Pattern Rule Sensitivity Training for Language Disorder

Recruiting at 2 trial locations

Overseen By Lisa Goffman, PhD

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Father Flanagan's Boys' Home

Disqualifiers: Hearing impairment, Intellectual impairment, Autism, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

400 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how children with developmental language disorder (DLD) process language patterns. Researchers aim to determine if difficulties in understanding language structure, such as sounds and meanings, relate to a broader issue with learning sequences. The trial includes various activities to assess children's responses to phonological (sound) rules and semantic (meaning) cues. It suits monolingual English-speaking children aged 4 to 8 diagnosed with DLD who struggle with language tasks, excluding those with hearing or intellectual impairments. As an unphased trial, this study provides a unique opportunity for children to contribute to understanding DLD and potentially enhance language learning strategies.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research shows that treatments focusing on sound patterns and word meanings are generally safe for children with developmental language disorders.

For sound patterns, studies have found that specific training can help children with language difficulties improve their ability to recognize and work with sounds in spoken language. These treatments enhance language skills without causing significant side effects.

For word meanings, research suggests that using word clues aids children in organizing and understanding language. This method is considered safe as it supports language development by improving understanding of word meanings and relationships, crucial for children with language challenges.

Overall, existing research supports the safety of these treatments, with no major safety concerns reported. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about these treatments for language disorders because they focus on enhancing sensitivity to phonological rules and semantic category cues, which are innovative approaches compared to traditional speech therapy. Unlike standard treatments that often emphasize repetitive practice and articulation drills, these methods aim to train the brain to recognize patterns and categories in language, potentially leading to more natural language learning. By targeting the underlying cognitive processes of language acquisition, these treatments may offer a more holistic and effective solution for children with language disorders.

What evidence suggests that this trial's treatments could be effective for developmental language disorder?

Research has shown that understanding the rules of sounds in language can enhance language skills in children with developmental language disorder (DLD). In this trial, one group of children will receive therapy focused on sensitivity to phonological rules, which studies have shown leads to significant progress in both understanding and speaking. The outlook for children with DLD is generally good, with 70% showing major language improvement by age three.

Another group in this trial will focus on sensitivity to semantic category cues. Awareness of word meanings and categories also proves helpful. Studies using eye-tracking technology have demonstrated that young children can better understand and use word meanings with specific training. Additionally, children with milder language issues respond well to treatments focused on word meanings, showing clear improvement in their language skills. Both methods offer valuable support for children with language difficulties. ^{6 7 8 9 10}

Are You a Good Fit for This Trial?

This trial is for children aged 4-8 with developmental language disorder (DLD) or speech sound disorder (SSD), who have normal hearing and oral structures. They must not have autism, intellectual impairment, significant motor impairment, or a history of related disorders if they are typically developing.

Inclusion Criteria

If you have trouble repeating made-up words, it might indicate you have a language disorder. If your score is less than 70% for correctly saying all the sounds in made-up words, it's a sign that you might have a language disorder.

My hearing is within the normal range.

Children with DLD will have difficulty using the correct verb endings in their speech, scoring below 80%.

Exclusion Criteria

I have an intellectual disability.

I have hearing loss.

I have major difficulties with movement.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Training

Children are trained on phonological and morphological sequence learning patterns, including Single Feature, OR/Disjunction, and Family Resemblance/Prototype patterns.

4-6 weeks

Generalization

Children are asked to name new novel words that are either consistent or inconsistent with the training pattern to assess learning generalization.

2 weeks

Follow-up

Participants are monitored for changes in sensitivity to phonological rules and semantic category cues.

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Sensitivity to phonological rules
• Sensitivity to semantic category cues

Trial Overview The study tests the link between morphological and phonological deficits in children by assessing their sensitivity to semantic category cues and phonological rules. It aims to improve assessments and interventions for DLD.

How Is the Trial Designed?

Group I: Sensitivity to semantic category cues: Children Experimental Treatment 1 Intervention

Arm 1.Referential cue during OR learning.

Group II: Sensitivity to phonological rules: Children Experimental Treatment 1 Intervention

Arm 1: Single Feature Pattern; Arm 2: OR/Disjunction Pattern; Arm 3: Family Resemblance/Prototype Pattern

Who Is Running the Clinical Trial?

Father Flanagan's Boys' Home

Lead Sponsor

Trials

14

Recruited

1,600+

The University of Texas at Dallas

Lead Sponsor

Trials

71

Recruited

108,000+

University of Arizona

Collaborator

Trials

545

Recruited

161,000+

Published Research Related to This Trial

Children with developmental language disorder (DLD) struggle significantly with repeating nonwords of all lengths compared to typically developing (TD) peers, indicating a broader issue with phonological memory.

DLD children also face challenges in fast mapping, particularly with longer novel words, suggesting that their difficulties in encoding phonological information affect their ability to learn new words efficiently.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Fast mapping short and long words: Examining the influence of phonological short-term memory and receptive vocabulary in children with developmental language disorder. Jackson, E., Leitao, S., Claessen, M., et al.[2020]

Eighteen individuals with primary progressive aphasia (PPA) showed significant and lasting improvements in naming abilities after receiving lexical retrieval treatment, with benefits observed immediately post-treatment and maintained for up to one year.

The frequency of treatment sessions (once vs. twice a week) and the addition of a booster phase did not significantly affect outcomes, indicating that even a single weekly session can lead to effective improvements in naming skills for individuals with both semantic and logopenic variants of PPA.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Treatment for Word Retrieval in Semantic and Logopenic Variants of Primary Progressive Aphasia: Immediate and Long-Term Outcomes. Henry, ML., Hubbard, HI., Grasso, SM., et al.[2020]

The study involved 89 language-impaired participants, including adults with acquired aphasia, schizophrenia, multiple sclerosis, and children with specific language impairment, to analyze noun and verb retrieval differences.

Findings suggest that naming deficits are complex and involve multiple levels of language processing, indicating that both genetic and neurobiological factors play a role, and that the traditional classification of verbs may need reevaluation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Grammatical Class Effects Across Impaired Child and Adult Populations. Kambanaros, M., Grohmann, KK.[2023]

The study of two severely aphasic patients revealed that their naming errors stemmed from different underlying cognitive deficits, highlighting the need for personalized assessment in language therapy.

Using cueing hierarchies effectively improved written naming for both patients, but only one patient showed improvement in verbal naming, suggesting that understanding individual deficits can help predict which language skills may improve with treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy and generalization of treatment for aphasic naming errors. Hillis, AE.[2019]

Children with Developmental Language Disorder (DLD) showed impaired ability to learn auditory categories through procedural learning methods, while their rule-based learning remained intact, indicating a specific deficit in procedural learning.

The study highlights that children with DLD have slower adaptation to optimal procedural strategies, supporting the idea that language disorders may stem from difficulties in procedural learning systems, which can affect their ability to form stable linguistic representations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Procedural auditory category learning is selectively disrupted in developmental language disorder. Derawi, H., Roark, CL., Gabay, Y.[2023]

Children with Developmental Language Disorder (DLD) can extend new words to broader categories similarly to their typically developing peers, indicating preserved conceptual knowledge for word learning.

Despite this ability, neither children with DLD nor their typically developing counterparts could specify categorization for more restricted instances, suggesting a potential area for therapeutic focus in improving word learning strategies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Preserved category-based inferences for word learning in school-aged children with developmental language disorder. Dauvister, E., Jemel, B., Maillart, C.[2022]

Adults with developmental language disorder (DLD) can learn certain types of artificial grammar, specifically the Family Resemblance grammar, as effectively as adults with typical development, indicating that their learning abilities are not universally impaired.

The study supports the sequential pattern learning deficit hypothesis, suggesting that difficulties in grammar learning for individuals with DLD are primarily linked to challenges in computing sequential dependencies rather than a general impairment in implicit learning.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Not All Procedural Learning Tasks Are Difficult for Adults With Developmental Language Disorder. Gerken, L., Plante, E., Goffman, L.[2021]

Children with specific language impairment (SLI) showed improved comprehension of words when using semantic cues and better production of words with phonological cues, indicating that tailored strategies can enhance word learning for this group.

In contrast, children with normal language (NL) performed similarly across both cue types but required fewer trials to learn words, suggesting that children with SLI may need more support in word learning compared to their peers.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Word learning by preschoolers with specific language impairment: effect of phonological or semantic cues. Gray, S.[2022]

A phonological schema-based approach to treating irregular past tense verb inflection in three 7-year-old children with developmental language disorder (DLD) showed positive acquisition effects for two of the participants, indicating that this method can be effective for some children.

Generalization of treatment effects to untreated verbs was observed in two participants, but there was no increase in the use of correct irregular verbs in naturalistic contexts, suggesting that while the approach may help with learning specific verbs, it may not fully translate to everyday language use.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Pattern-Based Target Selection for Treatment of Irregular Past Tense: A Single-Case Experimental Design for Children With Developmental Language Disorder. Hannig Russell, KM., Wilder, A., Wambaugh, JL.[2023]

Individuals with dyslexia showed impaired ability to learn categories based on information-integration, indicating a disruption in the procedural memory system, while their rule-based category learning remained intact.

The study suggests that dyslexia may involve inefficiencies in procedural learning strategies, which could contribute to difficulties in acquiring phonetic categories, highlighting the existence of multiple systems for category learning.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Impaired and Spared Auditory Category Learning in Developmental Dyslexia. Gabay, Y., Roark, CL., Holt, LL.[2023]

The study proposes that grammatical category deficits, like difficulties in naming nouns compared to verbs, can be understood through the balance of sensory and functional features in semantic representations, similar to semantic category effects.

Assessment of two patient groups revealed that those with 'verb spared' conditions struggled more with naming living things than inanimate objects, supporting the idea that damage to sensory features affects concrete noun naming more than verb naming.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Why is a verb like an inanimate object? Grammatical category and semantic category deficits. Bird, H., Howard, D., Franklin, S.[2006]

Citations

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Phonological awareness training and phonological therapy ... Children within group A showed significant improvement in the receptive, expressive and total language ages after language and phonological ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8005159/

Efficacy of the Treatment of Developmental Language Disorder The prognosis is generally good, as, in 70% of cases, expressive language improves significantly by three years of age and subsequently the ...

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Optimizing Outcomes for Children With Phonological ... In this article, we introduce the Speech Outcome Reporting Taxonomy (SORT), a tool designed to assist with the classification of outcome and experience ...

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Sensitivity and specificity of a low-cost screening protocol ... CONCLUSIONS: The screening test showed high diagnostic efficiency in determining the risk of language disorders in children aged between 0 and 5 years.

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Spoken Language Disorders A spoken language disorder is an impairment in the acquisition and use of language across due to deficits in language production and/or comprehension.

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Spoken Language Disorders A spoken language disorder is an impairment in the acquisition and use of language across due to deficits in language production and/or comprehension.

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6105119/

The Relationship Between Speech, Language, and ... Children with limited speech ability were found to have receptive language and letter–sound knowledge that supported the development of phonological awareness ...

8. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC2491683/

Speech-Language Impairment: How to Identify the Most ... Introduction. Speech-language deficits are the most common of childhood disabilities and affect about 1 in 12 children or 5% to 8% of preschool children.

9. pubs.asha.org pubs.asha.org/doi/10.1044/2022_JSLHR-22-00434

Phonological and Articulatory Deficits in the Production of ... Results showed that children with DLD were overall less phonologically accurate than TD children, and both groups showed the weakest performance ...

10. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0021992416300156

The sensitivity of children with SLI to phonotactic ... Phonotactic probabilities may help them to partially overcome their difficulties in developing and accessing the phonological lexicon during spoken word ...