• Potential treatment option for increasing the use of syntactically complex sentences in written work and/or sentence length: sentence combining
  • What does this look like?: Students combine two or more simple sentences into a single complex sentence. Can target the use of specific conjunctions (e.g., before, while, until, if, unless).
  • Does research support this approach?: Yes, to an extent. E.g., Half of the students in the Domsch, Rodriguez, Titzman, & Kester (2018) study made minor improvements on the sentence combining subtest of the TOWL-4 after 5 weeks of treatment using sentence combining, and 5 of 6 students improved on a nonstandardized measure of sentence complexity (but most of these improvements were also minor).
  • In my clinical practice: Might be a worthwhile approach for some students. But should also ensure a student would not be better served by targeting another syntactical structure in place of conjunctions (e.g., including parenthetical information, or comma usage). Could combine this intervention with others (e.g. the use of color coded graphic organizers) to address narrative deficits, etc.

Additional Consideration: "Complex talk reflects complex thought."

Per Nippold, Paul, and Hoffman (2014), typically developing and language impaired middle school-age students are more likely to utilize complex syntax when expressing complex ideas. The authors' sample procedure for comprehending, relating, discussing, and re-enacting an assignment involving a complex story with language-impaired students is as follows:

• 1) Dividing the assignment into smaller sections.
• 2) Teaching and practicing strategies for figuring out the definitions of unfamiliar vocabulary words and difficult syntactic structures.
• 3) Sentence combining (see above)!: Addressing how to build complex sentences from students' simple sentences pertaining to the assignment.
• 4) Discussing, retelling, and enacting the complex story in students' own words.

Additional Consideration: What type of feedback is best?

In a study by Smith-Lock, Leitão, Prior, & Nickels (2015), school-age children with specific language impairment (SLI) whose mistakes when attempting target morphological forms were corrected with additional attempts at targets elicited according to a cueing hierarchy improved more overall than did students whose errors were recast.

References

Domsch, C., Rodrigues, L.R., Titzman, L.E., & Kester, E. (2018). Increasing complex syntax use in

written language in school-age students: A multiple-baseline study of sentence combining.

Perspectives of the ASHA Special Interest Groups, 3(16), 4-19.

Nippold, M.A., Paul, R., & Hoffman, L. (2014). Language intervention at the middle school:

Complex talk reflects complex thought. Language, Speech & Hearing Services in Schools, 45(2),

153-156. doi:10.1044/2014_LSHSS-14-0027

Smith-Lock, K.M., Leitão, S., Prior, P., & Nickels, L. (2015). The effectiveness of two grammar

treatment procedures for children with SLI: A randomized clinical trial. Language, Speech &

Hearing Services in Schools, 46(4), 312-324. doi:10.1044/2015_LSHSS-14-0041

Zipoli Jr, R.P. (2017). Unraveling difficult sentences: Strategies to support reading

comprehension. Intervention in School and Clinic, 52(4), 218-227.