Evidence-Based Guide for Grammar Goals & Intervention in Speech Language Therapy

Are you a speech-language pathologist wondering how to effectively and efficiently implement grammar intervention in your therapy sessions with preschool and school-aged children?

Good news, you’ve come to the right place!

This is an SLP’s complete guide to:

🌟 Why you should target grammar

🌟 How to write grammar goals

🌟 What the research on grammar intervention tells us

🌟 How to structure therapy sessions

Why to Target Grammar in Speech Language Therapy

An estimated 7% of the world's children are affected by developmental language disorder (DLD), placing them at considerable risk for learning difficulties in academic language environments (Balthazar & Scott, 2024; Balthazar, Ebbels, & Zwitserlood, 2020).

Moreover, "DLD is persistent and there can be lifelong repercussions in education, employment, social relationships, and independent living" (Balthazar & Scott, 2024).

Compared to typically developing peers, children with DLD present with particular difficulties in morphosyntactic skills (Calder et al., 2020).

These skills are essential for forming and conveying coherent thoughts, allowing us to communicate effectively and engage meaningfully in conversations (Paul & Norbury, 2012). Morphosyntactic skills are also fundamental to literacy, comprehension, and overall academic success.

For instance, strong grammar skills enable children to understand complex instructions and explanations in the classroom (Ebbels, 2014).

And check out this quote from Balthazar & Scott (2024), "The inability to comprehend key sentences in a text will undermine finding the main idea, drawing conclusions, making inferences, or answering many comprehension questions."

Okay so I think we get the picture...grammar intervention plays in important role in language therapy!

But how do we effectively target grammar in therapy? Let’s back up just a bit and start by exploring strategies for writing meaningful grammar goals.

How to Write Grammar Goals

Researchers have identified syntax difficulties as a core feature of DLD with an emphasis on morphosyntactic systems that include pronouns (e.g. subjective, objective), articles (e.g. the, a, an), verb tense (e.g. past tense –ed, third-person singular –s, present progressive –ing,), and verb tense agreement (Balthazar & Scott, 2024).

Identifying Grammatical Skills to Target

How do we identify which morphosyntactic structures a child needs support with?

Here are some strategies to guide this process:

💡 Gather and analyze a language sample

💡 Complete an informal narrative assessment using SLAM cards or a wordless picture book

💡 Informal elicitation task using probes (e.g. pictures, books, play)

💡 Gather classroom writing samples

💡 Interview classroom teacher & caregiver(s)

💡 Use a standardized assessment

💡 Dynamic assessment

Once we identify skills that require support, it’s time to select which ones we want to write goals for.

Selecting Grammatical Skills to Target

For preschool aged children, we can utilize developmental norms like Brown's Stages of Syntactic and Morphological Development to support us with selecting grammar skills to target.

However, for school-aged children, selecting target skills becomes more complex, as we don't have a straightforward developmental progression of skills to guide us.

As Ukrainetz (2006) and Balthazar & Scott (2024) note, morphosyntactic skills vary for each individual based on modality (listening, speaking, reading, writing), language levels (word, sentence, text), and even genres (conversational, narrative, expository)!

So how do we select goals for school-aged children?

To guide us with the selection of intervention procedures and activities, we can refer to Fey et al.'s (2003) 10 evidence-based principles.

The first four principles are aimed at guiding the selection of intervention goals:

1️⃣ The basic goal of all grammatical interventions should be to help the child achieve greater facility in the comprehension and use of syntax and morphology in the service of conversation, narration, exposition, and other textual genres in both written and oral modalities.

2️⃣ Grammatical form should rarely, if ever, be the only aspect of language and communication that is targeted in a language intervention program.

3️⃣ Select intermediate goals in an effort to stimulate the child's language acquisition processes rather than to teach specific language forms.

4️⃣ The specific goals of grammatical intervention must be based on the child's “functional readiness” and need for the targeted forms.

With these guiding principles in mind, here are five practical ways to select meaningful targets for school-aged children:

✔️ Review Common Core standards or other relevant standards (e.g. national, state, district) to understand grade-level expectations

✔️ Consult the classroom teacher on skills the student is expected to demonstrate and use in the classroom

✔️ Refer to the Target Identification Spreadsheet (Ebbels & Nicoll, 2023)

✔️ Choose "umbrella" skills that relate to grammatical categories, principles, and operations to build a broader skillset (e.g. a goal for subject pronouns where you will target he, she, they, we, it rather than a specific goal for use of she pronoun)

✔️ Target a skill that is emerging, or that the student has cognitive/linguistic readiness to learn and a functional need

Writing Goals

After identifying the skills you want to target, you can choose to write goals from either a comprehension (receptive) or production (expressive) perspective.

Here are a couple of examples:

Comprehension:

After listening to a paragraph containing sentences with subject-verb agreement in the third-person singular -s, Student will demonstrate comprehension by accurately responding to 4/5 questions or prompts about the character's actions across three consecutive stories.

SLP reads paragraph: Sneezy orders 10 scoops of ice cream. He picks a variety of flavors. Sneezy licks each scoop one by one until the was down to the cone. He eats his cone with a crunch, crunch, crunch.

SLP questions or prompts: What does Sneezy order? Show me what Sneezy eats. Sneezy picks...

Production:

Given a list of third-person singular -s verbs from the story, Student will retell story events by producing 5 sentences that demonstrate correct subject-verb agreement using third-person singular -s across 4 out of 5 consecutive stories.

Okay, so now that we know how to select and write amazing goals, let’s explore research-backed strategies for effectively targeting these skills in therapy.

What the Research on Grammar Intervention Tells Us

When planning grammar interventions, we can consider the what and the how - what do we do and how do we do it?

Let's tackle the first part: what evidence-based practices can we use to inform our intervention?

Remember, Fey et al.'s (2003) 10 evidence-based principles? We already talked about the first four principles, which guide the selection of intervention goals.

Now, let's take a look at Principles 5-10, which guide the selection of intervention procedures and activities:

5️⃣ Manipulate the social, physical, and linguistic context to create more frequent opportunities for grammatical targets.

6️⃣ Exploit different textual genres and the written modality to develop appropriate contexts for specific intervention targets.

7️⃣ Manipulate the discourse so that targeted features are rendered more salient in pragmatically felicitous contexts.

8️⃣ Systematically contrast forms used by the child with more mature forms from the adult grammar, using sentence recasts.

9️⃣ Avoid telegraphic speech, always presenting grammatical models in well-formed phrases and sentences.

🔟 Use elicited imitation to make target forms more salient and to give the child practice with phonological patterns that are difficult to access or produce.

Building on this, Finestack et al. (2024) have identified five additional evidence-based strategies to support children's acquisition and use of grammatical forms:

1️⃣1️⃣ Present target forms using a large number of unique verbs.

1️⃣2️⃣ Present target forms using verbs that vary in difficulty.

1️⃣3️⃣ Present target forms in sentences that vary in syntactic structure.

1️⃣4️⃣ Incorporate the use auditory bombardment to teach target forms.

1️⃣5️⃣ Incorporate the use of explicit instruction to teach target forms.

Now, how do we utilize these evidence-based guiding principles?

There are two general approaches you can use to put these evidence-based principles into practice:

Discrete Skill Approach

This approach focuses on teaching grammatical forms directly and separate from meaningful activities. This might include grammar analysis, modeling, imitation drills, error detection, and sentence combining with randomly selected and/or contrived sentences.

Contextualized Approach

This approach integrates target grammatical forms into meaningful contexts like storytelling, writing tasks, or play, allowing children to practice within naturalistic contexts. Contextualized activities create natural opportunities to apply grammar rules, and supports carryover of skills (Ukrainetz, 2006).

When using discrete skill instruction, it is best used in short, focused sessions and should be used in conjunction with meaningful, contextualized activities (Eisenberg, 2006).

In addition to general approaches, you may want to consider specific, research-based intervention tools/approches such as:

• SHAPE CODING™

• MetaTaal

• Complex Sentence Intervention

You can read more about each of these three approaches and how to implement them in this article.

How to Structure Therapy Sessions

Now that we understand the “what” and “how” of effective grammar intervention, let’s look at some practical ways to apply these strategies in therapy sessions.

Here are three examples of how you could structure your therapy sessions:

🌟 Discrete + Contextualized Instruction

🌟 Contextualized Mini-Lesson

🌟 Literacy-Based Therapy framework

Discrete + Contextualized Instruction

This lesson plan, as described by Finestack et al. (2024), combines direct (discrete) instruction with meaningful, contextualized practice.

This lesson plan can be used with one-on-one or small group sessions dedicated to grammar intervention.

Each 20 to 30 minute session includes four targeted activities: sentence imitation, story retell, structured play, and auditory bombardment.

1️⃣ Sentence Imitation

Present a sentence with the target or the contrastive form for the child to repeat. Aim for 10-20 sentences.

Example targeting present progressive is/are verb+ing:

1. The tree is changing colors.

2. The trees are changing colors.

2️⃣ Story Retell

Read a short story with corresponding pictures to model the targeted grammatical form. Then prompt the child to retell the story and use question prompts to elicit productions of the targeted form.

Child: Tuyet want turkey.

SLP: Yes, Tuyet WANTS turkey. Now you tell me. Tuyet...

Child: Tuyet wants turkey.

SLP: Yes! What happens next? Tuyet TALKS...

Child: Tuyet talks to her mom.

3️⃣ Structured Play

Use modeling and question prompts to elicit productions of the target form while playing with a variety of toys and manipulatives. Example materials include toy cars, animals, small figurines, play dough, and kinetic sand.

Example targeting third-person singular –s while playing with cars:

SLP: Look at these cars. Amir drives a bus. What does your person drive?

Child: He drives a X.

SLP: Amir beats Lance in the race. Who does Amir beat in the race?

Child: Lance.

SLP: Yes, Amir BEATS Lance. Now you tell me. Amir...

4️⃣ Auditory Bombardment

Read a sentence with the target or the contrastive form while the child listens and looks at corresponding pairs of pictures.

You can implement this type of session structure with your own materials, or download free materials for regular past tense -ed, present tense third person -s, is/are + present progressive -ing, and do/does questions here by clicking on "Intervention Session Materials."

Contextualized Mini-Lesson

In a contextualized mini-lesson, grammar instruction is embedded within meaningful activities, like storytelling or themed activities (Eisenberg, 2006).

Mini-lessons work great for one-on-one sessions, as well as small group sessions focused solely on grammar intervention.

Each 20 to 30 minute intervention session includes four activities: observational modeling (auditory bombardment), explicit teaching, contrastive modeling, and practice activities.

The grammatical forms/words chosen can relate to a theme or come from a story you've read.

1️⃣ Observational Modeling (Auditory Bombardment)

Model 10-20 sentences using the target grammatical form to describe a picture. You can use pictures in a children's book or thematically related ones (e.g. season, holiday).

Examples using past tense -ed:

[book] Sneezy melted. Sneezy wrapped a scarf around his neck. Sneezy ordered 10 scoops of ice cream.

[winter] She skiied down the hill. He snowboarded down the mountain. My mom shoveled snow.

From here, you can move on to explicit teaching, or prompt the child to produce the same/similar sentences to describe the picture(s). Provide scaffolding support as needed (e.g. ask furthering questions, recast).

Example using irregular past tense:

SLP: Let's see what everyone did on the beach this summer. Tiger sat in a chair. Alligator drank lemonade. Cat built a sandcastle. Koala read a book. Rabbit laid on a towel. Turtle swam in the ocean. They stood on their surfboards. He took a picture. They hit the volleyball. He ate watermelon. Now you tell me what they did in the picture.

Child: He eated watermelon.

SLP: He ATE watermelon.

Child: He ate watermelon. Koala read a book. Alligator has lemonade.

SLP: What did Alligator do with the lemonade? Alligator...

Child: drank lemonade

SLP: Yes, Alligator DRANK lemonade. Tell me what they did.

2️⃣ Explicit Teaching

Teach/review the grammatical form, how it is used, and when it is used. Provide visuals and anchor charts as needed. Use examples from a children's book or related to a target theme (e.g. fall themed regular past tense -ed verbs: raked, picked, carved).

3️⃣ Contrastive Modeling

Model 10-20 sentences using the target grammatical form and another form that is semantically and/or grammatically related.

SLP: I'm going to say some sentences about these winter pictures. These sentences are about what is happening right now and the other sentences are about what already happened.

• Susie is rolling a ball.

• Sebastian is constructing a snowman.

• Xochi is creating a fort.

Now listen to these sentences. These sentences are about what already happened.

• Susie rolled the ball.

• Sebastian constructed a snowman.

• Xochi created a fort.

Do you hear the past tense -ed sound?

4️⃣ Practice Activities

There are a variety of activities you can use to provide the child with multiple opportunities to practice using the target grammatical form.

Here are some ideas:

• Listen to a story and identify examples of the target grammatical form

• Story retell or summarizing task (oral or written)

• Sorting contrastive forms (e.g. future vs past tense, singular vs plural noun)

• Writing sentences given target words

• Matching game & formulating sentences once you've made a match

• Orally describing or writing sentences to tell how to do something (e.g. how to make cookies, how to play hide and seek)

• Model and target the form during play, cooking, a science experiment that relates to the theme

Literacy-Based Therapy Framework

If you're a busy school-based SLP working with mixed groups, I'd highly recommend targeting grammar skills through the literacy-based therapy framework.

In a nutshell, literacy-based therapy is a contextualized language approach with a 5-step framework. Because it can be used to target practically any goal, it is ideal for targeting grammar skills in mixed therapy groups.

The five steps are:

1. Pre-story knowledge activation

2. Shared storybook reading

3. Post-story comprehension check

4. Targeted activities

5. Parallel story creation

Here are some ideas for working on grammar skills during each step in the framework:

👉🏽 Pre-story Knowledge Activation:

During this step, you engage children in a discussion about topics/themes related to the story, ofte using visual stimuli (e.g. book cover, pictures in the book, video on YouTube, pictures in related articles or text online, story props).

As you engage in discussion, use recasts, corrective feedback, and imitation to work on the target the grammatical form.

👉🏽 Shared Storybook Reading

During this step, you read the story to the children in an interactive manner using visuals, story props, and dialogic prompts. There are a number of ways to work on target grammatical skills in this step.

Listen for the target skill:

SLP: There is a plural -s in this next sentence. Listen carefully and see if you hear it.

Comprehension check:

SLP: Sneezy bought 10 scoops of ice cream and the girl bought 1 scoop of ice cream. What did Sneezy do? He... (production) Show me what Sneezy bought. (comprehension)

Retell using conjunction but:

SLP: Sneezy warmed himself by the fire but it was so hot, he melted. Tell me what happened in this part of the story.

Responding to questions:

SLP: Who wanted to sleep? Who crashed into the snowman? Who needed a new home?

👉🏽 Post-story comprehension check:

In this step, you ask questions to ensure the children understand the story. Incorporate the target grammatical skill into the questions about the story grammar and main events in the story.

Use recasts, corrective feedback, and imitation as needed.

SLP: Who felt sad? (character feelings)

Child: Little Taco Truck felt sad.

SLP: Yes, he FELT sad. What did Little Taco Truck plan to do? (character's plan)

Child: get to his spot first

SLP: Yes, Little Taco Truck PLANNED to get to his spot first. Now you tell me.

Child: Little Taco Truck planned to get to his spot first.

👉🏽 Targeted Activities

In this step you engage in a variety of activities targeting any language skill using the book as the context.

Let's say we're doing a story retell task. In your mixed group you might have...

Student A working on identifying story grammar

Student B working on past tense -ed

Student C working on conjunction "and"

Student D working on retelling the beginning, middle, end of a story

SLP: Okay friends let's retell the beginning of the story. Student A, can you tell us the main character and setting.

Student A: Sneezy and winter

SLP: Yes, our main character is Sneezy and the setting is winter. Student C, tell me two things about the setting. Start with, the setting is...

Student C: The setting is windy and cold.

SLP: Yes, the setting is windy AND cold. Student B, Sneezy was so cold, his friend...

Student B: gived him a hat

SLP: Yes, his friend GAVE him a hat. Now you tell me.

Student B: His friend gave him a hat.

SLP: Awesome! We've talked about the main character, setting, and problem in the story. Student D, can you put all of that information together to retell the beginning of the story?

Another idea for story retell is to have each student use pictography to retell each part of the story.

While Students A, C, and D are working on their pictography, you can work directly with student B by flipping through the pages to retell the story out loud using the target grammatical structure. Or maybe you use a worksheet that targets their specific grammatical skill.

Now let's take a look at an example with a discussion about story grammar:

SLP: Student A, who is our story about?

Student A: Sneezy

SLP: Yes, Sneezy is our main character. Student B what happened to Sneezy in this picture?

Student B: he melt

SLP: You're so close. This already happened so we have to remember to use our past tense -ed sound. If we add -ed to the end of melt, what would it turn into?

Student B: melted

SLP: Yes! MELTED. Okay now tell me again, what happened to Sneezy in this picture?

Student B: he melted

SLP: Yes, he melted! Okay, Student C who is the story about?

Student C: Sneezy

SLP: And what is our setting?

Student C: winter

SLP: Yes, now let's make one awesome sentence telling us the main character and setting of the story.

Student C: The story is about Sneezy and it takes place in winter.

SLP: I love that sentence and how you connected the main character and setting with the word "and"! Okay Student D, we have our main character and setting. We need one more story element to describe the beginning of the story. Can you remember what it is?

👉🏽 Parallel Story Creation

During this step, students work together to create their own narrative using the original story as a framework. You can use questions or prompts along with recasts, corrective feedback, and imitation to support the target grammatical structures while creating a narrative out loud.

Whew! That was a lot to digest, but I hope this complete grammar guide has been super helpful!

You might want to bookmark this page for future reference, and feel free to share the link with your colleagues!

Have an amazing day! 😊

References

Balthazar, C. H., Ebbels, S., & Zwitserlood, R. (2020). Explicit grammatical intervention for developmental language disorder: Three approaches. Language, Speech, and Hearing Services in Schools, 51(2), 226–246. Link.

Balthazar, C. H., & Scott, C. M. (2024). Sentences are key: Helping school-age children and adolescents build sentence skills needed for real language. American Journal of Speech-Language Pathology, 33(2), 564–577. Link.

Calder, S. D., Claessen, M., Ebbels, S., & Leitão, S. (2020). Explicit grammar intervention in young school-aged children with developmental language disorder: An efficacy study using single-case experimental design. Language, Speech, and Hearing Services in Schools, 51(2), 298–316. Link.

Ebbels, S. H. (2014). Effectiveness of intervention for grammar in school-aged children with primary language impairments: A review of the evidence. Child Language Teaching and Therapy, 30(1), 7–40. Link.

Ebbels, S. H., & Nicoll, H. 2023. Identifying Grammatical targets – 2nd edition. Link.

Eisenberg, S.L. (2006). Grammar: How can I say that better? In Ukrainetz, T. A. (Ed). Contextualized language intervention: Scaffolding prek-12 literacy achievement. (145-194). Pro-Ed, Inc.: Austin, TX.

Fey, M. E., Long, S. H., & Finestack, L. H. (2003). Ten principles of grammar facilitation for children with specific language impairments. American Journal of Speech-Language Pathology, 12(1), 3–15. Link.

Finestack, L. H., Ancel, E., Lee, H. J., Kuchler, K., & Kornelis, M. (2024). Five additional evidence-based principles to facilitate grammar development for children with developmental language disorder. American Journal of Speech-Language Pathology, 33(2), 552–563. Link.

Paul, R., & Norbury, C. (2012). Language disorders from infancy to adolescence (4th ed.). Mosby Elsevier.