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Narrative Intervention: Principles to Practice

Language, Speech, and Hearing Services in Schools

August 2020
51(4):1081-1096

DOI:10.1044/2020_LSHSS-20-00015

License
CC BY-NC-ND 4.0

Authors:

Trina D. Spencer

University of Kansas

Douglas B. Petersen

University of Wyoming

Purpose Narrative interventions are a class of language interventions that involve the use of telling or retelling stories. Narrative intervention can be an efficient and versatile means of promoting a large array of academically and socially important language targets that improve children's access to general education curriculum and enhance their peer relations. The purpose of this tutorial is to supply foundational information about the importance of narratives and to offer recommendations about how to maximize the potential of narrative interventions in school-based clinical practice. Method Drawing from decades of cognitive and linguistic research, a tutorial on narratives and narrative language is presented first. Ten principles that support the design and implementation of narrative interventions are described. Results Clinicians can use narrative intervention to teach story grammar, complex language, vocabulary, inferencing, and social pragmatics. Storytelling, as an active intervention ingredient, promotes the comprehension and production of complex language. Conclusion When narrative intervention is implemented following a set of principles drawn from research and extensive clinical experience, speech-language pathologists can efficiently and effectively teach a broad set of academically and socially meaningful skills to diverse students.

General continuum from easier to more difficult storytelling.

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LSHSS

Research Article

Narrative Intervention:

Principles to Practice

Trina D. Spencer

and Douglas B. Petersen

Purpose: Narrative interventions are a class of language

interventions that involve the use of telling or retelling stories.

Narrative intervention can be an efficient and versatile means

of promoting a large array of academically and socially

important language targets that improve children’s access

to general education curriculum and enhance their peer

relations. The purpose of this tutorial is to supply foundational

information about the importance of narratives and to offer

recommendations about how to maximize the potential of

narrative interventions in school-based clinical practice.

Method: Drawing from decades of cognitive and linguistic

research, a tutorial on narratives and narrative language is

presented first. Ten principles that support the design and

implementation of narrative interventions are described.

Results: Clinicians can use narrative intervention to teach

story grammar, complex language, vocabulary, inferencing,

and social pragmatics. Storytelling, as an active intervention

ingredient, promotes the comprehension and production

of complex language.

Conclusion: When narrative intervention is implemented

following a set of principles drawn from research and

extensive clinical experience, speech-language pathologists

can efficiently and effectively teach a broad set of academically

and socially meaningful skills to diverse students.

Narrative intervention is one of the most powerful

approaches to language intervention that school-

based speech-language pathologists (SLPs) can

use. We define narrative intervention as any language inter-

vention that involves children telling or retelling stories that

have specific language-related features purposefully tar-

geted by the interventionist (Petersen, 2011). In the last

10 years, there has been an increased focus on narrative

intervention in research. Consistently, effect sizes for improv-

ing various aspects of language in children with and without

language disorder have been large (e.g., S. L. Gillam et al.,

2014; Spencer et al., 2018). In addition to yielding powerful

effects on language, the research documents that narrative

intervention is also highly feasible and flexible. While our

purpose in this article is not to critically review the extant

literature, we provide empirical evidence, share clinical in-

sights, and outline how narrative intervention is versatile,

potent, and academically and socially relevant. We have or-

ganized the available empirical and practical guidance in a

manner that facilitates its transfer to clinical practice. As

we strive to help clinicians maximize their effective imple-

mentation of narrative intervention, we first present a brief

tutorial on narratives. Our understanding of narratives and

their characterizations emerge from a depth of clinical expe-

rience and empirical studies conducted over several decades.

The major points are summarized in this article to provide

the reader with an introduction to narrative language (see

Boudreau, 2008, and Johnston, 2008, for other summaries).

Following the tutorial, we offer 10 principles that can guide

the strategic use of narrative intervention in schools.

Introduction to Narratives

In the academic context, narratives are most often the

monologic telling or retelling of a real or imaginary event

(R. B. Gillam & Ukrainetz, 2006). Such narratives are goal

directed, where an agent’s efforts to resolve problems or

complications and the resulting consequences are described.

Canonical elements of stories include an initiating event

(usually a problem), an attempt to solve the problem, and a

consequence (Mandler, 1987; Stein & Glenn, 1979). Together,

these form a basic, minimally complete episode, and the in-

clusion of additional story grammar elements such as an

explicit plan to solve the problem and a resolution increases

a story’s episodic sophistication. When attempts to solve a

problem are ineffective, additional episodes extend the story

Department of Child and Family Studies, University of South

Florida, Tampa

Department of Communication Disorders, Brigham Young

University, Provo, UT

Correspondence to Trina D. Spencer: trinaspencer@usf.edu

Editor-in-Chief: Holly L. Storkel

Editor: Katie Squires

Received February 6, 2020

Revision received April 8, 2020

Accepted June 16, 2020

https://doi.org/10.1044/2020_LSHSS-20-00015

Disclosure: The authors receive financial benefits from the sale of Story Champs,

which is one of the published narrative interventions mentioned in this article.

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

1081

until an eventual resolution is achieved, as is common in

novels.

Stories are not stories without causal and temporal

relations between events. It is the causal links between the

initiating event (or problem), attempt, and consequence

that reveal a character’s goal-oriented behavior (Peterson

& McCabe, 1983). If story events are presented in an un-

expected order, comprehension of the causal connections

can be diminished. Nonetheless, specific sequences and

temporal and causal devices are culturally grounded. They

are taught through extensive exposure to a linguistic com-

munity’s storytelling patterns, which, over years of exposure,

shapes the understanding and production of narratives in a

certain way.

There can be cultural differences in narrative structure

(T. B. Champion, 1998; Gee, 1989; S. L. Gillam, Fargo,

et al., 2012; Gorman et al., 2011; Mills et al., 2013; Tappe &

Hara, 2013; C. E. Westby, 1994). For example, internal re-

sponsestendtobeemphasizedtoagreaterextentinnarratives

produced by Latino, Spanish-speaking children (Castilla-Earls

et al., 2015). Native American stories often do not unfold in a

linear manner (Sharifian, 2002), with story grammar that does

not always follow Stein and Glenn (1979) conventions.

Worth and Adair (1972) noted that Native Americans often

focus considerably more on setting information than stories

found in academic settings, with a major focus on detail and

implicit information as opposed to explicitly stated temporal

and causal connections (Basso, 1990; C. Westby et al.,

2002). Japanese children also tend to have a more implicit

style of narration, often producing brief, minimalistic stories

(Minami, 2002) or stories with minimal goal structure

(Matsuyama, 1983). African American children have been

noted to use a topic associating approach to narration simi-

lar to that used by Native Americans (T. Champion et al.,

1995; Gee, 1989; Hyon & Sulzby, 1994) as well as a call–

response interaction (Smitherman, 1977), which entails the

narrator producing a story with interspersed “calls”from

the listener.

Despite cultural variations, most stories still have pro-

tagonists seeking to solve challenges, and all children who

reside in the United States, including those from culturally,

ethnically, and linguistically diverse backgrounds, can bene-

fit from learning the story grammar and relational features

expected in U.S. schools. Narrative intervention can be ap-

plied to any approach to narrative structure (e.g., Applebee,

1978; Hudson & Shapiro, 1991; Labov & Waletzky, 1967),

yet what has been developed thus far has mostly followed

Stein and Glenn’s (1979) model of story grammar. For ex-

ample, each of the following assessments draw from Stein

and Glenn’s story grammar framework to some extent: the

Assessment of Story Comprehension (Spencer & Goldstein,

2019), the Edmonton Narrative Norms Initiative (Schneider

et al., 2005), the Monitoring Indicators of Scholarly Lan-

guage (S. L. Gillam et al., 2016), the Narrative Assessment

Protocol (Bowles et al., 2020), the Narrative Language

Mea sures subtest of the CU BED assessment (Petersen &

Spencer, 2012, 2016), the wordless picture books or other

sampling procedures used in conjunction with the Systematic

Analysis of Language Transcripts and the Narrative Scoring

Scheme (Heilmann et al., 2010; Miller et al., 2015), and

Westerveld and Gillon’s (2010) language sampling protocol.

Additionally, the following manualized intervention pro-

grams promote Stein and Glenn’s story grammar structure

for U.S. children: Let’s Know! (Language and Reading

Research Consortium et al., 2017), Story Champs, (Spencer

& Petersen, 2016), Story Grammar Marker (Moreau &

Fidrych, 1994), and Supporting Knowledge in Language

and Literacy (SKILL; S. L. Gillam & Gillam, 2016). Although

it is common in the United States to teach the story grammar

framework, doing so does not imply that such an approach

to narration should be considered a replacement for the

student’s own culturally unique storytelling approach. Teach-

ing children to tell stories in a manner that aligns with cur-

riculum expectations is a matter of teaching code-switching,

not code-overwriting.

Interwoven throughout the narrative structure is the

language used to express it. Whereas story grammar is used

to organize the gross discourse structure of a narrative, syn-

tax, morphology, semantics, and other features of language

are used to make up the narrative microstructure (Colozzo

et al., 2011). When a narrative contains microstructural

features that reflect literate, academic language, it is of-

ten markedly more complex than dialogic conversation

(MacLachlan & Chapman, 1988). This literate language

expressed in the context of a story, which we refer to as nar-

rative language, often consists of multiple causal and temporal

adverbial, relative, and nominal subordinate clauses, elabo-

rated noun phrases, adjectives, adverbs, appositives, and dia-

logue (Benson, 2009; Greenhalgh & Strong, 2001; Peterson

& McCabe, 1983; Roth & Spekman, 1986). To tell about

an event (either orally or in written form) that the listener/

reader did not also experience, and for the story to be com-

prehensible, the storyteller frequently uses sophisticated,

complex, precise language to paint a detailed picture (Bruner,

1986; Johnston, 2008; C. E. Westby, 1985). Effective storytell-

ing requires complex grammar to depict specific images

and evoke purposeful emotions, whereas effective conversa-

tion benefits from suprasegmentalssuchasgesturesand

joint attention, facilitating comprehension despite the use

of imprecise sentences (Hudson & Shapiro, 1991). Narra-

tives also often contain many complex and infrequent vocab-

ulary words that facilitate comprehension (Petersen et al.,

2020). The spontaneous use of complex vocabulary or

domain-specific words during storytelling demonstrates se-

mantic complexity and is arguably a better indicator of

one’s lexical aptitude (Hadley & Dickinson, 2018).

Narratives are commonly examined at macro and

micro levels, but that is not to suggest they are restricted

to story grammar or morphosyntactic analyses. In fact,

narratives showcase a large number of core skills that serve

as the foundation to a range of academic (C. E. Westby,

1985) and social abilities (Brinton & Fujiki, 2017). Narra-

tives bring several inconspicuous repertoires together to

form an integrated higher order composite that is clini-

cally convenient and useful (Boudreau, 2008). To be an

accomplished storyteller, a child must orchestrate many

1082 Language, Speech, and Hearing Services in Schools •Vol. 51 •1081–1096 •October 2020

simultaneously converging processes including attention,

cognition, memory, inferencing, and theory of mind

(Curenton, 2011; Dodwell & Bavin, 2008; R. B. Gillam

& Johnston, 1992; Hudson & Shapiro, 1991; Johnston,

2008; Lahey, 1990; Nippold & Schwartz, 1996). Consider-

ing narratives are a pervasive and complex form of dis-

course, they have considerable clinical utility.

A notable literature documents the predictive nature

of early narrative language skills for later academic achieve-

ment (Bishop & Edmondson, 1987; Dickinson & McCabe,

2001; Fazio et al., 1996; Feagans & Appelbaum, 1986). Chil-

dren’s narrative abilities are related to listening comprehen-

sion (Bourg et al., 1997), receptive vocabulary (Heilmann

et al., 2010), and writing (Griffin et al., 2004; Kim et al.,

2015; Scott & Windsor, 2000). The relation between early

oral narrative skills and later reading comprehension is par-

ticularly strong (Catts et al., 2002; Dickinson & McCabe,

2001; Gilmore et al., 1999; Griffin et al., 2004). For instance,

C. E. Snow et al. (2007) reported that the ability to produce

a narrative in preschool predicts reading comprehension per-

formance in the fourth, seventh, and 10th grades. Likewise,

Suggate et al. (2018) demonstrated that narrative skill at

school entry predicted reading comprehension performance

10 years later. Moreover, evidence exists of causal relation-

ships between narrative-focused oral language interventions

and reading comprehension (Clarke et al., 2010; Language

and Reading Research Consortium et al., 2019) and writing

outcomes (Kirby et al., 2020; Petersen et al., 2019; Spencer

& Petersen, 2018).

The value of narratives reflected by the current body

of research is mirrored in prevailing academic standards.

For example, the Common Core State Standards, adopted

by the majority of U.S. states (National Governors Associ-

ation Center for Best Practices & Council of Chief State

School Officers, 2010), specifically details story grammar

and language complexity outcomes for all primary, middle,

and high school grade levels. Objectives in the Common

Core State Standards related to narration can be found in

the English Language Arts Standards, dispersed through-

out specific reading literature, speaking and listening, and

language standards.

Narratives are socially important too. Parents of chil-

dren with disabilities often express their desire for children to

tell them about their day or what happened at school (Pituch

et al., 2011). Teachers need information about events that

took place on the playground or over the weekend, and peers

want to be entertained. All of these are related to storytell-

ing, and, in general, children with language disabilities do

not excel at social communication (Colozzo et al., 2011;

Dodwell & Bavin, 2008; Fey et al., 2004; Kaderavek &

Sulzby, 2000). Children who are good storytellers are more

accepted by their peers (Hart et al., 2004; P. C. McCabe &

Marshall, 2006) and receive parent and teacher approval

(Bliss & McCabe, 2012). Additionally, increased exposure

to narrative conversations predicts children’s future ability

to solve social problems (Leyva et al., 2014).

Storytelling appears to be a pivotal social skill in

that children naturally extend what is learned in training

environments (e.g., classroom or clinic room with SLP)

to untrained social contexts with minimal effort. From a

clinical perspective, what could be better? Narrative inter-

vention uses an authentic, functional context, which entails

the formation of a genuine connection between adult and

child, where meaningful information is conveyed, and lan-

guage processing, pragmatics, and social–emotional learn-

ing are integrated (Brinton & Fujiki, 2019). The natural

environment (i.e., peer and adult attention) can maintain

children’s efforts to tell stories and, by doing so, provide

additional opportunities for practicing the newly acquired

language skills. Possible evidence of this generalization is

seen in an important study comparing a written text compre-

hension intervention, an oral narrative intervention, and

a combination intervention (Clarke et al., 2010). Researchers

found that students in the oral language intervention-only

condition, but not the other two conditions, continued to

improve their reading comprehension performance, even

after the intervention was withdrawn. Brinton and Fujiki

(2019) examined whether a narrative-based language inter-

vention promoted language processing, pragmatics, and social

and emotional learning for children with developmental lan-

guage disorder. Intervention sessions were focused on story-

telling and story enactment. Children were taught how to

write or dictate a brief journal entry focusing on new con-

cepts learned from the story. Teacher ratings showed im-

provement in prosocial behavior, and the school-based SLP

reported improvement in expressive narrative language and

syntax.

Improving oral narration can improve written narra-

tion. Spoken narratives play a fundamental role in the devel-

opment of written stories and are more commonly addressed

by SLPs. Because young children cannot write what they

cannot say, children with language disabilities are at a par-

ticular disadvantage with respect to academic writing tasks

(Koutsoftas & Gray, 2012; Pavelko et al., 2017). Fortunately,

recent research indicates that an explicit and intensive focus

on oral narrative language has a direct and meaningful impact

on the quality of written narratives children produce, even

for children with significant disabilities (Kirby et al., 2020;

Petersen et al., 2019; Spencer & Petersen, 2018). Researchers

suggest that this transfer from oral narration to written nar-

ration occurs because the story grammar and linguistic struc-

tures taught and practiced through oral storytelling evolve

into a cognitive schema that generalizes to alternative modali-

ties, including writing (Hayes & Flowers, 1980; Rumelhart,

1980; C. Snow, 1983; C. E. Westby, 1984). Based on sche-

mata theory (Anderson & Pearson, 1984; Mandler, 1987),

the quickest way to promote story writing is to promote

oral storytelling that takes advantage of the shared story

level and sentence level structures.

One of the greatest advantages of addressing oral

narration for the purpose of improving written narration

is that it eliminates the interference during intervention

from other potentially delayed or emerging skills related

to transcription (i.e., handwriting mechanics, letter forma-

tion, spelling, and letter sounds), while garnering children’s

cognitive focus for generating and organizing their thinking

Spencer & Petersen: Narrative Intervention 1083

and speaking (V. Berninger & Graham, 1998; McCutchen,

1996). Even when transcription and decoding skills are au-

tomatized, the quality of written narratives and reading com-

prehension is intimately dependent on the oral language

foundation the child brings to the task (V. W. Berninger &

Abbott, 2010; Catts et al., 2006; Fey et al., 2004). Hence, it

is recommended that oral narratives receive considerable

attention during therapy, especially for young students and

those with language-based disabilities.

Clinicians must be strategic and planful to be able to

facilitate the development of narrative schemas that will

readily transfer to academically and socially meaningful

repertoires. Ultimately, the flexible and pragmatic use of

acquired narrative content and form is the goal. Various

conditions (Hughes et al., 1997) in which storytelling oc-

curs form a continuum of narrative tasks (see Figure 1).

For example, stories can be told or retold. Generating

quality narratives can be more challenging than retelling

a story (R. B. Gillam & Johnston, 1992; Kaderavek &

Sulzby, 2000), yet there can be simple story generations and

very complex story retells. Because retells reflect both listen-

ing comprehension and story production skills (Boudreau,

2008; Petersen & Spencer, 2012; Wagner et al., 1999), indi-

viduals who have weak receptive language may find gener-

ating a story easier than retelling one (Weddle et al., 2016).

Telling about recently heard/read events is a common aca-

demic task and would be considered a retell of a model

story. Stories about personal experiences are most often

produced for social reasons such as gaining attention from

peers or approval from adults (McCabe, 2017). The first

telling of the experience would be considered a story gener-

ation, but subsequent repeated productions would be best

classified as retells. Given social attention is the natural

(and powerful) consequence of storytelling and it is easier

to talk about real events (A. McCabe et al., 2008), personal

stories are pervasive in children’s spontaneous communica-

tion (P. C. McCabe & Marshall, 2006; Preece, 1987; C.

Westby & Culatta, 2016). When a story is not true and has

never been told before (either orally or written), we would

characterize it as a fictional generation. Fictional stories

can be more challenging than personal event narratives

(Allen et al., 1994; A. McCabe et al., 2008), yet this is not

always the case. A less common type of narrative is a script,

which has been defined as a recount of typical events,

based on a collection of personal experiences rather than a

single event (Hayward et al., 2007; Hudson & Shapiro,

1991; Hughes et al., 1997). For instance, if a child tells

about what he usually does on Sundays or how his fam-

ily celebrates a specific holiday, he is generating a script

narrative. This type of discourse is highly related to ex-

pository discourse because it does not focus on a specific

event.

Often, story retelling is the go-to context for initial

teaching. Once children have acquired a proper story gram-

mar framework, it can be extended to the generation of per-

sonal stories and eventually to the generation of fictional

stories and writing. Retelling a short, familiar book or a

story that was specifically designed for intervention allows

for graduated, controlled, and targeted practice because the

clinician can select stories based on an individual child’s

language skills.

Photos or illustrations that provide clues about story

content can be used to modify the demands of storytelling,

depending on the goal of narrative intervention and the

child’s abilities. Although visual materials can scaffold re-

tells (e.g., Meyer, 1969) and fictional stories (S. L. Gillam

& Gillam, 2016), not all classroom academic tasks, to which

narrative skills should generalize, involve visuals (e.g., listen-

ing and reading comprehension), especially as the grades

increase. Likewise, pictures and icons are generally not

available in social contexts. Some research suggests that

young children and children with language impairment

retell more complete episodes and include more informa-

tion units when they listen to stories without pictures as op-

posed to orally and pictorially presented stories (Schneider,

1996; Schneider & Dubé, 2005). Photos and illustrations

can support storytelling, but they may result in a low esti-

mate of a child’s abilities. Therefore, it is important to use

visuals strategically, prevent dependence on them, and pro-

mote the generalization of storytelling skills to more natural

and sophisticated contexts.

Principles to Practice

There is not one right way to implement narrative inter-

vention. Nonetheless, the extant research evidence and our

clinical experiences have revealed 10 principles of narrative

intervention that can help guide practice. Notwithstanding

the collection of principle-driven guidelines described below

and listed in Table 1, it is important to remember that chil-

dren’s Individualized Education Program goals and in-

structional objectives should drive the selection of specific

intervention parameters. Relevant assessment data should

inform the selection of individual goals and objectives, ensur-

ing a direct link from assessment to intervention. A chief

purpose of valid, reliable, and meaningful assessment is to

motivate efficient and effective intervention. Therefore, SLPs

are responsible for using purposeful assessments, converting

assessment data to goals, and making wise choices about

Figure 1. General continuum from easier to more difficult storytelling.

1084 Language, Speech, and Hearing Services in Schools •Vol. 51 •1081–1096 •October 2020

whether to work on story grammar or complex language,

retells or generations, personal or fictional stories, and what

type and timing of scaffolds to use. There are a number of

commercially available narrative intervention programs (e.g.,

SKILL, Story Grammar Marker, Story Champs) that can

reduce the time and energy needed for preparation, but

clinicians are still responsible for making evidence-based

choices regarding the selection of programs and for using

them effectively with their clients.

Build Story Structure Before Vocabulary

and Complex Language

If a child cannot yet tell or retell a story using a

complete episode, that is where we recommend clinicians

start. To work efficiently on syntax, grammar, or academic

vocabulary (or anything else) during storytelling, it is help-

ful for children to be able to tell and retell basic stories.

Once a child can produce the basic structure, storytelling

becomes the context for teaching a wide variety of other

skills (Justice et al., 2008; Swanson et al., 2005). Ensuring

children develop a cognitive schema related to story gram-

mar early can help reduce frustration of children with ex-

tremely limited language skills, by gradually increasing the

cognitive and linguistic demands. Spencer et al. (2013) pro-

vide an example of how this might unfold. They examined

an individual narrative intervention with 3- and 4-year-old

children with developmental disabilities, focusing exclu-

sively on story grammar for 12 sessions. Once storytelling

established and each child could retell a minimally com-

plete episode, language complexity targets such as tempo-

ral and causal subordinating ties were systematically folded

into the sessions.

Interventions with older children may not need to begin

at the level of story grammar construction. Research indi-

cates that children with language disabilities tend to strug-

gle with both story grammar and grammar/syntax, but

their use of complex language is often affected to a greater

degree (Colozzo et al., 2011; Fey et al., 2004; R. B. Gillam

& Johnston, 1992). If that is the case, then the goal can be

to provide a child with extra, incidental practice telling

stories while specifically modeling, prompting, and encour-

aging the use of correct syntactical forms. The same princi-

ple applies to vocabulary. If definitions of words and the

use of more sophisticated words are the desired targets,

children will learn them more efficiently if their cognitive

energy is not exhausted on constructing the narrative schema.

Gardner and Spencer (2016) investigated explicit vocabulary

instruction embedded in a narrative intervention delivered

to small groups of at-risk first graders. They observed that,

as retells improved, children became better at learning the

target vocabulary words. They also became better at fig-

uring out the meaning of novel, unknown words from a

story context. S. L. Gillam et al. (2014) also embedded

vocabulary targets in their classroom narrative intervention.

Although, as a group, the first graders who received the

intervention learned the vocabulary specifically taught to

them, children who were at risk acquired fewer new word

meanings.

An important point to remember is that, although

teaching children to tell stories may be necessary, narrative

intervention does not need to stop there. Numerous other

therapeutic targets can be contextualized in storytelling once

story structure is established to a minimal degree (S. L. Gillam,

Gillam, & Reece, 2012). If stories are strategically and care-

fully designed for intervention, it may be easier to facilitate

instruction on the embedded targets (see Spencer & Petersen,

2016) than if clinicians are dependent on what is available in

published storybooks. Stories can be designed (or selected)

for instructional purposes that include the promotion of gram-

mar, syntax, cohesion, elaborated noun phrases, mental

state verbs, dialogue, inference, theory of mind, vocabulary,

and social problem solving, to name a few. The focus of

narrative intervention is on oral narratives at this moment,

but the path from strong oral narratives to written narratives

is unconstrained (Petersen et al., 2019; Spencer & Petersen,

2018). Other critical academic skills that clinicians can

address from a firm oral narrative foundation include lis-

tening comprehension (i.e., answering questions about

what one hears; e.g., Spencer et al., 2013), reading compre-

hension (i.e., answering questions about what one reads;

e.g., Clarke et al., 2010), and expository discourse (i.e.,

telling or retelling information; e.g., Lee, 2020; Petersen

et al., 2019).

Use Multiple Exemplars to Promote Metalinguistics

and Generalization

Multiple exemplar training is a systematic procedure

to promote the generalization of higher order concepts (Le-

France & Tarbox, 2020). For narrative intervention, this

means that clinicians should use several different stories (as

opposed to one or two) with the same story grammar ele-

ments to teach story grammar. If the goal of the interven-

tion was for a child to tell or retell a specific story, then

practicing the same story over and over would work fine.

However, the child may not learn how to tell stories gener-

ally and may not know much about story grammar as a

higher order concept that could be transferred to other

stories or contexts. To avoid promoting the memorization

of specific stories, several exemplars (i.e., different stories

with the same story grammar components) should be used

as models in consecutive intervention sessions. Rapid ac-

quisition of story grammar concepts can be accomplished

Table 1. Principle-driven narrative intervention guidelines.

1. Build story structure before vocabulary and complex language

2.Usemultipleexemplarstopromotemetalinguisticsand

generalization

3. Promote active participation

4. Contextualize, unpack, and reconstruct stories

5. Use visuals to make abstract concepts concrete

6. Deliver immediate corrective feedback

7. Use efficient and effective prompts

8. Differentiate, individualize, and extend

9. Arrange for generalization opportunities

10. Make it fun

Spencer & Petersen: Narrative Intervention 1085

if the same stories are not repeated because, in narrative

intervention, the multiple exemplars promote children’s ab-

straction of the pattern. Thus, by presenting children with

different exemplars of the concept across sessions (Layng,

2019), story grammar schema emerges. Children quickly

learn that story content is not the salient feature, and what

is important is the schematic pattern. Knowledge of this

schema and the ability to describe the pattern of stories (i.e.,

naming character, problem, feeling, action, and ending) is

metalinguistic. A child’s successful generation or retelling

of a novel story resulting from narrative intervention is evi-

dence of generalization and metalinguistic development.

Although several narrative interventions have

employed storybooks (Adlof et al., 2014; Brinton & Fujiki,

2017; Catts et al., 2016; Petersen et al., 2010), some re-

searchers (including us) have strategically designed stories

for initial intensive and targeted narrative practice (Brown

et al., 2014; Favot et al., 2018; Hayward & Schneider, 2000;

Petersen et al., 2014; Spencer et al., 2020, Spencer, Petersen,

& Adams, 2015; Spencer & Slocum, 2010; Swanson et al.,

2005). Some advantages of using prepared stories (over story-

books) for narrative intervention include being able to control

what structures, vocabulary, and complex language children

are exposed to, easily teaching metalinguistics through multi-

ple exemplar training and rapid practice cycles within session

because stories are brief, and building narrative comprehen-

sion and production simultaneously. Most approaches to

narrative intervention eventually move away from a focus

on program-specific stories to the integration of authentic

children stories and curriculum materials.

Promote Active Participation

Decades of research indicate that active participation

leads to greater learning opportunities (Archer & Hughes,

2011; Ellis & Worthington, 1994; Engelmann & Carnine,

1982). Maintaining a brisk teaching pace increases chil-

dren’s opportunities to respond and reduces opportunities

for behavior problems (Forsyth & Archer, 1997). When

students are actively engaged and responding, they are learn-

ing (Greenwood et al., 1984; Pratton & Hales, 1986). Inter-

estingly, Knapp and Desrochers (2009) found that students

prefer interactive instruction in which they play a promi-

nent role.

Children need repeated opportunities to practice mean-

ingful language within an activity or session to ensure long-

term maintenance of the targeted skills (Ukrainetz, 2006).

Focused practice, supported by modeling and corrective

feedback, will enhance children’s ability to use the skills

spontaneously in nontraining environments. With respect

to narratives, this means that children must have ample

opportunities to tell or retell stories. Listening to stories

may improve comprehension of stories and have marginal

impacts on narrative expression, but to hasten children’s

ability to tell/retell stories, they must practice it. More prac-

tice is better.

To maintain high numbers of opportunities to respond

in the context of narrative intervention, the size of the inter-

vention group needs to be considered. If intervention is

delivered individually, it is easy to support the child to do

most of the talking. However, when other students are in the

group, time should be evenly distributed across the students

so that each student is responding frequently and everyone

has an opportunity to tell/retell at least one complete story,

beginning to end. It is common for children to have individ-

ual turns during small group narrative interventions, but it

is important to keep the groups small enough so that each

child receives numerous opportunities to practice storytell-

ing. Some small group narrative interventions encourage the

children who are listening to play games that demonstrate

they are actively listening and participating (Spencer &

Petersen, 2018; Spencer & Slocum, 2010; Story Grammar

Marker, 2020; Weddle et al., 2016). Although all the chil-

dren may not be talking at the same time, they are doing

something that requires their attention to story grammar,

which benefits comprehension and serves as scaffolding

for when it is their turn to tell the story. Through active

responding games, children also learn to be better listeners

and can even be encouraged to play the role of co-teacher.

If intervention will be delivered to large groups of

children, there are a number of other available strategies

that can support active engagement. In S. L. Gillam et al.’s

(2014) classroom-based narrative intervention, students

used graphic organizers. When children retold stories indi-

vidually, a teacher walked around the room to check on

them. Choral responding (Heward et al., 1989), which means

that all children respond in unison, has been used in several

large group narrative intervention studies (Petersen et al.,

2019; Spencer, Petersen, & Adams, 2015; Spencer, Petersen,

Slocum, et al., 2015). This strategy is helpful when there are

too many students for the teacher or interventionist to give

each one individual support. In these studies, children cho-

rally named the parts of the story (i.e., “character, problem,

feeling, action, ending”) as well as the story content, one

sentence at a time (e.g., “John was sad because his knee

hurt.”). After children had told the story in parts with the

group, they were paired with a friend in a class-wide peer

tutoring arrangement to retell the model story individually

(Bowman-Perrott et al., 2013). Choral responding ensures

that all children in the class/group talk, not just the students

who are confident enough to raise their hands, and peer

tutoring provides an opportunity for each child to retell a

story while their peer is attentive and playing the role of

teacher.

Contextualize, Unpack, and Reconstruct Stories

When teaching storytelling, it is important to make

the activity meaningful and relevant to children (R. B.

Gillam & Ukrainetz, 2006). Storytelling is used for pur-

poseful communication with one or more listeners. This

intentional, communicative purpose should not be lost dur-

ing the intervention process. It may be tempting to eliminate

story content that children are not yet able to retell indepen-

dently. Although that may be a good reason to select stories

designed for narrative intervention over storybooks, there

are several reasons to retain all the main episodic elements

(e.g., problem, attempt, and consequence) of a story. First,

1086 Language, Speech, and Hearing Services in Schools •Vol. 51 •1081–1096 •October 2020

comprehension of a narrative is facilitated through the rela-

tions between the story grammar elements (Curenton, 2011;

Schick & Melzi, 2010) and, when components are missing,

children cannot detect the causal and temporal relations

between them. Stories are much more than the sum of their

parts. Having children practice stating the character and

setting of a story without cohering it to the rest of the story

eliminates the purposeful, communicative nature of story-

telling and renders the activity a sentence repetition or pic-

ture description task. Second, children do not necessarily

develop story grammar in the sequence they are told and

often taught (e.g., character and setting first) because the

meaningful, related parts are in the middle. Although young

children can talk about characters and settings, storytelling

does not become storytelling until a child associates an

initiating event with an attempt and a consequence (cause

and effect). Development of storytelling can be thought

of occurring from the inside out, beginning with the feeling

that some past event triggered. As children develop, they

begin to add layers of information about the problem that

caused the feeling or what was done to resolve it, and even-

tually add the more distant contextual details such as the

setting and resolution. Third, when the goal of narrative

intervention is to teach the cognitive schema related to

narration, it is necessary for every story to adhere to that

pattern, otherwise, meta-skills will not be achieved. It is

difficult to promote the development of narrative schema

using multiple exemplars unless there are clear patterns

across those exemplars.

We recommend that stories used in intervention con-

tain, at a minimum, a basic, minimally complete episode

(problem, attempt, consequence) and that, before discuss-

ing the individual components in the intervention session,

the entire story is presented in its complete and complex

form first. This provides contextualizing information and

ensures children see it as a whole, thereby enhancing pur-

pose and motivation for the task (R. B. Gillam & Ukrainetz,

2006). Once the whole is modeled, the story can be broken

down into more manageable chunks, ensuring multiple

opportunities for children to practice each part. Yet, even

when each part is practiced individually, it is important

to contextualize the child’s utterance and attach meaning

to it. For example, asking questions related to story gram-

mar (e.g., “What was John’s problem in this story?”or

“Whatdidhedotofixhisproblem?”) or having children

practice retelling the parts, one part at a time (e.g., “John

was riding his bike down the street.”or “He asked his

mom for a bandage.”), is an appropriate scaffolding tech-

nique, allowing the interventionists to provide several models

and feedback during guided practice, yet we also encour-

age children to place those parts back into either the entire

narrative or a larger section of the narrative. For example,

after prompting a child to include the character’s feeling,

we often ask the child to go back one element in the story

(e.g., to the problem) and to retell both the problem and

the feeling so that there is cohesion and purpose in the task.

After a period of supported telling/retelling of the parts

within the same session, the story should be reconstructed

into its whole. Children should be encouraged (and sup-

ported) to tell/retell the story in its entirety and in order,

and to the extent possible, use cohesive devices to caus-

ally and temporally connect the episodic elements. Thus,

within a single intervention session, a story is presented as

a whole unit to contextualize it, then unpacked as parts for

guided practice, and reconstructed as a whole in indepen-

dentpractice(R.B.Gillam&Ukrainetz,2006).Inthis

manner, children are frequently reminded of the purpose

of each story grammar element and the importance of

their cohesion for generating a more meaningful whole.

This whole–part–whole framework driven by purposeful,

explicit instruction has been shown to be effective in a

number of narrative intervention studies (e.g., Brinton &

Fujiki, 2017, 2019; S. L. Gillam, Gillam, & Reece, 2012;

all Story Champs studies).

Use Visual Support to Make Abstract Concepts Concrete

Because storytelling requires the confluence of numer-

ous higher order processes, it is a demanding task for stu-

dents with language disabilities. We have already established

that the structure of stories is a concept (or schema) learned

through exposure to multiple exemplars. However, teaching

children about schemas can be a slow process without the

help of visual support (e.g., pictures, drawings, icons, graphic

organizers). Although clinicians should be cautious about

allowing children to always use visuals when telling or retell-

ing stories, they can be an extremely effective teaching tool,

especially when introducing a new story. Specifically, visual

supports can be used to make abstract concepts such as story

grammar and linguistic features (e.g., causal subordinate

conjunctions) more tangible and concrete for children.

The most popular visual support strategies include

using pictography, icons, symbols, gestures, or manipulatives

that represent the story grammar elements or linguistic tar-

gets. Icons, symbols, and manipulatives can be designed to

have correspondence to specific components (S. L. Gillam

et al., 2018; Spencer & Petersen, 2016; Story Grammar

Marker, 2020). In some studies, interventionists have

taught each component with its symbol or icon in isola-

tion and spent time explaining its purpose in stories (e.g.,

Brown et al., 2014; S. L. Gillam et al., 2014), but in our

research, we teach children the names of the story grammar

parts while modeling a new story. Through the repeated

visual presentation of the icons in a specific order and re-

peated aural association with the names of the parts, chil-

dren quickly acquire an understanding of the schema. Icons

have also been used to represent less common vocabulary

(i.e., Tier 2 words; Beck et al., 2013) and complex language

features such as causal and temporal ties (Gardner & Spencer,

2016; Petersen et al., 2019). Pictography, which involves the

use of simple line drawings to represent ideas and events in a

story, can support story retelling, story generation, and the

production of complex language (R. B. Gillam & Ukrainetz

2006; McFadden, 1998). We find pictography particularly

useful when children are asked to generate their own story.

By quickly drawing the content of the child’s story, children

can use the visual representation to support subsequent

Spencer & Petersen: Narrative Intervention 1087

retellings (Petersen et al., 2014; Spencer et al., 2013). Graphic

organizers and concept maps are additional examples of vi-

suals that have been used to help children learn the pattern

of stories (Boulineau et al., 2004; S. L. Gillam et al., 2015).

When visuals are used during intervention, clinicians

should be strategic about fading them. Sometimes, pictures

or illustrations correspond to the specially designed stories,

which reduce the demands for reticent children. If using

storybooks, interventionists need to be cognizant that the

illustrations can provide more information about the story

than is needed. In some cases, relying on that information

is beneficial, but sometimes, too many visual supports can

interfere in the acquisition of the cognitive schema that al-

lows them to use the structures in a generalized manner.

Icons, symbols, pictography, and manipulatives serve as

reminders of the narrative structure but contain less infor-

mation about a specific story than detailed pictures and il-

lustrations do. Therefore, we recommend fading pictures

and illustrations before icons so that children can benefit

from a smooth and gradual transition from easy to difficult

tasks within a session. For example, in recent studies featur-

ing small group narrative intervention with Spanish-speaking

preschoolers learning English (Spencer et al., 2019, 2020),

illustrations and icons were displayed while the story was

modeled and when the first child retold the story indepen-

dently. When the second child retold the story independently,

only the icons were available, and when the third child re-

told the story, no visuals were available.

Deliver Immediate Corrective Feedback

Feedback is a powerful teaching tool (Hattie &

Timperley, 2007). If a child is saying things you want

them to say again or if they are using language you want

them to repeat, the best positive feedback includes active

listening (e.g., nodding head, eye contact) and recasting

(Cleave et al., 2015). If the child is not including specific

aspects of story structure or language that you desire, a

correction is needed. Effective corrective feedback has three

main characteristics, all of which apply to delivering feed-

back in narrative interventions. First, effective feedback

focuses on what the child should do and minimizes atten-

tion given to the incorrect response. Students need infor-

mation about their performance and what they can do to

improve it. Ultimately, a successful correction leads to the

child producing the correct response (Watkins & Slocum,

2004). A possible correction could simply be a model of

what the child should say (e.g., “Say it like this. John was

sad.”) with a subsequent opportunity for the child to try

it again.

Second, effective feedback is immediate (Watkins &

Slocum, 2004). Practiced errors are likely to continue. There-

fore, as soon as an error is made, a correction should follow.

For example, if a child is retelling a story and skips a critical

element (e.g., action), this would be considered an error. The

interventionist should stop the story immediately and make

an appropriate correction. It is important not to wait until

the end of the story to provide the correction because feed-

back that is delayed from the performance is less effective

than feedback that is delivered immediately and contingent

up student responses (Archer & Hughes, 2011). This immedi-

ate feedback can be delivered in a naturalistic way, where

the interventionist can express genuine interest or confusion

about missing information in the story.

Third, effective feedback is specific (Watkins & Slocum,

2004). It is tempting to give a reminder or hint at what the

child should have said or provide some general information

that a mistake was made (“Oops. You forgot something.”).

Unfortunately, less intrusive corrections such as these can

confuse or frustrate children, further depressing their moti-

vation to try challenging things. If the response was firmly

in a child’s repertoire (in other words, it was easy), they

would have made it. It is best to assume that the response

is still too hard and to give that child-specific information

about what to do instead. This can be resolved by explicitly

telling the child what was missed (e.g., “Oops. You forgot

to tell us his feeling. How did he feel?”) or modeling what

the child should say and then giving the child the opportu-

nity to imitate it.

Telling or retelling story grammar elements in a con-

sistent sequence can hasten the acquisition of the schema

and prevent excluding critical information accidentally.

In a way, the story grammar components operate like the

links in a chain that function properly when arranged in a

certain order. For that reason, when a child skips a story

grammar element, it can be helpful to have them practice

the correct sequence again immediately following the cor-

rection. In Petersen et al. (2017), the interventionists made

immediate corrections and then asked the student to con-

tinue retelling the story starting with the component before

the one that was missed. This type of overcorrection proce-

dure honors the special cohesion between the elements and

helps students to depend on the ordinal unfolding of events

as they tell or retell stories.

Use Efficient and Effective Prompts

There is a large array of options when it comes to

prompting (Cengher et al., 2018). One method of prompt-

ing (and fading) was described above as it relates to the

use of visual materials. When the gradual withdrawal of

visual materials (e.g., illustrations and icons) is embedded

in the intervention’s procedural steps, prompting is con-

trolled by the curriculum. In other words, they are crucial

active ingredients that should not be altered by the inter-

ventionist. Aside from these built-in prompts, clinicians are

in control of the rest. It is the interventionist’s responsibil-

ity to select and use efficient and effective prompts.

Over the years, we have come to appreciate a simple

prompting technique that can reduce the amount of time

spent prompting while ensuring that the child is successful

in two easy steps. We call this procedure two-step prompting.

For any clinician-controlled response prompt, we recom-

mend first asking a question that includes specific informa-

tion about what the child missed or should have mentioned.

Although furthering prompts like “Then what happened?”or

“What happened next?”can be used, we do not consider these

response prompts because they do not provide information

1088 Language, Speech, and Hearing Services in Schools •Vol. 51 •1081–1096 •October 2020

about what response is expected from the child. Furthering

prompts are typically used to encourage the child to keep

going or redirect them to the task, but assume they do not

need help forming the expected response. In two-step prompt-

ing, we suggest that clinicians use questions such as “How

did John feel about his problem?”or “What did he do to fix

the problem?”because they direct the child’s attention to the

specific part of the story that needs to be told/retold. They

also enhance children’s ability to answer comprehension

questions about a story without explicitly teaching children

to answer wh-questions (Spencer et al., 2013). The second

part of two-step prompting is to model it for the child. If

the child is unable to tell/retell the expected target within a

few seconds after asking the question, the clinician should

quickly follow it up with a model sentence such as “John

was sad because he cut his knee. Now, you say that.”or “He

asked his mom for a bandage. Your turn.”

Two-step prompting has a number of advantages.

First, by using wh-questions as a prompting strategy, chil-

dren’s ability to answer wh-questions improves without spe-

cifically teaching it. In Spencer, Petersen, Slocum, and Allen

(2015), preschoolers who received large group narrative

intervention that addressed retelling using wh-questions

as prompts made substantial gains over the control group

on a story comprehension measure (d= 54). Second, the

two-step prompting procedure helps children be successful.

Children do not have to fail multiple times to get the amount

of help they need. It is important that children experience

success and receive approval and praise for their efforts,

which ultimately determines if they will try again. Third,

two-step prompting is efficient. It can take less than 10 s to

complete both steps if they are needed. This reduces the

amount of time a child experiences difficulty and reduces

the time other children are passively observing. Fourth, the

two-step prompting procedure is easy for the clinician to

remember. Multistep, systematic prompting can become

laborious for the interventionist to remember the steps, espe-

cially if those steps are individualized for different children.

Fifth, two-step prompting is generally applicable. This means

that it works for most children and most targets. It simplifies

how an interventionist differentiates within a group, depend-

ing on the needs of the children. For example, let us say

one child is still working on retelling a story with all the basic

story grammar elements and another child is working on

using complex vocabulary. For the first child, the interven-

tionist can ask a question about the story grammar element

missed, and for the second child, the interventionist can ask,

“What is the special word that goes in this sentence?”and

then model the sentence if needed (e.g., Weddle et al., 2016).

Finally, two-step prompting leads to independence while re-

ducing prompt dependency. By starting the prompting with

the question, which is often a natural part of storytelling be-

tween conversational partners, the clinician does not provide

more help than is needed. This allows the child an opportu-

nity to produce a mostly independent response when they

can do it.

While two-step prompting works with most children,

question prompts are not equally effective with all children.

In a recent narrative intervention study with children with

autism (Garcia et al., 2019), we discovered that participants

rarely responded to the first step of two-step prompting.

Presumably, they did not understand the questions. Model-

ing sentences and delaying the timing of models were more

effective than the story grammar–focused wh-questions. It

became apparent that, if a child has to be taught how to

respond to the intended prompts, then they cannot be used

effectively to “prompt”behavior. In our experience, two-

step prompting is a good procedure to start with, but clini-

cians may need to adapt their prompting procedures to align

with individual children’s strengths and weaknesses like we

had to do in the study with children with autism. Regardless

of adaptation of prompting, clinicians should continue to

follow the general recommendation of using the most effi-

cient and effective prompts possible. For children with

autism and other developmental disabilities, this may in-

volve providing longer wait times, limiting verbal prompts,

and strategically fading visual prompts (Favot et al., 2018;

Garcia et al., 2019; S. L. Gillam et al., 2015; Petersen et al.,

2014). If interventions are delivered individually, more

gradual least-to-most prompting (i.e., more than two steps)

is easier to manage and may be needed for some children

with autism to acquire storytelling skills (Whalon et al., 2019).

Differentiate, Individualize, and Extend

Small group narrative intervention is extremely versa-

tile and can facilitate differentiation and individualization

(Petersen et al., 2019; Spencer et al., 2018; Weddle et al.,

2016) because so many different targets can be addressed

within the context of a single story and in a single session.

If the story is purposefully selected, clinicians can focus in-

tervention for some children on basic targets such as using

the story grammar elements while encouraging other chil-

dren to practice advanced targets such as using more com-

plex sentences or complex vocabulary. It is even possible

to include children in the group who use augmentative

and alternative communication (Soto et al., 2007) or whose

targets involve receptive language. Likewise, the promotion

of perspective taking (Dodd et al., 2011) and inferencing

(Gardner & Spencer, 2016) can be targeted within a narra-

tive intervention. It is important to set the demands of the

intervention task (e.g., retelling, answering questions, manip-

ulating pictures) according to each child’s language targets

(Westerveld & Gillon, 2010) and to use two-step prompting

flexibly. School-based SLPs are frequently pressured to do

more with less time. Small group narrative intervention is

one way to accomplish that.

Depending on the age and development of the chil-

dren, clinicians can extend their interventions to promote

grade-appropriate academic and social skills. This means

that intervention should not end when children can tell or

retell a story using relevant story structure. This is just the

starting place that serves as a solid foundation for teaching

other critical skills that children with language disabilities

often lack (e.g., personal and fictional generation, writing,

using complex vocabulary). Even the discourse and sen-

tence level structures of expository language can be more

Spencer & Petersen: Narrative Intervention 1089

easily addressed once the narrative language foundation

has been established (Petersen et al., 2019). If students be-

come bored during intervention sessions, this is a red flag

that the clinician has not moved them along to more chal-

lenging tasks.

Sometimes, clinicians can struggle with what to do next.

Fortunately, there are a number of published programs that

can be helpful in this regard. Story Champs (Spencer &

Petersen, 2016) includes 57 different lesson plans with eight

add-on lessons so that teachers and clinicians have a large

variety of targets to choose from, including simple to com-

plex oral and written narratives, oral and written exposition,

vocabulary, and complex language. The Story Grammar

Marker program has a number of variations that facilitate

social emotional learning, text complexity and close reading,

and writing (Moreau & Fidrych, 2008). SKILL has explicit

procedures that move children from producing simple story

grammar elements to more complex stories with academic

language (S. L. Gillam et al., 2018). If a clinician decides

not to use a published program, we recommend consulting

the general education curriculum and academic standards

used locally or visiting http://www.coreknowledge.org for

helpful materials and grade-level academic sequences.

Arrange for Generalization Opportunities

Narratives are a great choice for language intervention

because they have direct relevance to highly valued academic

and social skills. To maximize the effect of intervention, we

recommend intentionally planning for generalization oppor-

tunities. One of our favorite ways to ensure this happens

is to involve classroom teachers in the intervention. For in-

stance, SLPs can support teachers’implementation of nar-

rative intervention, in large or small group arrangements.

A class can be divided into multiple small groups, and the

teacher and SLP can each focus on a group to work with at

the same time. In one study examining a multitiered imple-

mentation of narrative intervention in preschools (Spencer

et al., 2018), teachers and teaching assistants were both in-

volved in delivering the intervention. Cimburek and Petersen

(2017) examined a similar multitiered implementation for

preschool and kindergarten students. General education

teachers delivered large group narrative intervention while

SLPs delivered small group narrative intervention to at-risk

students. By engaging teachers in narrative intervention,

they learn the complex language that they should be en-

couraging their students to use and are more likely to extend

practice opportunities to other academic domains (e.g., so-

cial studies, writing). If teachers choose not to participate

in the intervention directly, the SLP might try to provide in-

tervention in the classroom (e.g., S. L. Gillam et al., 2014;

Weddle et al., 2016) so that the teacher at least observes

and hears what is being taught.

Another option is for SLPs to create activities for

students to practice narrative-related targets in other con-

texts and consult with teachers about how to facilitate their

use. For example, a simple lesson extension can be written

out that directs the teacher to have children “turn-n-talk”

about what they did over the weekend. SLPs can also

supply teachers with graphic organizers or concept maps

displaying the icons or symbols from narrative interven-

tion, making it easier for children to see how the skills

taught in intervention can be used during classroom activi-

ties such as reading comprehension or writing. If special

stories are used for initial training, then storybook reading

is an excellent context for generalization, whether the

books are read by an SLP, a teacher, or a parent. Family

engagement activities can be sent home so that children

have support retelling stories to family members. In a re-

cent study, we supplied teachers with posters of each of

the vocabulary words targeted during intervention (Spencer

et al., 2020). The purpose was to help the teacher and all

the students be on the lookout for those words and their

synonyms, which increases word consciousness (McKeown

et al., 2017). Resourceful SLPs can use their creativity to

craft activities that promote the generalized and spontane-

ous use of narrative-based language targets. The important

thing is that generalization is not left to chance. Planning

for it will hasten the acquisition and maintenance of trained

skills, as well as promote their use in meaningful contexts

(Alessi, 1987; Fey, 1988).

Make It Fun!

Simply put, people talk because they get attention

from others when they do. Other benefits may be associ-

ated with specific requests (e.g., asking for a drink), but

as humans, we are primarily motivated by social conse-

quences. When engaged in narrative intervention, SLPs

should keep in mind that the natural consequence of telling

a story is attention and approval from a listener. As clini-

cians strategically use their attention to reinforce storytelling

and make the interaction enjoyable, children will be willing

to try challenging things. It is helpful to choose published

narrative intervention programs that include games, mate-

rials, or activities that appeal to children, but it is danger-

ous to rely too heavily on them. If children are reticent,

bored, or complain, then it is the SLP’s responsibility to

facilitate engagement. Because children naturally want

to talk about themselves and their experiences, narratives

are the perfect context for practicing language without it

feeling like work.

We have a number of suggestions for how to make nar-

rative intervention fun. First, SLPs can increase the value of

their attention by being animated when listening. Use over-

exaggerated facial expressions and comments (e.g., “No

way!”) to show children you are listening carefully. Recasting

is an effective way to show approval while having the added

benefit of modeling complex language and expanding the

child’s utterance (Cleave et al., 2015). Second, teach other

children to be active, engaged listeners and praise them

when they show respect for the storyteller. Peers can be ex-

plicitly taught how to paraphrase a peer’sstorybriefly.

SLPs can model paraphrasing and encourage the other

children to do it after listening to a story. Third, play games

and use competition but do not eliminate attention and ap-

proval. It is okay to use consequences other than your at-

tention (e.g., points, getting to color in a square on a chart,

1090 Language, Speech, and Hearing Services in Schools •Vol. 51 •1081–1096 •October 2020

or moving a game piece), but although they may be needed

temporarily for training purposes, attention will be neces-

sary to maintain storytelling skills outside the intervention

context. Fourth, take advantage of peer mediation. Putting

children together in teams or pairs can increase motivation

for the storytelling tasks. Children often work to impress

their friends and may accept help from peers better than

from adults. Finally, engage children in role plays, using

props or puppets, or movement related to the stories. Re-

cent research suggests that combining movement with story-

telling enhances children’s language outcomes (Brinton &

Fujiki, 2017; Culatta et al., 2010; Duncan et al., 2019).

Conclusions

Our purpose was to provide an overview of the aca-

demic and social value of narratives and to offer principle-

driven guidance based on research and our own clinical

experience implementing narrative intervention. Narratives

are an extremely versatile conduit for learning a large num-

ber of academic and socially meaningful skills. Narrative

intervention can be used with children as young as 3 years

old, all the way through high school. Research has docu-

mented its effectiveness for typically developing children,

those who are at risk, children with language disabilities,

children with autism, and English language learners. While

there are a handful of published narrative intervention pro-

grams available for clinical use, narrative interventions

can be developed using materials that most SLPs have

readily available. When narrative intervention is implemented

following the principles of intervention outlined in this article,

SLPs can have confidence that their approach is supported

by research and extensive clinical experience. It is our hope

that every school-based SLP can harness the power of stories

in their clinical practice.

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CHILD DEV

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Dec 2021
LANG SPEECH HEAR SER

Purpose The purpose of this randomized controlled trial was to examine the effects of a multitiered system of language support (MTSLS) on kindergarteners' narrative retelling, personal stories, writing, and expository language. Method Participants were 686 kindergarten students from four school districts in the United States. Twenty-eight classrooms were randomly assigned to treatment (n = 337 students) or control (n = 349 students) conditions. The treatment group received 14 weeks of oral narrative language instruction using Story Champs, a multitiered language program. Classroom teachers delivered large group (Tier 1) instruction for 15–20 min a day for 4 weeks. After this short-duration whole-class instruction, speech-language pathologists began small group Story Champs (Tier 2) intervention with a random sample of students who did not make adequate progress from the large group instruction (n = 49). These students received Tier 2 intervention for 20 min twice a week in addition to continued Tier 1 instruction. Results Results indicated that the students in the treatment group had significantly higher scores on all outcome measures compared to the students in the control group. Analyses of outcomes from the 49 students who received Tier 2 intervention compared to a matching sample of at-risk control students revealed that the treatment group had significantly higher scores on narrative retells, personal stories, and expository retells. When compared to matched average-performing and advanced-performing control peers, the students who received Tier 2 intervention had significantly higher narrative retell scores and no longer had significantly lower personal story, expository, or writing scores. Conclusion This effectiveness study demonstrated that MTSLS can lead to meaningful improvements in kindergarteners' oral and written language skills, even helping at-risk students catch up to high-achieving peers.

Fostering Kindergarteners' Narrative Writing Through Oral Language Instruction

Poster

Full-text available

Dec 2019

Learning to write is one of the essential literacy skills to academic success (Biancarosa & Snow, 2004; Graham & Perin, 2007). Early intervention to foster children’s early writing development can prevent a long-term adverse effect on students’ writing performance (Berninger, Nielsen, Abbott, Wijsman, Raskind, 2008). The writing standards indicated that Kindergarteners should be able to “narrate a single event or several loosely linked events, tell about the events in the order in which they occurred, and provide a reaction to what happened” (National Governors Association Center for Best Practices & Council of Chief State School Officers, 2010, p. 19). Although some studies examined the writing development of preschool or Kindergarten students, these studies heavily focus transcription skills, such as spelling and writing conventions (e.g., Campbell, Chen, Shenoy, Cunningham, 2018). Converging evidence gathered from meta-analyses suggested that only transcription interventions have been researched with first-grade students or younger (Graham, McKeown, Kiuhara, Harrir, 2012; Datchunk & Kubina, 2012; McMaster et al., 2017). Nevertheless, narrative writing is more than a transcribing process. A well-established narrative writing includes a setting, initiating event, action, climax, ending, and reaction (Stein & Glenn, 1979). Writers need more than transcription skills. They also need to have knowledge of narrative structure or story grammar to generate a quality narrative (Graham & Harris, 1989; Graves, Montague, & Wong, 1990; Stein & Glenn, 1979). Writing interventions that only focus on transcription skills are not sufficient for fostering beginning writers’ narrative writing skills. The goal of our study is to bridge this research gap by examining the effect of an oral narrative intervention on Kindergartners’ narrative writing. A multiple baseline design across groups was conducted to examine the relationship between the oral language intervention and narrative writing outcomes. Six kindergarten students were assigned in pairs to one of three groups. Each of the three groups experienced three conditions: baseline, intervention, and maintenance. The onset of the intervention phase was staggered for the three groups based on generally stable baseline performances of the research participants in the group. During the baseline condition, students did not receive oral narrative instruction. However, a writing sample was collected from each student on most days. On the days in which students were absent, a writing sample was not collected. Once the intervention condition began for a group, the students participated in six small group (4-5 students) oral narrative instructional sessions. Each session lasted 20-30 minutes and occurred three times a week for two weeks. During the intervention condition, students continued to produce writing samples. For students who were available, two writing samples produced 3-4 weeks following the last instructional session were used to document the extent to which writing improvements maintained.

Development of the Narrative Assessment Protocol-2: A Tool for Examining Young Children's Narrative Skill

Article

Full-text available

Feb 2020
LANG SPEECH HEAR SER

Purpose Narrative skill, a child's ability to create a temporally sequenced account of an experience or event, is considered an important domain of children's language development. Narrative skill is strongly predictive of later language and literacy and is emphasized in curricula and educational standards. However, the need to transcribe a child's narrative and the lack of psychometrically justified scoring methods have precluded broad consideration of narrative skill among practitioners. We describe the development and validation of the Narrative Assessment Protocol-2 (NAP-2), an assessment of narrative skill for children ages 3–6 years, which uses event-based frequency scoring directly from a video recording of a child's narrative. Method The NAP-2 underwent a rigorous development process involving creation of four wordless picture books and associated scripts and identification of a broad item pool, including aspects of narrative microstructure and macrostructure. We collected two narratives from each of 470 children using the NAP-2 elicitation materials and scored each with the 60 items in the initial item pool. Results Cross-validated exploratory factor analyses indicated a single narrative skill factor. Rasch measurement analysis led to selection of 20 items that maintained high reliability while having good fit to the model and no evidence of differential item functioning across books and gender. Conclusions The NAP-2 offers a psychometrically sound and easy-to-use assessment of narrative skill for children ages 3–6 years. The NAP-2 is available freely online for use by speech-language pathologists, educational practitioners, and researchers. Supplemental Material https://doi.org/10.23641/asha.11800779

Early Efficacy of Multitiered Dual-Language Instruction: Promoting Preschoolers’ Spanish and English Oral Language

Article

Full-text available

Jan 2020

The purpose of this cluster randomized group study was to investigate the effect of multitiered, dual-language instruction on children’s oral language skills, including vocabulary, narrative retell, receptive and expressive language, and listening comprehension. The participants were 3- to 5-year-old children (n = 81) who were learning English and whose home language was Spanish. Across the school year, classroom teachers in the treatment group delivered large-group lessons in English to the whole class twice per week. For a Tier 2 intervention, the teachers delivered small-group lessons 4 days a week, alternating the language of intervention daily (first Spanish, then English). Group posttest differences were statistically significant, with moderate to large effect sizes favoring the treatment group on all the English proximal measures and on three of the four Spanish proximal measures. Treatment group advantages were observed on Spanish and English norm-referenced standardized measures of language (except vocabulary) and a distal measure of language comprehension.

The Classification Accuracy of a Dynamic Assessment of Inferential Word Learning for Bilingual English/Spanish-Speaking School-Age Children

Article

Full-text available

Dec 2019
LANG SPEECH HEAR SER

Purpose Educators often use results from static norm-referenced vocabulary assessments to aid in the diagnosis of school-age children with a language disorder. However, research has indicated that many of these vocabulary assessments yield inaccurate, biased results, especially with culturally and linguistically diverse children. This study examined whether the use of a dynamic assessment of inferential word learning was more accurate at identifying bilingual (English/Spanish-speaking) children with a language disorder when compared to static measures of vocabulary. Method Thirty-one bilingual Spanish/English school-age children—21 children with typical language and 10 children with a language disorder—ages 5;9–9;7 (years;months) were administered traditional static vocabulary assessments and a dynamic assessment of inferential word learning that used a test–teach–test design. Results Discriminant analysis and logistic regression indicated that the combined posttest scores and modifiability ratings from the dynamic assessment generated 90%–100% sensitivity and 90.5%–95.2% specificity, which were superior to the static vocabulary tests. Conclusion These preliminary findings suggest that dynamic assessment of inferential word learning may be an effective method for accurately identifying diverse children with a language disorder.

Improving Reading Comprehension in the Primary Grades: Mediated Effects of a Language-Focused Classroom Intervention

Article

Full-text available

Aug 2019
J SPEECH LANG HEAR R

Jessica A. R. Logan

Purpose This article includes results from a multistate randomized controlled trial designed to investigate the impacts of a language-focused classroom intervention on primary grade students' proximal language skills and distal reading comprehension skills. Method The sample included 938 children from 160 classrooms in 4 geographic regions in the United States; each classroom was randomly assigned to 1 of 2 experimental conditions (2 variations of a language-focused intervention) or business-as-usual control. For this study, the 2 experimental conditions were collapsed, as they represented minor differences in the language-focused intervention. All children completed assessments at multiple time points during the academic year. Proximal measures (curriculum-aligned measures of vocabulary, comprehension monitoring, and understanding narrative and expository text) were administered throughout the school year. Distal measures of reading comprehension were administered at the beginning and the end of the school year. Results Multilevel multivariate regression was conducted with results showing that students receiving the language-focused intervention significantly outperformed those in the control group in comprehension monitoring and vocabulary, with effect sizes ranging from 0.55 to 1.98. A small effect in understanding text (narrative) was found in 3rd grade only. Multilevel path analyses were then conducted to examine if the intervention had a positive impact on reading comprehension through the influence of proximal language outcomes. In all 3 grades, instruction impacted reading comprehension via the mediation of vocabulary, with sizable effects (1.89–2.26); no other indirect pathways were significant. Conclusions This study provides evidence that a language-focused intervention can positively impact students' performance on language measures that are closely aligned with the intervention, with indirect, large effects on distal reading comprehension measures. Theoretically, this study provides causally interpretable support for the language bases of reading comprehension.

Multi-tiered Narrative Intervention for Preschoolers: A Head Start Implementation Study

Article

Dec 2017

Trina D. Spencer

This implementation study examined the efficacy and feasibility of a multi-tiered narrative intervention when Head Start teachers and teaching assistants delivered all of the interventions and progress monitoring probes. In six Head Start classrooms, 105 children were assigned to receive the intervention or to receive their typical instruction. Children who attended the three classrooms that implemented the multi-tiered intervention showed significantly better story retelling and language comprehension skills than the children who attended preschool in the control classrooms. Additional questions addressed the feasibility of a multi-tiered system in Head Start classrooms. Findings indicate that Head Start teachers and teaching assistants can deliver large group, small group, and individual lessons with adequate fidelity; they can administer brief progress monitoring probes with fidelity and score childrenâ€™s retells reliably. Furthermore, as teachers and teaching assistants become more comfortable with the procedures, they report greater self-efficacy, and overall, greater feasibility of a multi-tiered model in their classrooms.

Western Apache Language and Culture: Essays in Linguistic Anthropology

Book

Mar 1990

Keith H. Basso

Actual Minds, Possible Worlds

Book

Dec 1986

Jerome Bruner

Effects of an adapted story grammar intervention on the listening comprehension of children with autism ☆

Article

Nov 2019
RES DEV DISABIL

Children with autism spectrum disorder (ASD) often develop the word reading skills necessary to read text but struggle with reading comprehension. Comprehension skills are often under addressed in early elementary settings leaving children with ASD at a disadvantage once they are expected to read for meaning. This study investigated the impact of an adapted story grammar intervention on the listening comprehension of five children with ASD in kindergarten through second grade. The intervention embedded evidence-based practices shown to support the learning of children with ASD during story grammar instruction. All participating children demonstrated increased correct responding to fact and inference questions following intervention. Data suggest that all participants required visuals to participate in and learn from the intervention. Social validity data indicate the classroom teacher perceived the intervention as helpful and feasible. Implications for instruction and future research are discussed.

Narrative Intervention: Principles to Practice

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