Grammar Treatment for Language Developmental Disorders

(DLDTreatment Trial)

Not yet recruiting at 3 trial locations

Overseen By Jeanette Eckert

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Ohio University

Disqualifiers: Neurodevelopmental, Emotional, Neurological, others

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

Compensation: Varies

Number of Visits: 23

Duration: 10 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores two methods to help children aged 8-11 with developmental language disorder (DLD) better understand and use passive sentences. Treatment 1 focuses on learning grammar through listening and imitation, while Treatment 2 involves direct teaching of grammar rules. Researchers aim to determine which method more effectively improves grammar skills. Children who struggle with understanding or forming sentences and have been diagnosed with DLD might be suitable candidates for this trial. As an unphased trial, this study provides a unique opportunity for children to contribute to research that could enhance language learning methods.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It might be best to discuss this with the trial coordinators or your doctor.

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

In a previous study, researchers examined two methods for teaching grammar to children with developmental language disorder (DLD). Both methods proved safe for the children. The first method, the explicit approach, involves directly teaching grammar rules. This method has been used successfully in classrooms, demonstrating that children handle it well. The second method, the implicit approach, helps children learn grammar through repeated exposure and has also shown good results without harmful effects.

These studies reported no negative effects from either method. Since this trial does not involve drugs or medical procedures, the treatments are expected to be safe. Children will participate in structured learning activities similar to those in a regular classroom. ^{1 2 3 4 5}

Why are researchers excited about this trial's treatments?

Researchers are excited about the Grammar Treatment for language developmental disorders because it explores innovative ways to teach passive sentence structures. Unlike traditional methods focusing on direct instruction over time, this approach includes both explicit and implicit teaching techniques, delivered immediately or after a delay. The implicit method uses a syntactic priming paradigm, a novel approach that encourages natural learning by exposure, potentially leading to more intuitive language use. Additionally, the delayed treatment arms help distinguish between improvements from the treatment itself versus natural maturation, offering valuable insights into the effectiveness of different teaching timelines.

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

Research has shown that direct grammar instruction benefits children with developmental language disorders (DLD). In this trial, participants will experience different grammar treatment approaches. The Explicit Immediate Treatment arm clearly teaches grammar rules, aiding children in learning and using new grammar forms more effectively. These children also tend to remember and apply these skills better than those who learn without direct instruction. In contrast, the Implicit Immediate Treatment arm emphasizes learning grammar through repeated exposure, without direct teaching, to make grammar acquisition feel more natural and automatic. Some studies suggest that combining both methods might be beneficial, but each has advantages depending on the child's needs. ^{1 6 7 8 9}

Are You a Good Fit for This Trial?

This trial is for children aged 8-11 with developmental language disorder (DLD), including those diagnosed with Central Auditory Processing Disorder, Language Developmental Disorders, or Acquired Language Disorder. It aims to help them understand and use passive sentence structures better.

Inclusion Criteria

Language impairment: standard score of 34 or lower on the Test of Language and Learning Skills

Native English speaker

Sentence comprehension screening/sentence chunking screening 50% or lower

Exclusion Criteria

Neurodevelopmental disorder

Emotional/behavioral disorder

Treatment for complex syntax from outside clinician

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

1 visit (in-person)

Treatment

Participants receive either implicit or explicit treatment for passive sentence structure learning over 10 weeks

10 weeks

20 sessions (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

5 weeks

2 visits (in-person)

Delayed Treatment (optional)

Participants in the delayed treatment group receive treatment 10 weeks after initial assessment

10 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Grammar Treatment

Trial Overview The study compares two treatments: an implicit approach where kids listen to sentences while looking at pictures, and an explicit approach teaching grammar rules. Each child will receive one of the treatments randomly over a period of 10 weeks.

How Is the Trial Designed?

Group I: Implicit Immediate Treatment Experimental Treatment 1 Intervention

This treatment involves providing participants an implicit approach to passive sentence structure learning via a syntactic priming paradigm immediately following the completion of the pre-treatment measures.

Group II: Implicit Delayed Treatment Experimental Treatment 1 Intervention

This treatment involves providing participants an implicit approach to passive sentence structure learning via a syntactic priming paradigm 10 weeks following the completion of the pre-treatment measures. This arm allows assessing whether improvement on the outcome measures is due to 10 weeks of treatment or just maturation.

Group III: Explicit Immediate Treatment Experimental Treatment 1 Intervention

This treatment involves providing participants an explicit approach to passive sentence structure learning via conventional teaching of grammatical rules immediately following the completion of the pre-treatment measures.

Group IV: Explicit Delayed Treatment Experimental Treatment 1 Intervention

This treatment involves providing participants an explicit approach to passive sentence structure learning via conventional teaching of grammar rules 10 weeks following the completion of the pre-treatment measures. This arm allows assessing whether improvement on the outcome measures is due to 10 weeks of treatment or just maturation.

Who Is Running the Clinical Trial?

Ohio University

Lead Sponsor

Trials

73

Recruited

17,800+

National Institute on Deafness and Other Communication Disorders (NIDCD)

Collaborator

Trials

377

Recruited

190,000+

Published Research Related to This Trial

In a study of 123 children aged 2 to 5 with language problems, various treatment approaches were effective, with significant improvements in language skills observed across all groups after one year.

Targeted language therapy was crucial for improving language comprehension, as children who only received surgical hearing improvements did not show significant gains in this area.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of different treatments in young children with language problems. Keegstra, AL., Post, WJ., Goorhuis-Brouwer, SM.[2015]

Language in Interaction Therapy (LIT) is an effective intervention for improving morphosyntactic skills in 4- to 5-year-old children with developmental language disorders, as demonstrated by a single-case study involving five children.

The study found that four out of five children showed increased mean length of utterance during LIT compared to baseline, with significant improvements in two cases, indicating that LIT can enhance language development when properly implemented with support and structured protocols.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Focused Stimulation Intervention in 4- and 5-Year-Old Children With Developmental Language Disorder: Exploring Implementation in Clinical Practice. Bruinsma, G., Wijnen, F., Gerrits, E.[2020]

The study demonstrated that a targeted intervention using the SHAPE CODING system significantly improved past tense marking in 21 children with developmental language disorder (DLD) over 10 weeks, with a large effect size (d = 3.03).

Improvements in past tense production were maintained for at least 5 weeks after the intervention, indicating the long-term efficacy of this explicit grammar intervention for early school-age children with DLD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Efficacy of an Explicit Intervention Approach to Improve Past Tense Marking for Early School-Age Children With Developmental Language Disorder. Calder, SD., Claessen, M., Ebbels, S., et al.[2022]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7225018/

Explicit Grammatical Intervention for Developmental ... This article summarizes the shared principles and evidence underpinning methods employed in the three sentence-level (syntactic) grammatical intervention ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6198921/

Evaluation of an Explicit Intervention to Teach Novel ... Study findings indicate that, as compared to implicit instruction, children are more likely to acquire, maintain, and generalize novel grammatical forms when ...

3. journals.sagepub.com journals.sagepub.com/doi/10.1177/02656590241308793

The efficiency of an explicit approach to improve complex ... Findings confirm the effectiveness of an explicit approach in grammar interventions and they provide new perspectives on language therapy ...

4. pubs.asha.org pubs.asha.org/doi/abs/10.1044/2019_LSHSS-19-00046

Explicit Grammatical Intervention for Developmental ... A description of each approach provides examples and summarizes current evidence supporting effectiveness for children with developmental language disorder ...

5. researchgate.net researchgate.net/publication/340512173_Explicit_Grammatical_Intervention_for_Developmental_Language_Disorder_Three_Approaches

(PDF) Explicit Grammatical Intervention for Developmental ... A description of each approach provides examples and summarizes current evidence supporting effectiveness for children with developmental language disorder ...

6. sciencedirect.com sciencedirect.com/science/article/pii/S0021992422000880

Teaching foreign language grammar to primary-school ... We conclude that pupils with DLD are able to make progress in foreign language learning in a classroom setting if provided with adequate support.

7. pubs.asha.org pubs.asha.org/doi/10.1044/2023_AJSLP-22-00247

A First-Person Account of Developmental Language Disorder The aim of this study is to share the lived experiences of an adult with developmental language disorder (DLD) and relate her experience to the evidence base.

8. speechandlanguage.org.uk speechandlanguage.org.uk/wp-content/uploads/2023/12/ican_dld_guide_final_aug4.pdf

Developmental Language Disorder This guide will help you understand more about DLD, including how to identify and support DLD in your classroom. Most children and young people with DLD.

9. withpower.com withpower.com/trial/grammar-treatment-for-language-developmental-disorders-636ff

Grammar Treatment for Language Developmental ... Research shows that explicit grammar interventions, like the SHAPE CODING system, significantly improve past tense production in children with developmental ...