Sentence Recast for Language Developmental Disorders
Recruiting in Palo Alto (17 mi)
Age: < 18
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: University of Houston
Disqualifiers: Sensory-motor concerns, psychiatric disorders
No Placebo Group
Trial Summary
What is the purpose of this trial?Of the 12 million children in the USA growing up bilingual, about 1 million experience Developmental Language Disorder (DLD), a disorder in language learning and use. Currently there is no guidance for speech language pathologists (SLPs) as to the language of intervention for emergent Spanish-English bilingual children with DLD. This project will examine the relationship between language proficiency and the language of intervention, considering monolingual intervention (Spanish or English) and interleaved Spanish-English intervention with the goal of improving language outcomes and thereby strengthening long-term academic achievement
Will I have to stop taking my current medications?
The trial information does not specify whether participants need to stop taking their current medications.
What data supports the effectiveness of the treatment Sentence Recast for language developmental disorders?
Research shows that conversational recast treatment helps children with language disorders learn grammar more quickly and effectively compared to other methods. Children who frequently repeat correct forms during treatment tend to show better progress, indicating that this approach can be beneficial for improving language skills.
12345Is Sentence Recast therapy safe for humans?
The research articles reviewed do not provide specific safety data for Sentence Recast therapy, but they focus on its effectiveness in improving language skills in children with developmental language disorders. Generally, language interventions like Sentence Recast are considered safe as they involve structured language practice rather than medical or drug-based treatments.
45678How does the Sentence Recast treatment differ from other treatments for language developmental disorders?
Sentence Recast treatment is unique because it uses conversational recasting, where children repeat and correct sentences modeled by a clinician, helping them improve their language skills through practice and self-correction. This approach is different from other treatments as it focuses on spontaneous repetition and structural priming to enhance language development.
24789Eligibility Criteria
This trial is for emergent Spanish-English bilingual children in the USA with Developmental Language Disorder (DLD). It aims to help speech language pathologists decide on the best language of intervention. Specific eligibility criteria are not provided, but typically would include a diagnosis of DLD and being bilingual.Inclusion Criteria
Pass a hearing screening test
Parent concerns and/or a history of receiving services in the public schools
Nonverbal IQ, as measured by the Kaufman Brief Intelligence Test-2, matrices subtest, will be at or above a standard score of 70.
+3 more
Exclusion Criteria
My child does not have major sensory-motor or psychiatric issues.
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Treatment
Participants receive monolingual or interleaved therapy for 16 hours over 9 weeks, focusing on recast therapy in the dominant language with opportunities to use the non-dominant language.
9 weeks
Weekly sessions
Follow-up
Participants are monitored for language proficiency and effectiveness of the intervention after treatment.
4 weeks
Participant Groups
The study is testing whether monolingual intervention (either in Spanish or English) or an interleaved approach combining both languages can better improve language outcomes for children with DLD. The goal is to enhance academic achievement over time.
2Treatment groups
Experimental Treatment
Group I: Monolingual therapyExperimental Treatment1 Intervention
A trained, bilingual SLP will treat the targeted structure at a rate of \~ 1 recast per minute, for 16 hours spread over 9 weeks to obtain a planned dose of 912-1008 recasts (960 +/- 5%). Following evidence on enhanced conversational recasting, the SLP will obtain the child's attention before recasting and systematically vary the lexical items in the recasts. Children receiving monolingual Spanish therapy will have the entire treatment session conducted in the dominant language of the child (Spanish or English).
Group II: Interleaved therapyExperimental Treatment1 Intervention
A trained, bilingual SLP will treat the targeted structure at a rate of \~ 1 recast per minute, for 16 hours spread over 9 weeks to obtain a planned dose of 912-1008 recasts (960 +/- 5%). Following evidence on enhanced conversational recasting, the SLP will obtain the child's attention before recasting and systematically vary the lexical items in the recasts. Children will receive therapy in the dominant language (Spanish or English) and will also be offered the opportunity to use the non-dominant language (Spanish or English) via communication bid in the child's non-dominant language every 3-5 minutes and continue in that language as long as the child responds. If the child does not respond or responds in their dominant language, the examiner will switch to the other language.
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
University of HoustonHouston, TX
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Who Is Running the Clinical Trial?
University of HoustonLead Sponsor
National Institute on Deafness and Other Communication Disorders (NIDCD)Collaborator
University of DelawareCollaborator
References
Data-Informed Guideposts for Decision Making in Enhanced Conversational Recast Treatment. [2022]Background To maximize treatment efficiency, it would be useful to determine how long to continue a treatment approach before concluding that it is not effective for a particular client, whether and when generalization of treatment is likely to occur, and at what point to end treatment once a child is approaching mastery. Method We analyzed aggregate data from 117 preschoolers with developmental language disorder from a decade of treatment studies on Enhanced Conversational Recast therapy to determine whether the timing of treatment response impacts its overall effectiveness and whether certain levels of accuracy during treatment enable 100% accurate generalization after treatment ends. Results We found that children who take longer than 10 days to answer one item correctly during treatment are unlikely to ever respond to the treatment approach. Generalization accuracy closely followed treatment accuracy, suggesting the two are tightly linked for this treatment method. We did not find evidence that attaining a certain level of accuracy below 100% during treatment enabled children to generalize with 100% accuracy after treatment ended. Conclusions Clinicians using Enhanced Conversational Recast treatment can use these markers to help make evidence-based decisions in their practice regarding how long to continue treatment. Importantly, these data suggest that stopping treatment before a child has attained 100% accuracy (for at least three sessions) does not ensure that a child will ever reach 100% accuracy on their own.
Individual Versus Small Group Treatment of Morphological Errors for Children With Developmental Language Disorder. [2023]Purpose This study examines the effects of enhanced conversational recast for treating morphological errors in preschoolers with developmental language disorder. The study assesses the effectiveness of this treatment in an individual or group ( n = 2) setting and the possible benefits of exposing a child to his or her partner's treatment target in addition to his or her own. Method Twenty children were assigned to either an individual ( n = 10) or group ( n = 10, 2 per group) condition. Each child received treatment for 1 morpheme (the target morpheme) for approximately 5 weeks. Children in the group condition had a different target from their treatment partner. Pretreatment and end treatment probes were used to compare correct usage of the target morpheme and a control morpheme. For children in the group condition, the correct usage of their treatment partner's target morpheme was also examined. Results Significant treatment effects occurred for both treatment conditions only for morphemes treated directly (target morpheme). There was no statistically significant difference between the treatment conditions at the end of treatment or at follow-up. Children receiving group treatment did not demonstrate significant gains in producing their partner's target despite hearing the target modeled during treatment. Conclusions This study provides the evidence base for enhanced conversational recast treatment in a small group setting, a treatment used frequently in school settings. Results indicate the importance of either attention to the recast or expressive practice (or both) to produce gains with this treatment. Supplemental Material https://doi.org/10.23641/asha.7859975.
Effects of imitative and conversational recasting treatment on the acquisition of grammar in children with specific language impairment and younger language-normal children. [2019]The purpose of the study was to compare the relative effectiveness of imitative treatment and conversational recast treatment in children with language impairment and in a group of children with normal language skills. Language treatment outcomes were compared between a group of older (4.7 to 6.7) specifically-language-impaired (SLI) children and a group of younger (2.2 to 4.2) language-normal (LN) children matched on language levels and on intervention targets. The results indicated: (a) Target acquisition was more rapid under conversational recast treatment for both groups: (b) This outcome held for targets absent initially (in pretreatment sampling and probing) as well as for initially partially mastered targets. (c) SLI children sometimes can learn grammatical structures as efficiently as language-normal children if similar language input is tailored to their specific developmental language levels. Implications of these findings for language treatment strategies with SLI children are discussed. Theoretical models compatible with the data also are considered.
The Role of Spontaneous Repetitions During Treatment of Morphosyntactic Forms for Children With Developmental Language Disorder. [2023]Purpose Children with developmental language disorder sometimes spontaneously repeat clinician models of morphemes targeted for treatment. We examine how spontaneous repeating of clinician models in the form of recasts associates with improved child production of those emerging morphemes. Method Forty-seven preschool children with developmental language disorder participated in Enhanced Conversational Recast therapy and were monitored for spontaneous repetitions of morphemes modeled by the clinician through conversational recasting. We calculated proportion of correct and incorrect productions elicited during treatment and for generalization probes as well as treatment effect sizes. We then used odds ratios to determine the probability that a spontaneous repetition may precede treatment gains and calculated correlations of correct repetitions with correct in-treatment productions of targets and treatment effect sizes. Results Spontaneous repetitions were highly likely to happen just prior to meaningful treatment progress. Children with higher frequencies of correct spontaneous repetitions of morpheme targets also showed higher frequencies of correct productions of these forms during the course of treatment. Furthermore, children with an earlier onset of repetitions and higher frequencies of correct repetitions showed overall larger effect sizes at the end of treatment. Conclusions Children's use of correct forms in their repetitions may serve as a self-scaffold for mastering productions of the correct form via structural priming mechanisms. Tracking spontaneously repeated targets may be a useful milestone for identifying response to treatment.
Comparison of conversational-recasting and imitative procedures for training grammatical structures in children with specific language impairment. [2019]The recent literature on language intervention has become increasingly focused upon developing treatments that more closely parallel normal language acquisition. However, there have been relatively few reports that directly compare imitative procedures to conversational-interactive interventions. The purpose of the present study was to compare the relative effectiveness of imitative intervention and conversational recast language intervention applied to a wide range of grammatical morpheme and complex sentence targets in 21 children with specific language impairment. The results indicated that although both kinds of treatments were effective in triggering acquisition of most targets, consistently fewer presentations to first spontaneous use were required in the conversational procedure. In addition, the transition from elicited production to generalized spontaneous production was more rapid under conversation-interactive treatment. Finally, although imitation treatment was more effective in generating elicited production, a significantly greater number of spontaneous productions occurred under the conversational training procedures. The theoretical and applied ramifications of these findings are discussed.
Predictors of Treatment Response for Preschool Children With Developmental Language Disorder. [2023]Purpose Enhanced Conversational Recast treatment is an effective intervention for remediating expressive grammatical deficits in preschool-age children with developmental language disorder, but not all children respond equally well. In this study, we sought to identify which child-level variables predict response to treatment of morphological deficits. Method Predictor variables of interest, including pre-intervention test scores and target morpheme production, age, and mother's level of education (proxy for socio-economic status) were included in analyses. The sample included 105 children (M = 5;1 [years;months]) with developmental language disorder who participated in 5 weeks of daily Enhanced Conversational Recast treatment. Classification and regression tree analysis was used to identify covariates that predicted children's generalization of their trained grammatical morpheme, as measured by treatment effect size d. Results Our analysis indicates that the Structured Photographic Expressive Language Test-Preschool 2 (SPELT-P 2) scores and the Peabody Picture Vocabulary Test-Fourth Edition scores significantly predicted the degree of benefit a child derived from Enhanced Conversational Recast treatment. Specifically, a SPELT-P 2 score above 75 (but still in the impaired range, < 87) combined with a high Peabody Picture Vocabulary Test-Fourth Edition score (> 100) yielded the largest treatment effect size, whereas a SPELT-P 2 score below 75 predicted the smallest treatment effect size. Other variables included in the model did not significantly predict treatment outcomes. Conclusions Understanding individual differences in response to treatment will allow service providers to make evidence-based decisions regarding how likely a child is to benefit from Enhanced Conversational Recast treatment and the expected magnitude of the response based on the child's background characteristics.
The efficacy of recasts in language intervention: a systematic review and meta-analysis. [2022]This systematic review and meta-analysis critically evaluated the research evidence on the effectiveness of conversational recasts in grammatical development for children with language impairments.
Simultaneous treatment of grammatical and speech-comprehensibility deficits in children with Down syndrome. [2022]Children with Down syndrome often display speech-comprehensibility and grammatical deficits beyond what would be predicted based upon general mental age. Historically, speech-comprehensibility has often been treated using traditional articulation therapy and oral-motor training so there may be little or no coordination of grammatical and speech-comprehensibility treatment. The purpose of this paper is to provide the rationale for and preliminary evidence in support of integrating speech and grammatical intervention using a type of recast treatment in six children with Down syndrome. Speech-comprehensibility and MLU growth in generalisation sessions occurred in 4/6 and 5/6 participants, respectively. Using multiple baseline design logic, two of these participants showed evidence of treatment effects on speech-comprehensibility and two in MLU in generalisation sessions, respectively. The study constitutes a conservative test of the intervention effects for reasons that are discussed. The theoretical and applied significance of these findings are discussed.
The Use of Structural Priming and Focused Recasts to Facilitate the Production of Subject- and Object-Focused Relative Clauses by School-Age Children With and Without Developmental Language Disorder. [2021]Purpose The purpose of this study was to examine the use of structural priming combined with a focused recasting procedure to elicit subject- and object-focused, center-embedded relative clauses from students with developmental language disorders (DLDs) and typically developing (TD) students. Method A total of 26 children (13 DLD, 13 TD), ranging in age from 6;10 to 10;11 (years;months), participated in this study. All children completed a priming and recasting task that targeted subject- and object-focused relatives. The stimuli were presented in two blocks, which each contained 40 trials for each sentence type. Results Children with DLD and their TD peers were significantly more accurate producing subject-focused than object-focused relatives. An analysis of rate of learning indicated that significantly more trials were required for subjects in the DLD group to demonstrate consistent performance on both subject- and object-focused relatives. Conclusions The study supports the feasibility of combining an implicit priming task with an explicit recasting task for teaching subject-focused relative clauses to children with DLD. However, it is likely that additional instruction and/or more trials will be necessary for children with DLD to attain consistent performance levels. Supplemental Material https://doi.org/10.23641/asha.12670847.