Monday, January 30, 2012

Is it worth trying? Evaluating a technique's potential effectiveness


I (Alaina) recently wrote about the Three-Period Lesson, which is a Montessori activity that may be a useful technique for the Speech & Language Pathologist, or other professional, to use to nurture the development of someone's vocabulary knowledge.

After reading about the three-period lesson, you might be asking yourself a few questions: How does the three-period lesson align with your current methods of meeting the goal of vocabulary development?  Is the three-period lesson likely to be more or less effective than your current methods? Could the three-period lesson be an effective therapy tool for any of the individuals with whom you work?

While learning about and thinking about the three-period lesson, I have been asking myself these same questions.  They are go-to questions for any potential therapy technique that I consider implementing.

But coming up with the answers to these questions takes some thinking.  SLPs are called upon to make evidence-based decisions, but there is rarely sure evidence for the effectiveness of any specific therapeutic technique.  So, I find it helpful to organize my thoughts by considering the characteristics of a technique.  There is often evidence for at least the theoretical efficacy1 of the characteristics that underlie different techniques.

Below I share an example of my thought process, when I am considering the characteristics of a technique to evaluate its potential effectiveness.  Please keep in mind that I'm not taking any position regarding whether or not the three-period lesson should be used.  Rather, I hope you find the questions below to be helpful as you make your own decision.  Therapeutic decision-making is a task best undertaken by someone who can integrate their knowledge with the learner's specific situation. 

Using characteristics of the Three-Period Lesson to evaluate its potential effectiveness:
 
I would characterize the three-period lesson as highly structured.  When do you find it more effective to present words in a highly structured format, such as by drilling flash cards or object words? In contrast, when do you find it more effective to present words in a loosely structured format, such as focusing on certain words in play or in conversation?  Related reading: Shriberg & Kwiatkowski (1982), and Cogher (1999).

In conjunction with its high structure, I would characterize the three-period lesson as adult directed. When do you find it more effective to present words in an adult-directed manner, such as by choosing the objects you want to teach and leading the child to listen to you, copy you, follow your directions, and answer your questions? In contrast, when do you find it more effective to present words in a child-directed manner, such as by watching the child and giving words for the objects/actions/concepts that the child chooses to engage with?  Related reading: Yoder, et al. (1993).

I would characterize the adult's directions in the three-period lesson as both instructive and evaluative. When do you find it more effective to present words in an instructive manner, such as by using the names of objects/actions/concepts? When do you find it more effective to present words in an evaluative manner, such as by giving a direction to "point to _____" or asking, "What is this?"  Related reading: Sohlberg, Ehlhardt, & Kennedy (2005).
 
The adult's choice about when to be instructive and when to be evaluative during the three-period lesson can be characterized as responsive to the child's current level of understanding. When do you find it more effective to present words responsively, such as by using the child's cues to inform your method or level of support? When do you find it more effective to present words in a predetermined way, such as by following a script or a standardized format?

Finally, I would characterize the Three-Period Lesson as linguistically consistentThe examples and explanations that I have seen use simple sentence frames such as "This is _____," and "Show me _____" to deliver each vocabulary word to the child. When do you find it more effective to present words in linguistically consistent sentences? When do you find it more effective to present words with linguistic variation, such as by using the new word in a variety of different sentence structures? Related reading: Onnis, et al. (2004).

Conclusion:

It's up to you! Does the three-period lesson sound potentially effective in any of your specific situations?

Footnote:
1. What is the difference between efficacy and effectiveness?  Efficacy is how well a treatment works under experimental controls and effectiveness is how well a treatment works under real world conditions.  A year ago Hannah and I spent a month using the technique of spaced retrieval to commit this to memory and it's stuck ever since :)