Group Phonological Awareness Intervention: It Works!

Greater Southern Area Health Service

This project won the 2006 Baxter NSW Health Awards, Appropriateness of Care category.

  Presentation given at the 2006 NSW Health Expo.

Contact: Melinda Hewitt

Abstract

The project was designed to evaluate the efficacy and validity of the Phonological Awareness Group (PAG) Program, and ascertain its success in treating groups of children with poor phonological awareness skills.
 
Children were selected to participate in the pilot study by scoring between one and three standard deviations below the mean on standardised test scores examining their phonological awareness abilities. These scores placed them below the expected scoring range for their age.
 
Two service delivery models were offered to cater for varied needs of clients, which allowed for further delineation regarding which model provided the greatest increase in skill level. Program A run over six consecutive weeks, with one session conducted each week for 50min (total contact time: five hours). Program B was conducted over one week, with one session each day for one hour (total contact time: five hours).

After completion of the groups, and analysis of their post-group test scores. The data revealed that 92% of scores increased, and the improvement was such that 90% of the children scored within the expected range for their age (as compared with 0% pre-group).

Aim

To evaluate the efficacy and validity of group phonological awareness intervention using two service delivery models and pre- and post- test standardised testing.

Background

Phonological awareness (PA) is a fundamental skill needed by all children for literary success and it's relation to early reading ability suggest its importance in children's communication (Blachman, 1984; Slaverio, 2000). PA skills refer to the explicit awareness of the sound structure of language. It encompasses the ability to recognise that a spoken word consists of smaller components such as syllables and phonemes (sounds) and that these units can be manipulated.

Over a period of six months at Wagga Community Health (WWCH), it became evident that a large number of children were presenting, with deficits in PA skills. Between April and September 2005, the number of children identified as having PA difficulties increased by 400%.

The group program was written so that it could be adapted into two service delivery models (an intensive program, and a weekly program), both of which allowed for pre- and post-testing. An evaluation was initiated following completion of the groups.

Method

• 46 children were identified as having literacy difficulties.
• Each child identified as being at a high risk for having poor phonological awareness skills, or those that had been reported to be struggling in this area, were assessed  using the Sutherland Phonological Awareness Test Revised (SPAT-R).
• 98% of these children had speech sound disorders, which was identified as a potential cause of the PA deficiency.
• Discussions between Speech Pathology professionals, identified that a group  treatment approach had the potential to be successful, rather than previous home  programming treatment.
• If the child received a score between -1 and -3 standard deviations below the mean on  the SPAT-R, they were deemed acceptable for group placement.
• With consideration for parental preference, children were placed into either the  intensive, or the weekly program that coincided with current schooling stages, and in  this case, the groups catered for Early Stage One, and Stage One students. i.e. NSW  Department of Education defines Kindergarten as Early Stage One, and Year 1 and 2  as Stage One.
• The pilot group program ran via two service delivery models.
• Within three weeks after each group had finished, the children within both groups  attended an individual review appointment and were re-assessed. Their scores and  percentiles were recorded and compared with pre-test data.
• In addition to the quantitative data obtained through pre- and post-test score  comparisons, the care givers/guardians were provided with the opportunity to give  feedback on their personal evaluations of either the 6-week or the intensive program,  and their perceived improvement in their child?s abilities, with provision to make  suggestions for future groups.
• The participants (children ranging from 5-9 years) in the group were also asked for  their feedback on what they 'liked', 'didn't like', and 'what could be changed for next  time'.
• Data was then collated and reviewed.

Planning and Implementation

Previously, with diagnoses of PA difficulties, clients were supplied with written programs, consisting of activities to be carried out with their caregiver/teacher in the home/school environment. Due to financial and time restraints, implementing programs in the past has been one means by which clients receive treatment, whilst reducing face-to-face contact hours. Implementation of external programming has not proven to be an effective way to target and treat PA difficulties.

It was identified that targeting PA in a group situation had the potential to be a more effective PA treatment program, whilst still maintaining cost effective and efficacious intervention.

Research was conducted into the development of PA skills, and a group program written that had the capacity to be carried out in two service delivery models.

An evaluation of the PAG program was initiated. 

Outcomes and Evaluation

• 92% of participants scores increased.
• An average increase in percentile rank of 31% occurred.
• 0% of the participants had percentile ranks within the normal range prior to group commencement, and 90% of participants had percentile ranks within the normal range after the completion of the group.
• The average percentile rank for the participants before the program was 13%; compared with an average percentile rank after the program of 42%.
• Carer reports/comments stated group effectiveness and observation of improvement in PA skills as 100% positive.
• Significant improvement in participant's skills based on post-test data (comparable with pre-test data) and qualitative reports confirm carer's support and recognition of the group affecting a positive change in participant's skill level.

Comparison of Treatment Models

Future Scope

Results indicate that group intervention targeting PA skills is significantly effective in improving the PA abilities of participants. A study conducted of practising Speech Pathologists (Barton, 2004) data reflected that between 30-70% of clinician's caseloads were comprised of children with a phonological impairment (avg: 48%), and with research confirming that children with phonological impairments are at a greater risk for PA difficulties, it is imperative that Speech Pathologists be aware that group treatment models have the potential for success. This program has the potential to be implemented by any Speech Pathologist that has children with PA difficulties and will continue to be run by WWCH.

References

• Barton, J.O (2004) Intervention Target Selections. Unpublished Masters research thesis, University of Sydney.
• Blachman, B.A. (1984) Relationship of rapid naming ability and language analysis skills to kindergarten and first-grade reading achievement. Journal of Educational Psychology, 76, 610-622.
• Slaverio, R.G. (2000) Development of phonemic awareness skills in the acquisition of reading. Post-Script 1.1, 56-78. Faculty of Education, Melbourne.