Supporting Reading or Ruining TV? Dr Carol Moxam, Dr Ghada Khattab and Laura Chambers

There is a growing interest in the potential benefit of using subtitles in children’s TV, and this has recently been championed by celebrities who have joined campaigns to call for subtitles to be turned on in children’s TV as standard (see, for example Before jumping on this bandwagon, it is worth considering whether this really is the way forward for struggling readers. 

Our Director of the Children’s Speech and Language clinic, Dr Carol Moxam, has on occasions suggested this as an additional support to complement reading done in the home with the child, but only with older children (aged 9 and over) who have a reading age of around 7. These children typically have some reading skills but are clearly behind with their reading in relation to the demands and expectations of the curriculum. Our director would not advise for subtitles to be used with younger children because, for them, it is more important to develop an interest and love of books. The focus should instead be on developing story comprehension before building sight word and decoding skills. For younger children (6-9years) with alphabetic knowledge and emerging decoding and sight word skills, there may well be a place to support building sight word vocabulary and reinforcing visual memory for common letter patterns and early high frequency words. However, regard needs to be given to factors such as the font size and the delivery speed of words on screen. In addition, consideration would need to be given to the child’s eye-tracking ability as well as their attention, listening comprehension, and verbal processing skills. These children’s cognitive processing skills will be taken up with listening and processing what is being said on screen, let alone adding processing load of decoding and sight word reading; this might potentially detract from and ruin the enjoyment of the TV experience. Use of subtitles assumes that the child has cracked the alphabetic code and can blend and synthesise letters in print for decoding. It also relies on the child having acquired a reasonable sight word vocabulary that they can access and retrieve at speed. Neither of these assumptions can be taken for granted with any young children, let alone struggling readers. One final thought that comes to mind is that, for the struggling reader, TV is likely one area where they can escape the pressures and demands of reading and homework, and instead relax. Subtitles on kid’s TV may well spoil one key downtime option the struggling reader has and can enjoy.  While it is not hard to find research under controlled experimental conditions which may show significant improvement in decoding skills following the use of subtitles, it is important to consider which age group this is feasible for and to solicit the children’s view on this and represent their voices before applying subtitles wholesale for supporting reading and potentially ruining TV.  

Introducing: the Child Language Research Group

Here at Newcastle University, members of the Speech and Language Sciences department hold a monthly Child Language Research Group meeting. We are a group of academic lecturers and researchers, clinical research staff, postgraduate students, and speech and language therapists from around the North East.  Our individual research areas converge around child language development, and as a group we include speech & language therapists, psychologists, teachers, economists, phoneticians and linguists. Our aim is to support and encourage one another as researchers and clinicians, so as to advance our research and clinical work in this socially critical field. Our research areas include (but are not limited to!) … 

  • Understanding typical speech and language development  
  • Impact of speech and language development on wellbeing and achievement.  
  • Assessment, intervention and service delivery for developmental speech and language disorders  
  • Multi-lingual language development (typical and atypical), assessment, and intervention 
  • Public health approaches to child language development 

Our meetings include presentations of work being carried out by group members, discussions of current topics in the field of language development and intervention, and discussions around research issues and processes. There is always time for questions and the sharing of both new ideas and sweet treats! (Though in our recent online meetings we suffice to gaze at one another’s home décor in lieu of cakes and chocolate). 

Each meeting is an enjoyable, encouraging, and often fascinating hour or two, and it provides in a variety of ways for our different members. In the spirit of research, we conducted an informal survey, asking our members for their input on what the CLRG means to them. Three key themes arose… 

Gaining Knowledge 

Perhaps the most fundamental part of the CLRG, and the most cited positive aspect by our members is finding out about other research happening in the department. It’s “an ongoing education” for all members, and as one respondent highlighted, it allows us to “learn from one another to enrich our research”. Bringing questions and topics for discussion to the group is an integral aspect of our meetings. One member commented, “I … find the CLRG a really useful place to discuss topics and bring questions – everyone has different knowledge and skills that can be pooled together to generate new ideas or answer a question.”  

Acquiring Skills 

The CLRG is an informal space for presentations of work “at different levels of ‘finished’”. Feedback from the group has helped many members in enhancing the content of their work, written or oral, and their presentation skills more broadly. Lots of postgraduate students, in particular, highlighted this as a key aspect, for example:  

“[the CLRG] has allowed me to develop skills like providing useful feedback and asking effective questions.” 

Developing Connections 

Our postgraduate students and research staff say that attending the CLRG helps to create and sustain social and professional relationships. This is especially true for newcomers to the group:  

“Attending the CLRG was a great introduction to the department and allowed me to meet a range of people.” 

For postgraduate students, the CLRG also helps to bridge the gap between being an undergraduate and taking ownership of their research as a postgraduate. One member said the CLRG helps them to “…[feel] less of a student and more a colleague.”  

Finally, several members commented on the importance of the relationships they had developed in relation to their own research practice: 

“Learning what areas of [the department] each person came from, and then know[ing] who to go to with small questions that would have taken a much longer time to answer alone. 

For attendees, it’s as simple as turning up on the appointed day and time each month (or a simple click of the ‘join’ button in online times!). For organisers, an email list, a Teams group (or similar) and a regular monthly meeting are the small price to pay in return for a huge range of benefits. We love our group and, we’d love to know what you think. Do you have a similar research group at your institution? If not, why not start one? 

Multidisciplinary work is important, but we should be paying more attention to our differences than our similarities. By Josie Tulip (ESRC funded PhD Candidate in SLS)

With thanks to one of my supervisors, I was given the opportunity to attend a meeting hosted by the Westminster Education Forum (WEF). WEFs are meetings in London which are attended and presented by a variety of practitioners, researchers, educators, policy makers, politicians and other professions concerning a particular topic. The discussion this time focused on the next steps for support, policy and practice in England for early years. Examples of talks included committee enquiry outcomes, suggestions for improving multi-agency working despite funding cuts, working with traveller/ gypsy families and those adverse childhood experiences, early language and literacy support priorities, and the impact of changes to the Early Years Foundation Stage profile. Although there was a lot to learn from the content of the talks (that will have to be another blog), I also learned a couple of lessons about the differences we all have when working in an interdisciplinary manner, and what we should be doing about it.

My first lesson was just how much WEF differed to the usual academic conferences I have been to, and what this meant. Specifically, forums like this WEF contained a larger pool of individual professions and perspectives. A variety of methods and procedures are also used for similar goals. An example of this was an MP aiming to improving adverse childhood experiences from a medical perspective and via committee enquiries; whilst a health visitor utilised a more ethnographic approach and worked more informally and directly with families. Including such a variety of perspectives about the same topic felt very enriching and holistic, helping consider more ways to create successful outcomes.

In contrast, the average research conference has a very specific idea about what type of information should be presented, and so is only appealing to very limited professions. For example, speech and language conferences are usually made up of researchers, students and expert occupational therapists, speech and language therapists and teachers; with information shared typically being research. For a number of professionals, sitting in methodologically-heavy presentations or approaching posters with complex graphs may not be appealing or feel applicable to them. If we want to further enrich the work we are doing, one suggestion is that we need to think about how to disseminate our work differently be more inclusive and appealing to these other professionals.

However, the individual attributes of more specialised meetings like academic conferences are also beneficial because of their unique ability to draw together so much empirically-based and robust knowledge about a specific topic important to policy and practice. This may not be possible if a conference had to adopt multiple other information types and disciplines as well. The question then is how can we have the best of what differences exist by working together without the benefits of different parties becoming less salient. Therefore, it should be recognised that still having more singularly-focused work is important (i.e. academic conferences), but creating and building on frameworks like WEF to larger and more expansive modes of dissemination is needed. This could include creating more large-scale interdisciplinary conferences, journals and practitioner and public engagement meetings. It is clear more work needs to be done to consider these options.

The second lesson relates to my first, but is more cautious about the contribution of multiple professionals. When hearing numerous professionals talking about the same issue and stating what appeared to be very similar goals, it struck me how very subtly, but very importantly they differed. In this meeting, the general consensus was that obviously, everyone wanted to improve the developmental trajectory of children in need. Previously, and within this meeting, I was repeatedly told that professionals need to find the similarities they have to be able to work well together. I find this rather contentious because it seems that “working together well” is framed primarily by the goal rather than the individuals and their motivations.

One example was a dispute between various different professionals about what factors affecting early years children should have been examined, as well as what recommendations should have been derived from a cross-party committee. It was clear from people’s comments and questions they all had different ideas on this, despite all agreeing there should be universal recommendations for early-years intervention. Another example is how a civil servant and a communication charity chief executive had different ‘spins’ on the same statistic of the same outcome. The civil servant stated evidence that more children are demonstrating good development in language, while the charity chief executive argued other factors in this outcome hadn’t been considered (e.g. more girls than boys were achieving good development in language). This evidently shows very different motivations and ideas of success despite looking at the exact same issue. Such important issues then become semantic debates, rather than a movement towards something mutually tangible and universally beneficial.

When taking both of these examples together, smoothing over differences via goals or just presenting information to different professionals will not create useful multidisciplinary working. Rather, it only demonstrates fragmented perspectives being demonstrated in the same room at the same time. We need to explicitly consider and discuss at the beginning of any work or any joint goal what the stakes, priorities and motivations are for each person involved, and attempt to have as many perspectives (especially if we disagree with them) included. However, it is also important to see what can be compromised, how goals will be defined and measured, and truthfully consider whether individuals in a group can successfully work together at all. Just putting professionals together to tick boxes for work and dissemination will be far less beneficial than having realistic partnerships and networks. Instead, these mixed messages and post-hoc disagreements will only confuse practitioners and policy makers, stopping useful progress.

From gaining these perspectives about some of the benefits and pitfalls of interdisciplinary working, I can see this issue is clearly complicated. This was perhaps my first real consideration of this subject, but I hope that the discussion here will give thought to this area for others. For anyone at the start of their career like me (or perhaps not), we need to actively consider what interdisciplinary work means, and what this relationship should look like. For me (right now), it’s okay to be different.

The Westminster Education forum website:



Factors Influencing The Functional Communication Skills of Pre-School Children with Language Difficulties: How Does Socio-Emotional-Behavioural and Language Profiles Interact With Functional Communication?

Here is the abstract from Louise Bulman’s final year research project, supervised by Dr Cristina McKean and Ana Trebacz (Post Graduate Research student)

Factors Influencing The Functional Communication Skills of Pre-School Children with Language Difficulties: How Does Socio-Emotional-Behavioural and Language Profiles Interact With Functional Communication?

Background: Functional communication is now a vital part of diagnosing developmental language delay (DLD). Currently there is a lack of research into the factors that may impact functional communication, which leaves professionals unable to identify children that may be at risk of experiencing functional communication difficulties, which could lead to a diagnosis of DLD.

Aims: The aim of the current study is to identify how socio-emotional-behavioural (SEB) difficulties impact on functional communication in pre-school age children, and if there are differences in functional communication between children with differing language profiles (expressive, receptive or mixed).

Methods & Procedures: The current cross-sectional observation study is nested within a larger therapy efficacy study, where 27 participants were recruited from schools (matched based on socio-economic-status), with expressive, receptive or mixed language difficulty profiles. Functional communication and SEB difficulties were measured, and analysed using correlations and statistical analysis.

Outcomes & Results: Significant correlations were found between (teacher reported) SEB difficulties and (teacher and parent reported) internalising difficulties with functional communication. Indicating that higher overall SEB difficulties and internalising difficulties are associated with poorer functional communication. No significant difference was found between children with differing language profiles on functional communication.

Conclusions & Implications: The findings give preliminary evidence to suggest that SEB, with particular strength to internalising difficulties are associated with poorer functional communication outcomes. Additionally, no evidence was found to suggest that functional communication is impacted by an expressive, receptive or mixed language difficulty profile.

Keywords: Functional Communication, Developmental Language Disorder, Socio-emotional-behavioural difficulties, expressive-receptive language

Exploring the Relationships Between Underpinning Theory and Intervention Choice for Children with Developmental Language Disorders:  Interpreting Data from a Practitioner Questionnaire Carried Out in 39 Countries

Here is the abstract from Rachel Forsythe’s final year research project, supervised by Professor James Law and Dr Carolyn Letts.

Exploring the Relationships Between Underpinning Theory and Intervention Choice for Children with Developmental Language Disorders:  Interpreting Data from a Practitioner Questionnaire Carried Out in 39 Countries

Children with Developmental Language Disorder (DLD) have impairments in their understanding and use of language. Speech and Language Therapy interventions can be effective for DLD but there is limited research into practitioner-reported interventions, especially across countries. Therefore, it is important to investigate the current use of intervention approaches alongside rationales and scientific evidence across a diverse range of countries.

Practitioner-reported questionnaires were distributed online in 39 COST Action countries. The participants were 2408 practitioners. Analysis included thematic analysis, coding qualitative data and statistical exploration.

A wide range of intervention approaches and rationales were reported. Most responses included a client-centred factor. Participants were more likely to use the client’s level of functioning as a rationale if they reported a severe impairment. Participants with University level education were less likely to report basing intervention on client-centred factors. Overall there was limited use of scientific evidence. Specific interventions were used across countries. The key themes of intervention had varying levels of scientific evidence.

Certain client and practitioner characteristics could have an impact on the intervention approaches and rationales used across countries. Limited numbers of practitioners reporting use of scientific evidence suggest that there should be more initiatives to encourage scientific evidence-based practice.

Key words: Developmental Language Disorders, Language Intervention for Children, Qualitative Data analysis, Quantitative Data analysis

Enablers and barriers to the use of high-tech AAC in the specialist classroom

Here is the abstract from Catherine Morrison’s final year research project, supervised by Dr Carolyn Letts and Kate Laws.

Enablers and barriers to the use of high-tech AAC in the specialist classroom

Numerous factors interact with alternative and augmentative communication (AAC) use in the specialist classroom. Despite this, there are no studies known to the researcher in the UK which consider the enablers and barriers to high-tech AAC in this setting. This project specifically aims to discover the enablers and barriers to communication via high-tech AAC in the specialist classroom. Qualitative methods of five classroom observations and thirteen interviews with speech and language therapists, teachers and learning support assistants were used to gather data. Thematic analysis was conducted to reveal key enablers and barriers to high-tech AAC use. A wide range of factors were identified under the themes of those relating high-tech AAC use and the student’s capabilities, external factors and the attitudes of staff/students. Factors, including communication partner behaviour, vocabulary on the device and perception of purpose of the device, were perceived as enablers and barriers, varying between classroom situations. Implications include that considering the potential enablers and barriers to use should be part of the assessment process during high-tech AAC provision. Once barriers are identified strategies to minimise the impact of these if possible, should be incorporated into interventions used so students are encouraged to reach their communicative potential.

Key words: Qualitative Data analysis, Alternative and augmentative communication


Comparing Interactions of Children with Autism with their Parents and Learning Support Assistants

Here is the abstract from Lucy Dempster’s final year research project, supervised by Dr Faye Smith and Professor Helen McConachie.

Comparing Interactions of Children with Autism with their Parents and Learning Support Assistants

Children with autism have difficulties initiating interactions and generalising skills across contexts.  Therefore, providing intervention in both home and school contexts may be beneficial.  The aim of this study was to compare the baseline level of adult synchrony and child initiations to see if there were any differences between parents and LSAs.  Participants were 77 children with autism with a parent and LSA from the PACT-G trial who were filmed interacting separately with each adult. Adult communication acts were coded according to synchrony and child communication acts were coded as initiations or responses.  A synchronous communication act follows the child’s attention, and a child initiation starts an interaction.  No significant differences were found between the proportion of parents’ and LSAs’ synchronous responses or between the proportion of child initiations with parents and LSAs.  There was no correlation at baseline between adult synchrony and child initiations.  The results of this study indicate that when interacting with a child with autism, parents and LSAs have very similar interaction styles and the children interacted similarly with both adults.  This indicates that both adults could benefit from intervention to increase synchrony as this has been associated with increased child initiations.

Key words: Language Intervention for Children, autism

Listen, we have something to say: Developing methods for eliciting, analysing and understanding children’s stories about themselves

Here is the abstract from Emma Higgins’ final year research project, supervised by Dr Cristina McKean and Dr Carolyn Letts.

Listen, we have something to say: Developing methods for eliciting, analysing and understanding children’s stories about themselves

This study aimed to evaluate methods of eliciting and analysing typically developing children’s personal narratives to inform the development of a method for assessing the personal narratives of children with developmental language disorder (DLD).  To do this, it evaluated, using ten-year-old children, the elicitation method for children’s personal narratives designed by the IALP Child Language Committee.  It also evaluated two methods for analysing children’s personal narratives, a structural focused analysis method and a coherence focused analysis method, in relation to children with DLD.  It found the elicitation method enabled children of a range of abilities to tell a range of personal narratives.  It also found, with development of both approaches, a combination of the two analysis methods has potential to provide a reliable and sensitive analysis method providing useful information for the diagnosis of and intervention planning in DLD.

Key words: Developmental Language Disorders, Qualitative Data analysis, Quantitative Data analysis


Long-term Functional Outcomes Following Transoral Robotic Surgery for Patients with Hypopharyngeal Cancer

Here is the abstract from Holly Bocock’s final year research project, supervised by Dr Nicole Lallini and Diane Goff (Newcastle upon Tyne Hospitals NHS Foundation Trust).

Long-term Functional Outcomes Following Transoral Robotic Surgery for Patients with Hypopharyngeal Cancer

This study aimed to evaluate the long-term functional swallow outcomes following transoral robotic surgery (TORS) for patients with hypopharyngeal cancer.

Outcome measures of physical swallow function, diet modifications and dysphagia-related quality of life were gathered by retrospectively analysing scores on the Water Swallow Test (WST), Performance Status Scale (PSS) for normalcy of diet and M.D. Anderson Dysphagia Inventory (MDADI) obtained prior to TORS, at three-months post-surgery and after a year.

Twelve patients (10 male), mean age 64.9years, were included. Participants most commonly had T2 staging (58.3%) with no nodal involvement (N0=50%). Survival to the time of study was 50%. WST revealed reduced swallow capacity and speed one-year post-TORS, but no statistically significant change. Four of six patients were able to eat a normal diet after one year, no statistical difference in PSS scores was found over time. Comparative analysis was not possible for MDADI scores due to limited data, however 50% fell within the ‘optimal’ category (>80 points), and 50% within the ‘adequate’ category (76-79).

For patients with hypopharyngeal cancer, TORS was shown to provide encouraging long-term functional outcomes, with no significant difference in physical swallow ability, adaptations to diet or self-perceived swallow function found from pre-TORS to one-year post-TORS.

Key Words: Quantitative Data analysis, Dysphagia, Head and neck cancer

Exploring Prosody in Depressive Speech and The Relationship Between Therapist and Patient Prosodic Features in the Therapeutic Setting

Here is the abstract from Hannah Grime’s  final year research project, supervised by Dr Laurence White.

Exploring Prosody in Depressive Speech and The Relationship Between Therapist and Patient Prosodic Features in the Therapeutic Setting

To investigate the relationship between prosody and depression severity and compare patient and therapist prosodic variables, the speech of 32 people with depression and eight therapists was analysed. Articulation rate, F0 range, and median F0 were measured within (early/late) and across (first/last) sessions. Quantitative speech analysis, answered three research questions: 1. What is the relationship between severity of depression and prosodic variables, articulation rate, F0 range, and median pitch? 2. Do patient’s prosodic features change within sessions and over the course of therapy? 3. Does the relationship between patient and therapist prosodic features change within sessions and over the course of therapy? There was no relationship between prosodic features and depression severity. There was an interaction effect of chunk and session on patient articulation rate. Comparing patient and therapist prosodic features showed no differences within or between sessions. In female-female pairs, therapists had higher articulation rate and median F0, female-female pairs showed signs of converging articulation rate.
Many findings in the current study differ from previous findings, possible reasons for differences are discussed. These findings suggest that accounting for gender and gender pairings is important when investigating depression speech and the relationship between prosody in depressed and non-depressed speakers.

Keywords: depressive speech, vocal prosody, convergence, articulation rate, F0 range