The development and testing of a classroom-based intervention targeting working memory, attention and language skills in 4-5 year old children from areas of social disadvantage
: a cluster randomised feasibility trial

  • Anita Rowe

Student thesis: Doctoral Thesis


Background: In areas of social disadvantage (SD), high proportions of children have impoverished language skills and poor attention. There is international debate around how best
to support this population. Targeting working memory (WM) as an underlying skill may improve these real-world skills.
Aims: To develop and test a classroom-based intervention targeting working memory to enhance attention and language skills in 4-5 year olds from areas of SD.
Methods: A mixed methods, multi-phase study including: 1) A systematic review of WM interventions applied in children’s everyday contexts; 2) A qualitative study that explored health professionals’ (HPs) (n= 13) and teachers’ (n= 10) perceptions of WM; 3) Coproduction work with HPs (n= 5), teachers (n= 2) and parents (n= 2) of 4-5 year olds; and 4) A cluster randomised feasibility trial of the novel intervention.
Findings: Evidence from the systematic review and the qualitative study, synthesised with the experience of HPs, teachers and parents led to the co-production of ‘Recall to Enhance Children’s Attention, Language and Learning’ (RECALL). It is a 6-week intervention that includes direct executive-loaded WM tasks, phoneme awareness training and fantastical play and is delivered to whole classes of children by HPs and teachers. The feasibility trial indicated that the trial processes could be scaled-up into a definitive trial but there were mixed findings about the acceptability of the intervention. In the whole class setting, large group sizes reduced the dose (number of practice items) accessed by individual children, particularly those who may benefit most from RECALL.Outcomes: RECALL should be optimised as a small group intervention (for children at risk of low WM) and tested in a full-scale trial. Teachers require training on the theoretical underpinning of classroom-based interventions. Policy-makers and practitioners in school-based services should reflect on the effectiveness of whole-class interventions, considering the potential dilution of the potency of interventions in this setting.
Date of AwardMay 2020
Original languageEnglish
SponsorsThe Research and Development Division of the Public Health Agency (Northern Ireland), UK
SupervisorJill Titterington (Supervisor) & Laurence Taggart (Supervisor)


  • Working memory
  • Classroom-based interventions
  • Children
  • Transdisciplinary
  • Speech and language therapy

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