students with additional
learning needs, such as adolescents with persistent LI, are
regularly enrolled in mainstream classes, yet teachers report
feeling undersupported in addressing their needs (Pearce &
Forlin, 2005). The value of the present study is its contri-
bution to ways in which SLPs can support both teacher
and student populations at the secondary education level.
Offering professional development in instructional language
modification techniques over a period of time appears to
benefit teachers’inclusive teaching practices, with positive
benefits for their students with LI as well.
Observed improvements in students’listening compre-
hension and written expression in our study suggests that
specific areas of intervention may benefit from a systems-
based whole-population approach whereas other intervention
areas, such as reading comprehension, could benefit from
additional individualized specialist services. In this way,
SLPs working with this student population could adopt both
approaches for a comprehensive model of service delivery
in supporting secondary students with LI.
Using the analogy of a “ripple effect,”the teachers par-
ticipating in our study reported that information and skills
developed through the training program were passed on to
teachers who were not directly involved in the training, and
that the adopted techniques were used in classes other than
the ones that were directly involved in the study. One teacher
stated, “Some teachers that I have shared the techniques with
have used the ideas with a different year group and found
they have worked really well.”Another trained teacher
(history) talked about taking a class of final-year students
for an absent teacher, and discovered that the students did
not have a robust understanding of some key vocabulary
for the topic that they had already been studying for a few
lessons (the topic being the Vietnam War, the key vocabulary
including such terms as communism). The teacher decided
to prioritize direct vocabulary instruction with this class,
with positive feedback reported from the students that the
exercise was helpful to their better understanding of the
fundamental concepts integral to the topic.
Such reports of the generalizability of the techniques
across broader student groups, including those with no LI,
are in line with the findings of a synthesis of learning
disability research (Vaughn et al., 2000). According to these
authors, “In all cases where interventions have demonstrated
significant positive effects for students with learning dis-
abilities, they have resulted in at least as high (and most
often higher) effect sizes for all other students in the class ”
(Vaughn et al., 2000, p. 108). Although it was not possible
in the current study to directly examine this issue, future
studies could assess both LI and typically developing stu-
dents before and after teacher professional development.
Crucial to the success of the program was the positive
support and direct involvement of the schools’executive
staff (such as principals, vice principals, and heads of
departments). The NSW government schools follow the
guiding principles of the Quality Teaching model (NSW
Department of Education and Training, 2003), which in-
cludes the pedagogical dimension of promoting a quality
learning environment for all students. The schools’in-
volvement in this study, and their teachers’and students’
involvement in the training program, was seen as being of
direct relevance to the aims of the model. As a result of the
perceived value of the program to their staff and students,
executive staffs’direct involvement occurred at all stages of
administration and decision making, including the alloca-
tion of special funds for resources and the provision of
release time for the teachers. This explicit support of the
program sent a strong message to the teacher participants that
their involvement in the study was supported and valued
across the schools’teaching and administrative community.
No one intervention can possibly address, or have a
positive impact, on all issues arising from the presence
of a complex disorder such as LI. However, it would
appear that the changes observed in the trained teachers
and their students with LI could be influenced by a
490 LANGUAGE,SPEECH,AND HEARING SERVICES IN SCHOOLS •Vol. 43 •474–495 •October 2012
constellation of interacting elements, ones that SLPs could
universally adopt as part of their overall caseload manage-
ment. First, we raised the teachers’awareness of the presence
of students with LI in their classes, as well as the nature and
impact of LI. Second, the need for change was highlighted
by demonstrating the ability of teachers’instructional lan-
guage to either open or close doors to learning for these
students. Third, changing teaching practice was made po-
ssible by providing the teachers with practical and usable
techniques. This constellation of therapeutic supports created
a student-centered and supportive language-based learning
environment.
Future Directions
One of the motivations behind this study was to con-
tribute a useful and evidence-based service delivery model
to the field of adolescent LI. It is hoped that the results of the
present study will encourage and promote further interven-
tion research into how to best support whole populations
of adolescents with LI.
ACKNOWLEDGMENTS
This study was completed in partial fulfillment for a PhD by
Julia Starling at The University of Sydney, Australia. Funding for
this study was provided by The Jack Bloomfield Scholarship
(SPELD-NSW) and Speech Pathology Australia. We would like to
acknowledge the valuable contribution of the staff and students at
the schools involved in the study, as well as the many RAs who
collected and coded data. We also thank Rob Heard for his
assistance with statistical analysis.
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494 LANGUAGE,SPEECH,AND HEARING SERVICES IN SCHOOLS •Vol. 43 •474–495 •October 2012
APPENDIX A. EXAMPLES OF ACTUAL WRITTEN LANGUAGE MODIFICATION TECHNIQUES USED IN
THE TEACHER TRAINING PROGRAM
Original teacher version Issues discussed by SLP and teacher Modified version
Risk Story 1. Unfamiliar vocabulary
(minimum, consequences)
1. Used different words e.g. write for devise,
and explained words: “The context
(setting) of the story”.Students are to devise a story that outlines a
character (a minimum of three), context
and events related to their risk environ-
ment. Students need to identify and de-
scribe the following:
2. Ambiguous instruction:
“...that outlines a character
(a minimum of three)”.
One or three or more
characters needed?
2. Wording changed to “3 characters or
more”.
1. Possible consequences of the situation
e.g. physical, emotional, legal, financial,
for each character
3. Instructional words may be
difficult to interpret: devise,
identify, describe
3. Included descriptions for key instruction
words e.g. Identify: To name something.
Placed these in a box to the side of the main
text.
2. Reason why each one might have occurred
4. Difficult sequence to follow.
4. Set out the sequence of the story: The main
events, the risks involved, the possible
problems that happen as a result.
5. No examples provided for the
“consequences.”
5. Provided one example for each conse-
quence e.g. “Financial e.g. the cost of
repairing broken property”.
APPENDIX B. EXAMPLES OF ACTUAL VOCABULARY INSTRUCTION TECHNIQUES USED IN THE
TEACHER TRAINING PROGRAM
Original teacher version Issues discussed by SLP and teacher Modified version
Topic: Sculpture -Too many new words at one time 1. Following the “10 Key Words”process
introduced in the program, 10 of the 20 words
were chosen from the list by the teacher as
being essential for learning the new topic.
Copy these 20 words and definitions
into your Visual Arts Diary:
-Some words are very complex
2. The new word learning task became interac-
tive between the teacher and all students,
with the end result being:
1. Appropriation: To take or borrow
something and use it elsewhere
-Some definitions are also very complex, and
so may be difficult to process and retain
a) a list of words and their descriptions, decided
on by the students and using familiar
language (for example: Geometric: To do
with shapes such as circles, triangles and
squares.), and
2. Conduit: To channel something
in a certain direction
-The task is passive, i.e. copying from an
overhead to a notebook.
b) a poster created by the students with the
10 words, their descriptions and a visual
symbol for each as a referent point for
further topic study.
3. Abstraction: Non-representational
-This would be a time-consuming task, and
there is likely to be little associated learning
of the glossary words and their meanings.
4. Anthropomorphic: Appropriation
of human motivation, characteristics,
or behavior to inanimate objects,
animals or natural phenomena
(plus items 5-20)
Starling et al.: Training Secondary Teachers 495
DOI: 10.1044/0161-1461(2012/11-0066)
2012;
2012;43;474-495; originally published online Jul 23, Lang Speech Hear Serv Sch
Julia Starling, Natalie Munro, Leanne Togher, and Joanne Arciuli
Controlled Trial
Techniques to Support Adolescents With Language Impairment: A Randomized
Training Secondary School Teachers in Instructional Language Modification
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