It’s important to stay on topic when having conversations so everyone involved can participate and follow along. Individuals take turns sharing thoughts and opinions with each other during a successful conversation. Conversations become challenging to follow when the topic shifts too often or quickly.
Some children age 0-5 years with language disabilities may experience difficulty maintaining topics and taking appropriate conversational turns. This may look like interrupting other communication partners, talking over others, switching from one topic to another very quickly without providing enough detail, or contrarily, expanding on one topic and not letting the communication partners have a turn. Various language assessments and intervention strategies can be utilized to help children increase their knowledge of topic maintenance and taking appropriate conversational turns. This knowledge can help further their language learning and development of pragmatic skills!
Assessing Difficulty Maintaining Topics and Conversational Turns
Clinical Evaluation of Language Fundamentals (CELF) Preschool-3
This assessment can be used with children aged 3:0-6:11 and assesses areas of language deemed necessary for preschool children in order to meet the language demands of the classroom
The CELF Preschool-3 has a Pragmatics Profile & Pragmatic Activities Checklist which evaluates social aspects of communication which include topic maintenance and appropriate conversational turn taking
The Pragmatic Activities Checklist is supplementary, and used to observe functional communication skills during conversational interactions to identify both verbal and nonverbal behaviors that may adversely influence academic and social communication
The Pragmatics Profile subtest is used to identify verbal and nonverbal pragmatic skills that might influence social and academic communication in context
Strength: these subtests allow for the administrator to observe the child's pragmatic behaviors in a more naturalistic and observational way, rather than having the child answer questions from a stimulus book
Weakness: results can be somewhat subjective and may not capture the child as a whole, there isn't specific scoring for just difficulty with topic maintenance and appropriate conversational turn taking so the administrator has to use their best judgement when assessing these aspects
Preschool Language Scales 5th Edition (PLS-5)
The PLS-5 is a developmental language assessment that comprehensively covers pre-verbal skills, interaction-based skills, emerging language, and early literacy. This assessment can be used to assess children from birth to 7:11
This assessment covers a wide range of topics in both expressive language and auditory comprehension. In regards to topic maintenance and appropriate conversational turn taking, the PLS-5 assesses joint attention which is necessary for building language skills, using a variety of words and constructions for pragmatic functions, and answering questions logically
Strength: the administrator can assess the child's ability to maintain topics and appropriately take conversational turns through their response to the prompted questions and test stimuli. For example, if the administrator asks the child "What toy is round and bounces? You play catch with it", and they respond with a story about a bounce house and their friend's birthday party next week, the child is not truly maintaining the topic or answering the target question which is a pragmatic skill
Weakness: the assessment doesn't directly assess topic maintenance and appropriate conversational turn taking, the administrator will have to look for patterns in the child's responses throughout the evaluation
Sampling Utterances and Grammatical Analysis Revised (SUGAR)
SUGAR is a valid, evidenced-based language analysis method that collects 50-utterances from a child and analyzes components such as Mean Length of Utterance, Words/Sentence, and Total Number of Words. Norms begin at age 3:0. The administrator can also calculate type-token ratio which measures vocabulary variation. This could informally assess how many topics the child covers within the 50 utterances
Strength: the language sample can be obtained during play and may allow the administrator to gather observations about the child's ability to maintain topics and appropriately take conversational turns across 50-utterances. The administrator can listen to the recording for instances of the child not taking conversational turns or staying on topic
Weakness: this does not directly look at topic maintenance and appropriate conversational turn taking, but collecting the sample could provide you with information on the repetition of words they used and how long the child's utterances are about a certain topic
Language Intervention Approaches for Maintaining Topics and Conversational Turn Taking
Coaching the Caregiver - coaching caregivers allows for an SLP to educate caregivers, preschool teachers, and other communication partners techniques used in therapy to assist in facilitation of strategies used in therapy sessions. This could include:
Encouraging Productions - this intervention approach for children birth to five uses games, toys, and other stimuli to engage the child in turn taking with their vocalizations or utterances. This can vary based on age and the child's language abilities
Strengths:
Incorporates caregiver, siblings, and peers - involves the family, not just the SLP
Utilization of simple games, toys, and mirrors to to elicit productions - child friendly!
Infants productions are celebrated with touch, smile, and attention - positive reinforcement!
Weaknesses:
Consistent responses from caregivers is needed to reinforce productions. Therefore this intervention approach relies on caregiver or conversational partner frequency and commitment
Modeling Typical Patterns - modeling to elicit responses in children birth to five with language disorders guides and supports the child's future growth. The exposure to these patterns may begin to reflect in the child's life after continued practice
Strengths:
Model to elicit- turn-taking, and establishing joint attention
Allowing the child to choose the topic initially and modeling appropriate turn-taking and shifting the conversation as needed facilitates socially appropriate pragmatic skills
Weaknesses:
Modeling intervention is heavily dependent on the caregiver/clinician instruction and support. Therefore carryover/generalization can be difficult for client if they don't understand the difficulty/deficit
2. Script Training
Script training is a written and/or visual prompt that initiates or sustains interaction
Scripts are often used to help cultivate social interaction. In addition, it can also be used in a classroom setting to facilitate academic interactions and to promote academic engagement (Hart & Whalon, 2008)
These scripts can help children stay on topic and as they practice their script more, it may generalize into conversations with peers and other conversational partners
Strength:
Scripts are extremely helpful for direct instruction on topic maintenance and taking conversational turns. This technique can be very prescriptive and shows the child exactly when to take their turn in conversations and what appropriate responses could look like
Weakness:
Script training may be hard to generalize in children with language disabilities ages 0-5. This may be more appropriate for school aged children, though it is an evidence-based intervention approach
Activity Idea: Topic Maintenance Railroad Activity
Explain to the child that each of the train cars reflects what we say about a choice topic by pointing to the train in the illustration below. The train vehicle will go off the track if the conversation is off-topic. The goal is to keep the train on the track!
As the child becomes more familiar with the activity - you can try this out:
"There are six cars on our train, let's try to think of six things to say about our topic!" instead of giving them a script
Alternative, access, and or societally based approach for difficulty maintaining topics/conversational turns
Communication partners such as caregivers and preschool teachers could provide children with alternative, accessible approaches to make language more accessible for children who have difficulty maintaining topics and taking appropriate conversational turns. This could include allowing the child to expressive themselves verbally even if the difficulty maintaining the topic is a challenge. The caregiver or other communication partner could give verbal cues and model appropriate conversational turn-taking so the child can see what a pragmatically appropriate conversation entails. A societally based approach could include providing the child with a cue card with a visual, such as the topic maintenance railroad, that they could have access to in environments where they'll be having conversations with peers and various communication partners. Another approach is immersing these children in environments where they'll see typical patterns of topic maintenence and appropriate conversational turns. Increased exposure helps these skills develop!
References:
Hart, J. E., & Whalon, K. J. (2008). Promote academic engagement and communication of students with autism spectrum disorder in inclusive settings. Intervention in School and Clinic, 44(2), 116–120. https://doi.org/10.1177/1053451207310346
Pavelko, S.L. & Owens, R.E. (2019). Diagnostic accuracy of the SUGAR measures for identifying children with language impairment. Language, Speech, and Hearing Services in Schools, 50, 211-223.
Preschool Language Scales: Fifth Edition. PLS-5 Preschool Language Scales 5th Edition. (n.d.). https://www.pearsonassessments.com/store/usassessments/en/Store/Professional-Assessments/Speech-%26-Language/Preschool-Language-Scales-%7C-Fifth-Edition/p/100000233.html?tab=product-details
Quigley, J., Griffith, A. K., & Kates-McElrath, K. (2018). A Comparison of Modeling, Prompting, and a Multi-component Intervention for Teaching Play Skills to Children with Developmental Disabilities. Behavior analysis in practice, 11(4), 315–326. https://doi.org/10.1007/s40617-018-0225-0
https://www.pearsonassessments.com/store/usassessments/en/Store/Professional-Assessments/Developmental-Early-Childhood/Clinical-Evaluation-of-Language-Fundamentals-Preschool-3/p/100002031.html?tab=qinteractive