International Journal of Speech-Language Pathology, 2010; 12(3): 178–189 Profiling oral narrative ability in young school-aged children MARLEEN F. WESTERVELD & GAIL T. GILLON Int J Speech Lang Pathol Downloaded from informahealthcare.com by Hebrew University on 05/25/15 For personal use only. University of Canterbury, New Zealand Abstract This study aimed to determine if oral narrative comprehension and production measures derived in a fictional story retelling task could be used to create a profile of strengths and weaknesses in oral narrative ability (Profile of Oral Narrative Ability: PONA) in young school-aged children. The story retelling task was field-tested with 169 typically developing children, aged between 5;0 and 7;6 years. Children listened twice to an unfamiliar story while looking at the pictures in a book. Comprehension questions were asked after the first exposure. Following the second exposure, children were asked to retell the story without the use of the pictures. Story retellings were analysed on measures of semantics, morphosyntax, verbal productivity, and narrative quality. Results indicated sensitivity for age on measures of comprehension, narrative quality, semantics, and verbal productivity, but not for morphosyntactic measures. Factor analysis indicated that oral narrative performance comprised three factors, explaining more than 80% of the variance. Two clinical case examples are presented, which show the potential of the PONA to reveal different patterns of strengths and weaknesses across the oral narrative measures. Although early evidence suggests the potential usefulness of the PONA, further research is now needed to test the validity, reliability and clinical application of this tool. Keywords: Oral narrative skills, language sampling analysis, school-age children. In the last decade, researchers and clinicians have become increasingly interested in finding ways in which children’s oral narrative abilities can be described in order to assist clinicians in making clinical judgments about their students’ oral narrative performance (e.g., Bliss, McCabe, & Miranda, 1998; Justice et al., 2006; Petersen, Gillam, & Gillam, 2008; Strong, 1998). This interest stems from research indicating that the ability to understand and produce oral narratives is strongly linked to academic performance, particularly with respect to reading comprehension (e.g., Feagans & Appelbaum, 1986). Clinical assessment tools can be divided into standardized tests and criterionreferenced procedures. Although standardized tests of oral narrative ability will determine if a child functions significantly below expectations compared to his or her peers (e.g., Bishop, 2004; Gillam & Pearson, 2004), in general these tests do not yield the detail in oral narrative comprehension or production performance that is needed for intervention. In contrast, criterion-referenced procedures provide the clinician with detail about a child’s oral narrative performance (e.g., Applebee, 1978; Justice et al., 2006; Petersen et al., 2008). Ideally, both comprehension and production of oral narratives should be addressed (Boudreau, 2008) and macro- as well as microstructural aspects of performance should be included (Liles, Duffy, Merritt, & Purcell, 1995). The current study, therefore, examined if a story retelling task that was developed as part of a language sampling protocol (which also included elicitation of conversation and personal narratives, see Westerveld, Gillon, & Miller, 2004, for a copy of the protocol) would yield descriptive data in all these aspects of oral narrative performance to provide the clinician with a profile of a child’s strengths and weaknesses in oral narrative ability. The importance of oral narrative skills for academic achievement Research supports the predictive and concurrent relationship between aspects of oral narrative ability and academic performance (e.g., Feagans & Appelbaum, 1986). Moreover, studies of oral narrative performance in children with language and/or reading disabilities have revealed weaknesses in these children’s oral narrative ability when compared to chronologically age-matched and/or reading-age matched peers (Feagans & Short, 1984; Snyder & Downey, 1991; Westerveld, Gillon, & Moran, 2008). It is therefore not surprising, that general consensus exists that oral narrative analysis Correspondence: Marleen F. Westerveld, PhD, School of Literacies and Arts in Education, College of Education, University of Canterbury, Private Bag 4800, Christchurch, New Zealand. E-mail: [email protected] ISSN 1754-9507 print/ISSN 1754-9515 online ª The Speech Pathology Association of Australia Limited Published by Informa UK Ltd. DOI: 10.3109/17549500903194125 Profile of oral narrative ability Int J Speech Lang Pathol Downloaded from informahealthcare.com by Hebrew University on 05/25/15 For personal use only. should play a pivotal role in the speech-language pathologist’s assessment and intervention practices (Boudreau, 2008; Johnston, 2008). Apart from standardized testing to confirm or refute language impairment, international best practice recommends the use of spontaneous language sampling, not only to support standardized test results but also to provide the clinician with the linguistic detail needed for intervention and monitoring purposes (Gillon, Moriarty, & Schwarz, 2006; Miller, 1996). Although a plethora of guidelines have been published on how to elicit and analyse oral narrative samples (see Hughes, McGillivray, & Schmidek, 1997), local field-test data are urgently needed to allow the clinician to determine a child’s performance relative to his or her age-matched peers. Assessment of oral narrative ability Oral narrative ability can be assessed in two modalities (comprehension and production) and analysed at two levels (macrostructure and microstructure levels). From a clinical perspective, a child needs adequate skills in all of these aspects to meet the ever increasing higher-level discourse demands of the school curriculum. Children are exposed to narratives on a daily basis; They are required to listen to and understand the teacher’s narrative explanations, are expected to share personal stories and re/tell fictional stories, and are exposed to written narratives that increase in complexity as children progress through the reading levels (Milosky, 1987). Theoretical perspectives on the links between oral narrative ability and reading comprehension confirm the need for evaluation of oral narrative ability across domains and modalities (Graesser, Singer, & Trabasso, 1994; Kintsch, 1988). It is thus proposed that analysis of oral narrative ability may be used to obtain important information about a child’s spoken language abilities that are deemed important to academic participation and reading comprehension (see also Cain, Oakhill, & Bryant, 2004). More specifically, analysis of oral narrative comprehension ability will help determine the child’s ability to understand text-level language (e.g., Gough & Tunmer, 1986). Analysis of oral narrative production ability at microstructure level will potentially provide an indication of the child’s strengths and weaknesses in the spoken language domains of semantics, syntax, and morphology, whereas macrostructure analysis of oral narrative production ability will provide insight into the child’s ability to apply narrative structure knowledge and produce a coherent narrative that contains all the important story grammar elements (e.g., see Hughes et al., 1997). Oral narrative comprehension Procedures used for assessing oral narrative comprehension include asking the child to act out action 179 units contained in a narrative (Feagans & Short, 1984), asking the child comprehension questions following exposure to a story (and prior to retelling that story) (Norbury & Bishop, 2002; Westerveld et al., 2004), or asking comprehension questions immediately after a child has retold a story (Liles, 1987; Snyder & Downey, 1991; Wagner, Sahlen, & Nettelbladt, 1999). Although some researchers support the use of story retell to assess a child’s narrative understanding (e.g., Skarakis-Doyle & Dempsey, 2008), others argue that comprehension and production of oral narratives may be distinct skills (Wagner et al., 1999). Even though both methods rely to some extent on the child’s productive language abilities, it can be argued that answering questions may yield more specific information about the child’s receptive abilities than a story retelling task. A retelling task is more complex, as it not only involves the memory processes underlying successful comprehension but also entails a semantic and morphosyntactic component (see Mar, 2004). Merritt and Liles (1989) suggested using comprehension questions following a story retelling to identify if factors other than expressive spoken language skills influenced the child’s oral narrative production performance. The advantage of asking comprehension questions prior to the story retelling task is, however, that a more immediate measure of oral narrative comprehension is obtained (i.e., which has not been affected by a child’s difficulty to store information in short-term memory and/or which has not been influenced by the child’s attempt to retell the story). Furthermore, previous research has shown high correlations between story comprehension and the ability to tell the story afterwards both in children with language impairment and in children with typically developing skills (Norbury & Bishop, 2002). Oral narrative elicitation: Context and conditions Both story generation and story retelling tasks are used in the research literature to elicit oral narrative production skills. Examples of generation tasks include telling a story about a single picture (Justice et al., 2006; Ripich & Griffith, 1988), completing a story started by the examiner (Merritt & Liles, 1989), and creating a story about something that is not real (Roth & Spekman, 1986). Story retelling tasks can be described as either spontaneous (e.g., retelling a familiar story or a TV program) or more directed. Directed tasks include story productions after movie viewings (Gummersall & Strong, 1999; Liles, 1985) and story retelling, with or without pictures, after listening to a story (with or without pictures) (Ripich & Griffith, 1988; Schneider, 1996). Merritt and Liles (1989) found clear advantages to using a story retelling task rather than a story generation task for assessing oral narrative production abilities. Results indicated that retold narratives were Int J Speech Lang Pathol Downloaded from informahealthcare.com by Hebrew University on 05/25/15 For personal use only. 180 M. F. Westerveld & G. T. Gillon generally longer and contained more story grammar components and complete episode structures than story generations. In addition, generated stories were often confusing to the listener and, therefore, difficult to score at macrostructure level. When asking a child to retell a story, both the quality and the length of the resulting oral narrative will depend on the elicitation tasks and the sampling conditions (Schneider, 1996). Factors that may influence task performance include the child’s perception of the examiner’s familiarity with the model story (Masterson & Kamhi, 1991), the number of exposures to the model story (Gummersall & Strong, 1999), the contextual support for the story (e.g., single pictures, picture books, see Masterson & Kamhi, 1991), and the linguistic complexity and length of the model story (e.g., Holloway, 1986). After careful evaluation of the literature, Westerveld and Gillon (1999/2000) concluded that optimal sampling conditions for eliciting fictional oral narratives in school-aged children (with and without spoken language disorders) involved: . . . . A listener who is unfamiliar with the story the child is retelling (Liles, 1985; Masterson & Kamhi, 1991). For example, Masterson and Kamhi demonstrated that children retell longer, grammatically more complex stories to naive listeners. Two exposures to the model story (Gummersall & Strong, 1999). The results from Gummersall and Strong’s study indicated that a more informative oral narrative language sample (containing more words and more complex syntactic structures) may be obtained if a child listens to a model story twice, before being asked to retell the story. A retell of the story without the support of picture-sequences (Masterson & Kamhi, 1991). Masterson and Kamhi found that children’s story retelling samples that were collected without the support of picture books contained more compound sentences, higher lexical accuracy, and better fluency than those obtained in a picture supported condition. In contrast, grammatical accuracy decreased in the absence of pictures. Stimulus materials that contain levels of linguistic complexity that are similar to, or more advanced than the child’s own (Griffith, Ripich, & Dastoli, 1986; Holloway, 1986). Oral narrative production measures Consideration needs to be given to the type of measures that are included when investigating a child’s oral narrative performance. Some recent research studies investigating clinical applications of scoring systems have focused on relatively complex measures; one example is the Index of Narrative Microstructure (INMIS) by Justice et al. (2006) that is an aggregated score of a child’s performance at microstructure level. Another example is the Index of Narrative Complexity (Petersen et al., 2008) that assigns scores to a range of categories related to oral narrative performance, including macro- and microstructural aspects. For the current profile of oral narrative ability it was decided to use transparent, frequently used microstructure measures of oral narrative performance that are known to correlate significantly with advancing age and to be sensitive to disordered language performance (e.g., Botting, 2002; Boudreau & Hedberg, 1999; Fey, Catts, Proctor-Williams, Tomblin, & Zhang, 2004; Watkins, Kelly, Harbers, & Hollis, 1995). These measures include mean length of utterance, number of different words and grammatical accuracy. However, consistent with previous studies, to capture the quality of the oral narrative, a total score will be assigned that covers a range of characteristics such as story grammar elements, theme, and coherence (e.g., Fey et al., 2004; Miller, Heilmann, & Nockerts, 2006). The current study The current study aimed to determine if a Profile of Oral Narrative Ability (PONA), based on measures derived from a story retelling task, has clinical utility with young school-aged children. The story retelling task was field-tested with 169 typically developing children, aged between 5;0 and 7;6. Children were asked comprehension questions following the first exposure to the story, and story retelling samples were analysed at macrostructure and microstructure levels. Method Participants The 169 children in this study were participants in the New Zealand database project (see Westerveld et al., 2004). All story retelling transcripts from children who were aged between 5;0 and 7;6 were included in the current study. The children were randomly selected from mainstream primary schools in major urban areas in New Zealand. Children with diagnosed disorders such as autism, Down syndrome, and cerebral palsy were excluded prior to the random selection. The schools reflected a range of socio-economic areas. Only children who spoke English as their first language and who had no history of sensory deficits or neurological disorder were included in the study. There were slightly more girls than boys (ranging from 53% to 56% per agegroup). The ethnicity of the groups resembled the largest cultural groups in New Zealand (Ministry of Education, 1998) and comprised the following subcategories: New Zealand European (61.5%), Maori (20.7%), Pacific peoples (4%), Asian (3%), Profile of oral narrative ability and Other (9.8%). Ethnicity was based on the cultural groups the parents had identified on their child’s school-enrolment form. Details on the age and gender distribution of the participants are shown in Table I. Int J Speech Lang Pathol Downloaded from informahealthcare.com by Hebrew University on 05/25/15 For personal use only. Procedures Elicitation procedures. All testing was conducted by certified speech pathologists working for Group Special Education (New Zealand Ministry of Education). These clinicians were trained by the first author on the elicitation procedures. Each child was seen individually in the child’s school setting and was administered the full Westerveld & Gillon Language Sampling Protocol (LSP). The original protocol included elicitation of spoken language in three conditions: conversation, personal narratives, and story retelling. The protocol has been included in Westerveld et al. (2004) or can be downloaded from: http://www.education.canterbury.ac.nz/ documents/gillon/languageprotocol.pdf. In addition, a New Zealand speech and language screening test (Gillon & Schwarz, 1998) was administered. Any child who performed very poorly on the receptive language screening task (i.e., who could not follow basic instructions) was excluded from the database study. Children’s language samples were excluded from the database for reasons such as poor taping quality or not engaging in the task (i.e., unwilling to retell the story). The data presented in the current study relate to the story retelling condition of the language sampling protocol. In this context, the child was required to listen twice to an audio-recording of an unfamiliar story (while looking at the pictures in a story book). The story was an English translation of Ko au na Galo [Ana gets lost] (Swan, 1992). The story is about a Pacific Islands girl who gets lost in the city, while looking for her mum and dad. It is a 10-page reader of the type typically used in Year 1 and Year 2 New Zealand classrooms, with coloured pictures and Tokelauan text. The original translation of Ko au na Galo was adapted slightly to add a little further length and complexity to the story. A transcript of the story is presented in Appendix A. Following the first exposure to the story, the child was asked eight questions about the story to evaluate story comprehension. To ensure all children had Table I. Age and gender distribution of the participants. Age (year; months) Female/ Male Age group n Mean SD Age range n % 5-year-olds 6-year-olds 7-year-olds 39 81 49 5;6 6;5 7;3 0;3 0;3 0;2 5;0 – 5;11 6;0 – 6;11 7;0 – 7;6 22/17 44/37 26/23 56/44 54/46 53/47 181 access to the same information prior to the children listening to the story for a second time, children were provided with the correct information after answering the questions if they did not respond to the question, or if their answers were clearly incorrect. This method was used to make sure that if children generated weak stories, they were likely to be the result of the children’s difficulty in applying story structure knowledge when retelling the story, rather than the result of the children’s failure to remember and/or pay attention to important elements of the story. Following the second exposure to the story, the child was asked to retell the story without the use of pictures. Transcription procedures. All language samples were tape-recorded. Samples were transcribed by speech pathology students who were trained in the standard Systematic Analysis of Language Transcripts-New Zealand version (SALT-NZ) transcription conventions (Miller & Chapman, 1984–2003). Utterance segmentation was based on communication units (CU), using Loban’s (1976) rules. Defined by Loban, a CU consists of ‘‘each independent clause with its modifiers and associated independent clauses, or of an answer to a question lacking only the repetition of the question elements to satisfy the criterion of independent predication’’ (p. 9). Only complete and intelligible (C&I) utterances were used for analysis; Interrupted and abandoned sentences were excluded as well as utterances containing unintelligible segments. Measures Oral narrative comprehension (ONC). Each child was asked eight questions following the first exposure to the story. ONC was calculated as a percent questions correct score. The questions are listed in Appendix B. Microstructure. Only quantitative measures of oral narrative ability that are relatively easy to compute by clinicians, that have been shown to distinguish between children with spoken language impairment and children with typical development, and that are likely to change with age or ability were included: number of different words (NDW, see Miller, 1996; Watkins et al., 1995), total number of utterances (UTT), mean length of utterance in morphemes (MLU-M, see Brown, 1973), and grammatical accuracy (percent grammatically correct utterances: GA, see Fey et al., 2004). Macrostructure. The story retelling transcripts were analysed at macrostructure level. To evaluate the child’s ability to apply story structure knowledge when retelling a story, the story retellings were scored on a story quality rubric. The rubric was adapted from Jones and Lodholz (1999) and assessed Int J Speech Lang Pathol Downloaded from informahealthcare.com by Hebrew University on 05/25/15 For personal use only. 182 M. F. Westerveld & G. T. Gillon inclusion of six text structure elements: introduction, main character/s, supporting character/s, conflict, resolution, and conclusion, as well as a measure of holistic coherence. It also investigated whether the child included the theme of the story. Theme is defined as ‘‘the overall coherent topic of the text and its essential points’’ (Westby, 2005, p. 162). For more details or to obtain a copy of the rubric used in the current study, please contact the first author. The child was awarded points for each characteristic: 5 points if the child proficiently included the characteristic, 3 points if the skill was emerging, and 1 point if the child provided minimal or no information. The rubric includes specific scoring examples to promote easy and reliable scoring by other examiners. The scores were totalled to yield an Oral Narrative Quality (ONQ) score. As a result, the minimum score was 8 and the maximum score was 40. Reliability Accuracy of transcription and coding of the original stories was reported in detail in Westerveld et al. (2004). For the present study, all samples were rechecked by the first author and any transcription or coding errors that were found were corrected. For the macrostructure analysis, 20% of the transcripts were randomly selected and scored by an independent examiner who was trained in scoring the stories on the ONQ rubric. Reliability of the total scores on the ONQ rubric, using Cronbach’s alpha analysis, was .96. The total scores (of all individual stories) awarded by the two examiners differed by 4 points or less. For individual characteristic scores, the scores never differed more than 2 points (i.e., one category). Results Descriptive statistics Table II reports the means and standard deviations by age group on the six measures of oral narrative ability: oral narrative comprehension (ONC), oral narrative quality (ONQ), mean length of utterance in morphemes (MLU-M), number of different words (NDW), number of utterances (UTT) and grammatical accuracy (GA). As expected, there was a general linear increase in performance with age for all the measures, except for MLU-M which was the same for the 6- and 7-year-old age groups. To determine if the oral narrative measures were sensitive to age, separate linear regression analyses were conducted with Age as the independent variable. The following linear regressions were significant (p .001): ONC (r ¼ .25), ONQ (r ¼ .35), NDW (r ¼ .39), UTT (r ¼ .36). The regression was significant at p .05 for GA (r ¼ .16) and not significant for MLU-M (r ¼ .14). It was noted, however, that there were 2 outliers (scoring below 3 standard deviations) when the linear regression was conducted for GA. When excluding those outliers, the effect of age on GA was no longer significant (p ¼ .53). Correlational analyses To determine internal consistency of the measures, correlation coefficients between the oral narrative measures were calculated and are reported in Table III. This shows that the GA measure was not correlated to any of the other oral narrative measures. In contrast, all other measures (ONC, ONQ, MLU-M, NDW, and UTT) showed significant correlations, except for MLU-M and ONC, and MLU-M and UTT. Factor analysis A principal component factor analysis, using Varimax rotation with Kaiser normalization was conducted, entering all six oral narrative measures. At first, two factors were identified using eigenvalue 41 as the cutoff value (explaining 49.2% and 16.7% of the variance respectively). Because the third factor demonstrated an eigenvalue of .997 and explained an Table II. Group performance on oral narrative measures. 5-year-olds 6-year-olds 7-year-olds M SD M SD M SD Comprehension ONC 6 1.5 6.4 1.4 7 1.2 Production Macrostructure ONQ 21.5 5.9 24.5 6.6 28.2 5.9 1.2 13 4 14.9 7.3 49 13 87.9 0.9 16 5 11 7.3 59 16 91.8 0.9 14 4.6 9.8 Measures Microstructure MLU-M NDW UTT GA 6.9 40 10.6 86.2 Note: ONC ¼ Oral narrative comprehension, maximum score is 8; ONQ ¼ oral narrative quality, range of scores is 8–40; MLUM ¼ Mean length of utterance in morphemes; NDW ¼ number of different words; UTT ¼ total number of utterances; GA ¼ grammatical accuracy in percent grammatically correct utterances. Table III. Correlations between the oral narrative measures. Measures ONC ONQ MLU-M NDW UTT GA ONC ONQ MLU-M NDW UTT GA – .38** – .13 .26* – .37** .79** .27* – .33** .73** .01 .93** – .19 .18 .03 .14 .13 – Note: ONC ¼ Oral narrative comprehension; ONQ ¼ Oral narrative quality; MLU-M ¼ Mean length of utterance in morphemes; NDW ¼ Number of different words; UTT ¼ number of total utterances; GA ¼ Grammatical accuracy. *correlation is significant at p 5 .05. **correlation is significant at .001 level. Profile of oral narrative ability retelling task, several analyses were conducted. First, the 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles were calculated, based on weighted averages (see Table V). As shown in Table V, median scores for all oral narrative measures were similar to mean scores, except for the GA measure in the 5- and 7-year-old age groups. Next, the distribution of the scores was investigated, using skewness and kurtosis statistics. Normal distributions have skewness (degree of asymmetry of the distribution around its mean) and kurtosis (the peakedness or flatness of a distribution) statistics close to 0. Values of two standard errors of skewness or more (in this case 4.38) are considered skewed to a significant degree (Tabachnick & Fidell, 1996). As illustrated in Table IV, about half of the oral narrative measures showed a skewed distribution, with the GA measure showing a very high skewness statistic in every age group. This indicates that scores for all age-groups on this measure clustered at the high end of the scale. The results also showed significantly peaked (positive) and flat (negative) distributions, with around half of the values greater than two standard errors of kurtosis (i.e., 4.75). Int J Speech Lang Pathol Downloaded from informahealthcare.com by Hebrew University on 05/25/15 For personal use only. additional 16.6% of the variance, it was decided to retain the third factor. The first factor reflected a content component and consisted of the variables NDW, UTT, ONQ and to a lesser extent ONC. The second factor reflected a grammatical ability component and comprised GA and to a lesser extent ONC. The third factor reflected a grammatical complexity component and consisted of MLU-M (see Table IV). This factor structure did not match the hypothesized macrostructure and microstructure components of oral narrative ability, which would have resulted in loadings of NDW, UTT, GA, and MLU-M on one factor (microstructure) and ONQ and perhaps ONC on the second factor (macrostructure). Distribution statistics To determine the shape of the distribution of the oral narrative performance scores derived in the story Table IV. Rotated factor loadings. Variables Factor 1 Factor 2 Factor 3 .394 .950 .957 .854 .011 .094 2.951 49.19 .502 .094 .080 .172 .930 .031 1.002 16.70 .170 .162 7.116 .197 7.047 .984 .997 16.62 ONC NDW UTT ONQ GA MLU-M Eigenvalues % Variance 183 Case examples To provide further insights into how the PONA may potentially assist speech-language pathologists in clinical practice, two case examples of children with delayed development are presented: James and Shelley (pseudonyms used). James, aged 6 years 3 months, was referred to the University clinic because of concerns about his expressive language skills. James has a twin brother, Note: ONC ¼ Oral narrative comprehension; NDW ¼ Number of different words; UTT ¼ number of total utterances; ONQ ¼ Oral narrative quality; GA ¼ Grammatical accuracy; MLU-M ¼ Mean length of utterance in morphemes. Table V. Distributional performance and statistics by age on the oral narrative measures. Age Group Mean 5-year-olds (n ¼ 39) NDW 40 UTT 10.6 ONQ 21.5 ONC 6 GA 86 MLU-M 6.9 6-year-olds (n ¼ 81) NDW 48.5 UTT 13 ONQ 24.5 ONC 6.4 GA 87.9 MLU-M 7.3 7-year-olds (n ¼ 49) NDW 59 UTT 16 ONQ 28.2 ONC 7 GA 91.8 MLU-M 7.3 Median SD 5% 10% 25% 50% 75% 90% 95% Skewness Kurtosis 39 10 22 6 90 7.1 13.3 4 5.8 1.5 14.9 .2 18 5 14 3 56 5.2 22 6 16 4 61 5.4 32 8 18 5 85 6 38 10 22 6 90 7.1 50 14 25 7 100 7.9 62 15 30.4 8 100 8.5 63 16 32 8 100 8.5 .03 .43 .43 7.66 71.3 .007 7.81 7.61 7.57 .012 1.01 7.9 48 13 24 7 88.9 7.3 16 5 6.6 1.4 11 .9 25 6 12 4 66.7 5.8 29 7 16 4 77.8 6.1 36 9 20 6 81.8 6.7 48 12 24 7 88.9 7.3 62 17 28 7 95.2 7.9 69 20 34 8 100 8.4 77 22 36 8 100 8.5 .25 .29 .036 7.82 71.59 7.184 7.95 7.9 7.45 .11 4.8 7.53 63 17 28 7 94.4 7.2 14.4 4.6 5.9 1.2 9.8 .9 35 8 18 5 73.3 5.9 37 9 20 5 77.9 6.1 50 13 24 6 88.2 6.8 63 17 28 7 94.4 7.2 69 19 32 8 100 7.8 73 21 35 8 100 8.4 76 21.6 38 8 100 8.5 7.71 7.28 7.17 7.97 71.36 .41 .29 7.66 7.32 .025 1.73 .9 Note: NDW ¼ number of different words; UTT ¼ total number of utterances; ONQ ¼ oral narrative quality, range of scores is 8–40; ONC ¼ Oral narrative comprehension, maximum score is 8; GA ¼ grammatical accuracy in percent grammatically correct utterances; MLUM ¼ Mean length of utterance in morphemes. 184 M. F. Westerveld & G. T. Gillon Table VI. James’ performance on the PONA. Performance 95 90 75 50 25 10 5 NDW 38 UTT 12 ONQ 24 X X ONC 2 GA 58.3% X X MLU-M 6.17 X X Int J Speech Lang Pathol Downloaded from informahealthcare.com by Hebrew University on 05/25/15 For personal use only. Note: NDW ¼ number of different words; UTT ¼ total number of utterances; ONQ ¼ oral narrative quality, range of scores is 8–40; ONC ¼ Oral narrative comprehension, maximum score is 8; GA ¼ grammatical accuracy in percent grammatically correct utterances; MLUM ¼ Mean length of utterance in morphemes. Performance is displayed (X) as a percentile score. The shaded area indicates performance below the average range. was born at 32 weeks’ gestation, and showed some delay in developmental milestones. James and his brother started school on their fifth birthday. Although James had received speech-language therapy intervention in the past, he was not receiving intervention at the time of the study. As part of the routine assessment battery, the following tests were administered: Clinical Evaluation of Language Fundamentals, Preschool-2nd Edition (Wiig, Secord, & Semel, 2004): Core Language standard score (SS) 63, Receptive language SS 72, Expressive language SS 66; Peabody Picture Vocabulary Test-3rd Edition (PPVT-III Dunn & Dunn, 1997): SS 86. Preschool and Primary Inventory of Phonological Awareness (PIPA; Dodd, Crosbie, McIntosh, Teitzel, & Ozanne, 2000): rhyme awareness SS 3 and phoneme segmentation SS 7. Spontaneous language was elicited in a personal narrative and a story retelling condition, using the Westerveld & Gillon LSP (see also Westerveld et al., 2004). When comparing 50 complete and intelligible utterances derived in the personal narrative context to the database of New Zealand language samples integrated into SALT (Miller et al., 2008), the standard measures profile report indicated below average performance on measures of semantics (NDW) and morphosyntax (high number of omitted words and word errors). Table VI shows James’ profile or oral narrative ability, using the story retelling task of Ana gets lost, and the transcript is included in Appendix C. As shown in Table VI, James showed adequate performance on content measures, but demonstrated difficulty in grammatical complexity and grammatical ability. More specifically, he provided a sufficient number of utterances to retell the story (UTT), showed satisfactory performance on the oral narrative quality (ONQ) measure, and scored in the 25th percentile for NDW. However, he demonstrated significant difficulties on measures of comprehension (ONC), and grammar (MLU-M and GA). Further inspection of the ONQ score shows a weakness in the coherence characteristic and particular difficulty with the story grammar parts of introduction and conflict. Shelley, aged 6 years 8 months, was referred for speech-language pathology evaluation as a potential candidate for a research project, because of teacher concerns about her language and literacy skills. As part of the routine assessment battery, the following tests were administered: Test of Nonverbal Intelligence (TONI; Brown et al., 1997): SS 93; Clinical Evaluation of Language Fundamentals-3rd Edition (Semel et al., 1995): Total Language SS 65, Receptive language SS 65, Expressive language SS 69; PPVT-III: SS 83. Neale Analysis of Reading Ability-3rd Edition (NARA; Neale, 1999): Reading accuracy percentile rank (PR) score 16, reading comprehension PR 10. Spontaneous language was elicited in a personal narrative and a story retelling condition, using the Westerveld and Gillon LSP (see Westerveld et al., 2004). When comparing 50 complete and intelligible utterances derived in the personal narrative context to the SALT-NZ database, the standard measures profile report indicated significant difficulties in areas of semantics (NDW) and morpho-syntax (MLU-M and grammatical accuracy). Table VII shows Shelley’s profile of oral narrative ability and the transcript is included in Appendix C. As shown in Table VII, Shelley’s performance was below the level expected for her age on all measures of oral narrative performance, but consistent with standardized language testing. Further analysis of the ONQ score shows immature to emerging performance across all characteristics. Discussion The current study aimed to determine if the profile of oral narrative ability (PONA) based on the results of a story retelling task has clinical utility with young school-aged children. The story retelling task comprised a comprehension and a retelling component. Children’s retelling skills were analysed at macrostructure (oral narrative quality) and microstructure measures (semantic and morphosyntactic ability as well as story length). The task was field-tested with a representative sample of 169 typically developing children, aged between 5;0 and 7;6 years. Profile of oral narrative ability 185 Table VII. Shelley’s performance on the PONA. Performance 95 90 75 50 25 10 5 NDW 28 UTT 7 X X ONQ 18 X ONC 4 GA 58.1% MLU-M 6.43 X X X Int J Speech Lang Pathol Downloaded from informahealthcare.com by Hebrew University on 05/25/15 For personal use only. Note: NDW ¼ number of different words; UTT ¼ total number of utterances; ONQ ¼ oral narrative quality, range of scores is 8–40; ONC ¼ Oral narrative comprehension, maximum score is 8; GA ¼ grammatical accuracy in percent grammatically correct utterances; MLUM ¼ Mean length of utterance in morphemes. Performance is displayed (X) as a percentile score. The shaded area indicates performance below the average range. Descriptive analyses First, it was examined if the oral narrative measures derived from the story retelling task were sensitive to age. Regression analyses revealed sensitivity for age for measures of comprehension (ONC), narrative quality (ONQ), semantic diversity (NDW), and number of utterances (UTT). In contrast, there were no age-related changes in measures of grammatical complexity (MLU-M) and grammatical accuracy (GA). Closer inspection of the MLU-M measure (see Table II) reveals an increase in MLUM from 5 to 6 years, and no change between 6 and 7 years. This seems a reflection of the MLU-M measure, rather than the task, as similar trends have been observed in previous studies. For example, Justice et al. (2006) analysed performance on a story generation task and noticed a linear increase in MLU from 5 to 7 years and then a decrease in performance on the MLU-M measure from 7 to 8 years. In contrast, Leadholm and Miller (1992) observed very similar performances when comparing 5- to 6-year-olds on the MLU-M measure (based on 100 utterances derived in a narrative context), followed by an increase in MLU from 6 to 7 years. When inspecting the GA measure in the current study, a linear upward trend was seen from 5 to 7 years of age, but no significant differences were found between the different age groups. Other researchers who have used this measure also found little variation with age for typically developing children (Fey et al., 2004). Despite the finding that the MLU-M and GA measures did not show a significant increase with age, results from previous studies demonstrating these measures’ sensitivity to language ability support the importance of including these measures in the PONA (Fey et al., 2004; Liles et al., 1995; Scott & Windsor, 2000). However, further research investigating the performance of groups of children with language impairment on the PONA is needed to confirm this hypothesis. Descriptive statistics revealed that performance on the oral narrative measures was not always normally distributed. Although the median scores were generally close to the mean scores, ONC and GA in particular showed scores that were clustered onto the high end of the scale. The obvious explanation concerns ceiling effects for ONC and GA, with 10–25% of the children in all age groups responding correctly to all comprehension questions and producing 100% grammatically correct utterances to retell the story. The lack of a normal distribution of scores on some narrative microstructure measures at each age group was not unexpected, as previous research has shown a generally large variability in performance on oral narrative tasks (e.g., Justice et al., 2006; Liles et al., 1995). The debate on whether language sampling analysis can be standardized is likely to continue (e.g., Miller, Heilmann, Nockerts, Andriacchi, & Iglesias, 2006), until, as Justice and her colleagues argued, a theoretical explanation can be found for these ‘‘distributional irregularities’’ (Justice et al., 2006, p. 187). Although this inherent variability in oral narrative performance affects its potential for norm-referencing and indicates that the results should be used with caution, it should not rule out its use in clinical practice. It is thus proposed that the PONA may be used by clinicians as part of their language assessment battery to determine a child’s relative performance compared to his or her peers. Analysis of the correlational data showed consistently strong correlations between ONC, NDW, ONQ, and UTT. MLU-M only showed significant correlations with ONQ and NDW, whereas GA was not significantly correlated to any of the other measures. The factor analysis yielded three dimensions, a content factor (containing NDW, UTT, ONQ and to a lesser extent ONC), a grammatical ability factor (comprising GA and to a lesser extent ONC), and a grammatical complexity factor (consisting of MLU-M). These findings do not seem to confirm the hypothesized distinction between microstructure and macrostructure measures and appear to contradict results from previous research in this area (Liles et al., 1995). Liles et al. conducted a factor analysis of oral narrative measures derived in story retelling conditions, which showed two distinct categories, referred to as ‘‘Content Organization’’ (macro-level) and ‘‘Linguistic Structure’’ (more local level) (p. 421). The measures under Int J Speech Lang Pathol Downloaded from informahealthcare.com by Hebrew University on 05/25/15 For personal use only. 186 M. F. Westerveld & G. T. Gillon investigation in the Liles et al. study included: (1) Content factor: total number of episodes, ratio of possible episodes, ratio of complete cohesive ties, and (2) Linguistic structure factor: mean number of words per subordinate clause, mean number of subordinate clauses per utterance, and ratio of grammatical utterances. Interestingly, the mean number of words per main clause measure did not load on the matrix at all. There are several possible explanations for the differences in findings between the current study and the Liles et al. (1995) study. First, different oral narrative measures were used in the studies, which accounted for only 41.3% of the variance in Liles et al. study, compared to over 82% in the current study. For example, Liles et al. did not include a NDW measure. Based on results from the current study, it seems reasonable to expect that NDW would have loaded on to the Content Organization factor in the Liles et al. study. In addition, Liles et al. did not include a comprehension measure, which could have accounted for additional variance. Second, the current study uses a much larger sample of participants, which may have provided stronger factor loadings. Another finding from the factor analysis relates to the separate loadings of the GA and the MLU-M measure, indicating these measures tap different constructs. Results from Justice et al. (2006) also showed that microstructure measures of oral narrative performance did not represent a single construct. When analysing oral narrative production measures derived from a story generation task (n ¼ 250, age 5–12 years), factor analysis revealed two factors, accounting for a combined 76.3% of the variance. One factor (labelled productivity) contained measures of TNW, NDW, story length, number of coordinating conjunctions, number of subordinating conjunctions, and number of complex sentences. The second factor (complexity) contained measures of MLU and proportion of complex sentences. The authors admitted, however, that the factor loadings did not match the hypothesized productivity and complexity loadings. In summary, results from the current study confirm that oral narrative performance taps multiple underlying factors (Justice et al., 2006; Liles et al., 1995) and highlight the importance of analysing oral narratives on a range of measures. Future research should consider a wider range of oral narrative measures to further investigate the dimensionality of oral narrative performance. Case studies The two case studies, James and Shelley, showed the potential application of the PONA for assessment and intervention practices. The percentile scores for the oral narrative measures (see Table V) can be used to create a profile of a child’s strength and weaknesses in oral narrative performance across these measures. Interestingly, although James and Shelley showed similar performance on a broad spectrum standardized language test, their performance on the PONA differed. As shown in Tables VI and VII, James’ strengths were in measures tapping semantic ability, including number of different words, oral narrative quality and the number of utterances used to retell the story. In contrast, Shelley demonstrated difficulties in all aspects of oral narrative ability, indicating both semantic and grammatical problems. Further inspection of the children’s performance on the story quality rubric as well as analysis of the types of grammatical errors produced during story retelling will add further detail to the results obtained with the PONA. As a result, and consistent with evidence-based practice, these data can inform the programming of intervention goals to specifically address areas of weakness in oral narrative performance. Limitations of the study and future directions One limitation of the current study is the limited sensitivity of the ONC and GA measures. However, this may be due to the task that was used: a 10-page picture book with a relatively short story. For typically developing 5- to 7-year-old children this task may not have been sufficiently challenging, resulting in ceiling effects on both of these measures. Despite the skewed distribution for both these measures, however, the mean scores were close to the median scores and the percentile scores showed a linear increase. Furthermore, the case examples highlighted the difficulties on these two measures demonstrated by the two children with language impairment. In addition, results from our research involving children with reading disability showed performance on this oral narrative task to differentiate between poor readers and their typically developing peers on the ONC and the ONQ measures (Westerveld et al., 2008) and on the MLU-M and the GA measures (Westerveld, Gillon, & Miller, 2006). Further research with larger groups of children is needed to determine if the PONA can reliably differentiate children with language impairment from their typically developing peers. The PONA should be used with caution with children from different cultural and/or linguistic backgrounds. The results from a pilot study investigating the performance of 6-year-old children from Maori, Pacific peoples, and New Zealand European backgrounds revealed no differences in performance between the cultural groups on a range of oral narrative measures (Westerveld & Gillon, 2001). It is not clear, however, if these findings can be extended to younger children or to children for whom English is their second language. Future research should consider culturallinguistic styles that may influence performance on the PONA to help distinguish disordered Profile of oral narrative ability Int J Speech Lang Pathol Downloaded from informahealthcare.com by Hebrew University on 05/25/15 For personal use only. performance from cultural differences in oral narrative performance (see also Gutierrez-Clellen, Pen˜a, & Quinn, 1995). It is not clear if the PONA can be used to demonstrate progress in oral narrative ability following intervention. Because the story is short, a learning effect may be evident, and further study of the story retelling task to determine test-retest validity is clearly needed. The PONA should not be used as a screening measure until further research into this application is conducted. Until then, its purpose is to provide clinicians with local field test data that can be used as an addition to their battery of language assessments. Conclusion The PONA provides the clinician with an overview of a young school-aged child’s strengths and weaknesses in several aspects of oral narrative performance compared to his/her typically developing peers. However, clinicians should be careful not to use the story retelling sample as the basis for a full microstructure analysis. It is well established that analysis of at least 50 complete and intelligible utterances is needed to perform a comprehensive analysis of children’s semantic, syntactic, and morphological skills (Miller, 1996). Therefore, the PONA shows potential to be used as one aspect of the clinician’s assessment battery to describe children’s spoken language performance. This profile of oral narrative ability will then contribute to the clinical evaluation of a child’s spoken language ability and will potentially provide detailed direction for oral narrative intervention. Acknowledgments The authors would like to thank the children and the children’s parents and class teachers for their cooperation in the database project. Thanks are also extended to the speech-language pathologists who assisted in the data collection process. The support of the New Zealand Ministry of Education, the New Zealand Speech-Language Therapists’ Association and the Don Bevan Travel Scholarship was greatly appreciated. Finally, this project would not have been possible without the assistance from Professor Jon Miller and Ann Nockerts from SALT Software, LLC. References Applebee, A. (1978). The child’s concept of story. Chicago, IL: University of Chicago Press. Bishop, D. V. (2004). Expression, Reception and Recall of Narrative Instrument (ERRNI). Oxford: Harcourt Assessment. 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Poster presented at the ASHA Convention, Miami Beach, Florida. Westerveld, M. F., Gillon, G. T., & Moran, C. (2008). A longitudinal investigation of oral narrative skills in children with mixed reading disability. International Journal of SpeechLanguage Pathology, 10(3), 132–145. Wiig, E. H., Secord, W., & Semel, E. M. (2004). Clinical Evaluation of Language Fundamentals Preschool-Second Edition. San Antonio, TX: Psychological Corporation. Profile of oral narrative ability Appendix A 189 Appendix C Story retelling by James and Shelley Int J Speech Lang Pathol Downloaded from informahealthcare.com by Hebrew University on 05/25/15 For personal use only. Ana Gets Lost (Swan, 1992) One Saturday morning, Ana’s mum and dad went fishing on the beach. Ana had been sick all week, so she had to stay at home with her big brother Tom. She asked Tom if he wanted to play with her. ‘‘No thanks’’, he said, ‘‘I want to read a sports magazine’’. Ana got bored. So when Tom fell asleep, she decided to go looking for her mum and dad. She quietly opened the front door and went outside. Ana walked towards the beach, but she got lost. She kept walking until it got dark. Ana got very scared and she started to cry. She stopped outside a dairy. She was still crying and didn’t know what to do. Then Ana felt a pat on her shoulder. She looked around and saw a policeman. ‘‘Hello’’, he said, ‘‘are you Ana?’’ ‘‘Yes,’’ said Ana, giving him a big smile. The policeman took Ana home in the police car. Mum and dad were very happy to see Ana. They thanked the policeman for finding Ana and bringing her home safely. The policeman told Ana not to get lost again. Then he smiled and drove away. Appendix B Comprehension questions 1. 2. 3. 4. 5. 6. 7. 8. Who is the story about? Why did Ana have to stay at home? Why did Ana get bored? Where did Ana go to find her parents? Why did Ana get scared? Who found Ana? What did the policeman do? Why were Ana’s parents happy to see her? Story retelling by James, aged 6;3 years C (uhm) she (uhm) she walked to town. C she we* {yawns}4 E what was the story about? C (uhm) Ana. E uhuh. E anything else you can remember? C (uh) she got lost. E uhuh. C and she cried and cried. C (and then got when) when the sky got dark and dark [NGA]. E ok. C and she asked (her brother to can) his brother to play with her [NGA]. E ok, and then? C (she wa* she she w*) she quietly open the front door [NGA]. C and (she she) she got lost. E oh and anything else you can remember? C (and) and (uhm) the police (asked her to uhm uhm) pat him on the shoulder [NGA]. C and (uhm she she uhm) he got her back home. E oh 5and4. C (5a*4) and his parents got happy [NGA]. C and the man told her (uhm uhm) not to get lost again. C ¼ child; E ¼ examiner. Mazes (reformulations, filled pauses) are put in brackets. [NGA] ¼ not grammatically accurate. * indicates unfinished word. 4indicates unfinished sentence.5 4indicates overlapping speech. ONQ score: 24 Introduction 1; Theme 5; Main characters: 3; Supporting characters: 3; Conflict: 1; Coherence: 1; Resolution: 5; Conclusion: 5. ONC score: 2. James correctly answered questions 6 and 7. Story retelling by Shelley, aged 6;8 years C Ana got lost. E uhuh and then? C and (then) then she open the door quietly [NGA]. C and (she thought she has t* she x) she has to find her mum [NGA]. E uhuh and then? C (uhm and then she) the police took her home back to her mum and dad. E uhuh. C and her brother. E uhuh and then? C then (uhm) Annie (had) had a smile and then waved [NGA]. E 5yes4. C 5and the4 police (go*) was gone. ONQ score: 18 Introduction: 1; Theme: 3; Main character: 5; Supporting characters:1; Conflict: 1; Coherence: 1; Resolution: 3; Conclusion: 3. ONC score: 4. Shelley correctly answered questions 1, 5, 6 and 7.
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