Building Early Sentences Therapy (BEST)

Developed by Dr Cristina McKean, Dr Sean Pert and Dr Carol Stow © 2010 - 2016

Winner of the Sternberg Award for Clinical Innovation - Royal College of Speech and Language Therapists, November 2012

Who is it for?

Building Early Sentences Therapy (BEST) is a language intervention for children who find it difficult to understand and/or produce sentences with 2, 3 and 4 clause elements e.g.: ‘the boy is giving a banana to a baby’. This intervention aims to change children’s underlying linguistic representations of the elements of a sentence so they can use sentences more flexibly, which may increase their rate of language progress.  This intervention does not replace learning language through play, but it is an additional more structured approach for those who need a little extra help.

There are promising initial results from a pilot study indicating that BEST may improve a child’s expressive language.

How does it work?

The key focus of this intervention is that the child receives good input – this means that the focus is on learning through listening. The children hear the therapist and the other children in the group use a range of sentences at the same time as seeing it acted out with toys. The sentences are also signed to provide further visual support. The sentences are repeated lots of times to help the children to learn and remember them. BEST can seem repetitive, but we know that children with language learning difficulties need up to 10 times more repetitions to learn a word than other children.

The sentence presentation in each session is very structured, but the therapy approach is informal in style. As long as the children are happy and engaged, we know they will be learning from hearing the language in the group and seeing the actions acted out.

Therapy sessions

The intervention will be delivered by a speech and language therapist to small groups of children. The group sessions will take place twice a week for 8 weeks = 16 sessions in total. Each group will last up to 30 minutes. Children hear the sentences over the 16 group sessions in a specific order designed to help them retain the new learning and generalise this to other sentences.

The children are given the opportunity to say the sentences in each of the sessions, but they don’t need to say anything until they are ready. We find that over the course of the 8 weeks children learn the sentences they hear and by the end, all are joining in well.

Homework

This intervention asks parents to complete simple homework tasks each day with their children throughout the 16 sessions. The homework resources will be sent to parents along with clear instructions and a video demonstration. The homework packs also include a star chart to help motivate the children.

The homework packs ask the parents to describe the pictures in the books provided - the sentence is written underneath each picture to make the task easy and enjoyable. The focus again is on listening; the children are hearing the sentences that they heard in the group session in school. This can help them to develop a model of how different spoken sentences are formed.

Key features

• Aim is to support children’s understanding and use of sentences
• Delivered in group sessions (twice a week for 8 weeks = 16 sessions)
• The focus is on learning through listening
• Repetition is important for children with language difficulties

 More information about BEST can be found in the BEST Manual‌ (opens as a pdf)