©Self & Apel, 2005
Wichita State University Evidence?Based Practice Reference Analysis Worksheet
Student’s Name: Natasha Cummings
NOTE: All sections must sections including comments must be completed.
Check one: ? Assessment article ? Intervention article

Iverson, J. M., ; Braddock, B. A. (2011). Gesture and motor skill in relation to language in children with language impairment. Journal Of Speech, Language, And Hearing Research: JSLHR, 54(1), 72–86. https://doi-org.subr.idm.oclc.org/10.1044/1092-4388(2010/08-0197)

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Purpose Statement: Examiners examined gesture and motor abilities in relation to language impairments (LI).

Level of Evidence: 4 -Case control study (see descriptors on page 3)
Number of Participants: Total # 27Total #/group 11 LI, 16 TD
Participant selection (age, gender, disorder?type, native language, etc.):The participants selected for the exwere 11 preschool-age children who ha been referred to regional speech clinics by parents or pediatrician because of concerns about language learning difficulties with no apparent cause (the LI group) and 16 children with typical language (the TD group). The eleven children of the (LI group) consisted (8 males, 3 females) mean age 3;11 ranging from 2;8-6;1. The sixteen children of the (TD group) consisted of (13 males, 3 females) mean age 3;9 ranging from 2;7-5;10.

Quality of participant description:
1 2 3 4 5
can’t replicate may be able to replicate replicable
lacks sign.info mostly complete info all info present

Comments: The children of each group were selected based on chronological age, and were comparable to the LI group. There were no parent concerns about language or cognitive development for any on the children in the TD group.

Evaluation Tools: 2 picture narrations, Battelle Developmental Screening Inventory, Child Development Inventory, PLS-VE ( Preschool Language Scale -Verbal Expression), PLS-AC ( Auditory and Comprehension), LBIQ ( Leiter Breif IQ Screen), BDSI-GM.

Quality of evaluation tools:
2 3 4 5
seems inappropriate appropriate appropriate
no rationale no rationale rationale for use

Comments: Rationale was present and group into 3 sections : Comprehension observation, Motor Skills, and Standardized language and cognitive measure. However, some of the assessment tools should be altered and used more directly instead of being screening tools alone.

Procedures: The children targeted starting with the LI group were screened over two visits, and where schedule no more than a week apart. They were screened in a naturalistic environment as well as as in a preschool. The communication portion was completed in the first visit and cognitive measure were administered during the second visit. The TD group were screened and completed both portions in one setting at their home. The motor skill observation lasted approximately 30 min, was administered upon completion of the communication observation. Fine and gross motor items from the BDSI were assessed while caregivers completed the fine and gross motor sections of the CDI. Gross motor items for the age range of the children in the present study assess general balance and coordination .Fine motor items such as eye–hand coordination were also taken into consideration. Scores were computed on the basis of the administration manual. The CDI is a parent report instrument consisting of yes/no questions about the developmental status of children in a variety of domains and can be used with children between the ages of 1 and 6 years.

Time Period: 2 weeks

Reliability/validity/control of bias:

2 3 4 5
no controls some control controls used
inadequate minimally adequate adequate

Comments: Procedures showed some control , and were able to be altered accordingly and measures proved to be reliable .

Outcome Measures/Dependent Variables:
Outcome measure included the TD group having all test administration done in one sitting and proved to use less gestures than children with LI , providing more oral communication.

Quality of Outcome Measures/DVs:
2 3 4 5
seems inappropriate appropriate appropriate
no rationale no rationale rationale for use

Comments: Researcher may consider administering the LBIQ and PLS-3 on both groups of children instead of solely administering these test to the LI group.

Significant findings/Strong effect sizes:
A series of tests revealed a single statistically significant difference: Children with average IQs produced a significantly greater number of verbal utterances per minute (U = 3, p = .042). There were no differences on any other measure of language or gesture. Relative to TD peers, children with LI used gestures at a higher rate and produced greater proportions of gesture-only communications, conventional gestures. However, they
poorly on measures of fine and gross motor abilities. Regression analyses indicated that within the LI but not the TD group, poorer expressive language was related to more frequent gesture production.

Means and standard deviations:
The  Mean intercoder agreement for language measures was .94 for identifying utterances (N = 544), .93 (N = 518) for number of different root words, .88 (N = 544) for classifying utterances as intelligible, and .88 (N = 230) for morpheme identification. For gesture measures, mean intercoder agreement was .92 (N = 228) for gesture occurrence, 93 (N = 212) for classifying gestures by type, and .86 (N = 107) for classifying the informational relationship between gesture and language.

Other findings: Eight of the 11 children with LI produced gesture at a rate above the median for the TD group , whereas only two children of the TD group gestured at a rate higher than the LI medians. Also, the sample size of these finding was relatively small compared to previous finding , but still was able to be replicated within similar standards or larger groups of children.

Interpretation of results:
1 2 3 4 5
interpretation some extension of data related
beyond data interpretation beyond data tied to past research

Comments: The interpretation of results was based on previous studies, and proved that children with LI will struggle with motor abilities and gesture take over a major role conveying information that may be difficult for the speaker to express in oral language. In comparison will other studies this design was able to be replicated on a smaller sample size.

Overall Comments:
Credibility of source:
2 3 4 5
source unknown trade journal or peer?reviewed
self?published/reported edited publication professional journal

Journal Of Speech, Language, And Hearing Research: JSLHR J Speech Lang Hear Res 2011 Feb; Vol. 54 (1), pp. 72-86. Date of Electronic Publication: 2010 Aug 18.

Feasibility of Use in a Clinical Setting:
2 3 4 5
unlikely possible, with some modifications highly likely

Comments: This study would seem unlikely to be conveniently done in a clinical setting. This study proved to be more effective having the targeted children in a more naturalistic setting for better results.

Ideas for future research:
Ideas for future research should include: a comparison group of targeted children that match the levels of expressive language in order to gather a better look at the differences described may be considered a function of language ability. Also motor measure were only used as screening tools , and in future research should include more assessment and analyses of the children’s motor abilities.

Levels of Evidence:
Level May use when:
1 Large randomized controlled trials Identified population matches client seen and clinical setting
2 Small randomized controlled trials; repeated randomized single?case designs Identified population matches clients seen and clinical setting;
Identified case matches client seen and clinical setting
3 Non?randomized study with control group(s); single?case design using alternating treatments or multiple baseline methods Identified population matches clients seen and clinical setting;
Identified case matches client seen and clinical setting
4 Case control study Identified case matches client seen and clinical setting
5 Data from basic research with theoretical implications for clinical services No evidence is available from aforementioned levels
6 Opinion of clinical expert No evidence is available from aforementioned levels