Phonological Pattern Learning for Language Disorder in Toddlers

No longer recruiting at 2 trial locations

Overseen By LouAnn Gerken, PhD

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Father Flanagan's Boys' Home

Disqualifiers: Hearing, Intellectual, Autism, Motor, others

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

Compensation: Varies

Number of Visits: Unknown

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) learn speech patterns. The goal is to determine if a link exists between pattern learning and language skills, potentially aiding in the early identification and support of children with DLD. The trial will assess how toddlers respond to phonological (sound) patterns, focusing on their sensitivity to phonological rules and referents. Ideal participants are toddlers with normal hearing and language development, who have spoken English from infancy, and have no major medical or developmental issues. As an unphased trial, this study provides a unique opportunity to contribute to foundational research that could enhance early detection and support for children with DLD.

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this protocol is safe for toddlers?

Research has shown that treatments focusing on how toddlers understand sounds and words have not caused harmful effects in past studies. Although specific safety data for these treatments is lacking, no negative side effects have been reported, suggesting they are likely safe. The trial is in the "Not Applicable" phase, indicating that the treatment's safety is still under study. However, the absence of problems in earlier research is encouraging. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about these approaches because they focus on helping toddlers with language disorders by enhancing their sensitivity to phonological patterns. Unlike traditional speech therapy methods that might prioritize vocabulary building or articulation, this technique targets the underlying phonological rules. The innovative aspect here is the use of phonological sensitivity training, which aims to improve how toddlers recognize and process the sounds and patterns in language. By focusing on these foundational skills, the hope is to create long-lasting improvements in language development, potentially offering a more effective and targeted intervention for young children with language challenges.

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

Research has shown that children with developmental language disorder (DLD) might struggle with learning patterns, impacting their language skills. This trial will explore two approaches to teaching phonological rules to toddlers. Participants in the "Sensitivity to phonological rules & referents OR: Toddlers" arm will receive training focused on the OR condition, while those in the "Sensitivity to phonological rules & referents FR: Toddlers" arm will focus on the Family Resemblance condition. Studies indicate that teaching children about phonological rules (how sounds are organized in language) can enhance their expressive abilities. Specifically, one study found that about 70% of children showed significant improvement in expressive language by age three with treatment. Another study demonstrated that children trained in phonological awareness made noticeable progress in both understanding and using language. These findings suggest that focusing on sound patterns can effectively aid toddlers with language disorders. ^{6 7 8 9 10}

Who Is on the Research Team?

Lisa Goffman, PhD

Principal Investigator

Father Flanagan's Boys' Home

Are You a Good Fit for This Trial?

This trial is for toddlers with no medical or developmental concerns, normal speech, social, and motor development, dominant exposure to English from infancy, normal hearing, and expressive vocabulary above the 10th percentile. Toddlers with hearing or intellectual impairments, autism, reported developmental disorders or significant motor impairment cannot participate.

Inclusion Criteria

My toddler has no medical or developmental issues, according to our doctor.

My child has been mainly exposed to English since birth, according to my observations.

Toddlers should have normal language, speech, social, and motor development based on their parents' reports.

Exclusion Criteria

I do not have significant problems with movement.

I do not have a history of developmental, speech, language, or hearing disorders.

You will be excluded if you have trouble hearing.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Training

Participants are exposed to phonological and morphological sequence learning tasks to assess sensitivity to pattern types

4-6 weeks

Generalization

Participants are tested on their ability to generalize learned patterns to new nonwords

3-5 minutes

Follow-up

Participants are monitored for retention of learned patterns and any developmental changes

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Sensitivity to phonological rules & referents FR: Toddlers
• Sensitivity to phonological rules & referents OR: Toddlers
• Sensitivity to phonological rules & referents: Toddlers

Trial Overview The study tests if there's a link between morphological and phonological deficits in language learning by observing toddlers' sensitivity to phonological rules. It aims to improve assessments and interventions for children with developmental language disorder (DLD) or specific language impairment (SLI).

How Is the Trial Designed?

Group I: Sensitivity to phonological rules & referents OR: Toddlers Experimental Treatment 1 Intervention

OR condition

Group II: Sensitivity to phonological rules & referents FR: Toddlers Experimental Treatment 1 Intervention

Family Resemblance condition

Who Is Running the Clinical Trial?

Father Flanagan's Boys' Home

Lead Sponsor

Trials

14

Recruited

1,600+

University of Arizona

Lead Sponsor

Trials

545

Recruited

161,000+

Boys Town

Collaborator

The University of Texas at Dallas

Collaborator

Trials

71

Recruited

108,000+

Published Research Related to This Trial

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]

Nine-month-old infants can learn and recognize specific phonological patterns in their native language, demonstrating their ability to extract new sound rules from fluent speech.

The study found that while infants can rapidly learn these patterns, the ease of acquisition varies, indicating that some phonological regularities are more accessible for them to grasp than others.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Pattern induction by infant language learners. Saffran, JR., Thiessen, ED.[2019]

The article outlines a pattern-based approach to assess and treat phonological disorders in children, utilizing phonological processes to analyze and improve speech patterns.

A case study demonstrates the effectiveness of this approach, highlighting how targeted interventions can be structured using identified phonological processes to enhance speech development.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Pattern-based approaches to phonological therapy. Stoel-Gammon, C., Stone-Goldman, J., Glaspey, A.[2004]

Children with developmental language disorder (DLD) demonstrated significant deficits in producing rhythmic sequences, showing less accuracy and more variability compared to typically developing peers, based on a study involving 57 children aged 4 to 5.

The findings suggest that the difficulties in rhythmic grouping in children with DLD are linked to cognitive impairments in organizing rhythmic events rather than motor skills, highlighting the importance of rhythmic organization in both language and music for diagnosis and intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Children With Developmental Language Disorder Show Deficits in the Production of Musical Rhythmic Groupings. Kreidler, K., Vuolo, J., Goffman, L.[2023]

The study found that infants who demonstrated a mature auditory response to pitch changes were also able to recognize linguistic rules, indicating a strong link between basic auditory processing and language learning.

In adults, those who successfully learned linguistic rules showed enhanced auditory processing for pitch, suggesting that effective auditory functions are crucial for both infants and adults in acquiring language skills.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Auditory perception at the root of language learning. Mueller, JL., Friederici, AD., Männel, C.[2021]

In a study involving 4 children aged 3 to 5 years, two different phonological treatment procedures led to significant improvements in their speech, with marked changes observed in their phonological systems within just 2.5 months.

Both treatment methods were effective in eliminating up to three phonological processes, supporting the idea that addressing phonological processes can enhance articulation remediation and that phonological acquisition occurs gradually.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Clinical application of two phonologically based treatment procedures. Tyler, AA., Edwards, ML., Saxman, JH.[2019]

Infants at familial risk of dyslexia showed a deficit in implicit sequential learning, as they could not distinguish between grammatical and ungrammatical strings in an artificial language, unlike typically developing infants.

This study suggests that difficulties in tracking non-adjacent dependencies in language may contribute to the development of dyslexia, highlighting the importance of implicit learning in language acquisition.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Non-adjacent dependency learning in infants at familial risk of dyslexia. Kerkhoff, A., De Bree, E., De Klerk, M., et al.[2019]

Infants can learn sound patterns that involve local sequential dependencies, which are challenging for adults, highlighting a unique aspect of early language acquisition.

Children with developmental language disorder (DLD) struggle with learning sequential dependencies, which affects their ability to acquire words and grammar, but they can still learn patterns based on stored forms, indicating a specific area of impairment in language learning.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A developmental account of the role of sequential dependencies in typical and atypical language learners. Goffman, L., Gerken, L.[2023]

Toddlers' ability to learn new words is influenced by their exposure to novel phonological patterns, as shown in a study with 41 two-year-olds who were familiarized with new words before learning label-object pairs.

Children with smaller vocabularies were able to learn all new word pairings, while those with larger vocabularies only learned words that matched the new phonological patterns, indicating that phonological knowledge plays a significant role in word learning.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Phonological Learning Influences Label-Object Mapping in Toddlers. Breen, E., Pomper, R., Saffran, J.[2020]

Phonological complexity in language input can significantly influence language learning in children with functional phonological delays, suggesting that more complex sounds may enhance their learning process.

The review emphasizes the importance of selecting target sounds for treatment based on linguistic complexity, which can lead to better generalization of language skills in children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Phonological complexity and language learnability. Gierut, JA.[2022]

The study involved three related experiments with 6 children who had phonological disorders, focusing on how their productive phonological knowledge affects their ability to generalize learning.

Results showed that children's understanding of their own sound system significantly influenced their generalization learning, with better outcomes when treatment was tailored to their specific level of phonological knowledge.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A functional analysis of phonological knowledge and generalization learning in misarticulating children. Gierut, JA., Elbert, M., Dinnsen, DA.[2019]

In a study involving nine children aged 3 to 5 with phonological disorders, different learning patterns emerged despite identical training on misarticulated sounds, highlighting variability in how children process phonological knowledge.

The findings suggest that children's phonological knowledge may be represented in ways that differ from adult norms, which has important implications for clinical assessments and interventions in speech therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Generalization patterns associated with training least phonological knowledge. Williams, AL.[2019]

Citations

1. 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 ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10764452/

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 ...

3. tandfonline.com tandfonline.com/doi/full/10.1080/02699206.2025.2568701

Full article: Longitudinal relations between phonological ... We conducted a growth curve analysis on outcome measures for phonological and grammatical complexity and accuracy. Our results show that the children with DLD ...

4. pubs.asha.org pubs.asha.org/doi/abs/10.1044/2021_LSHSS-21-00004

The “Sound of Silence”: Sensitivity to Silent Letters in ... Repeated-measures ANOVA showed that children with DLD produced significantly more errors on silent letters than did both control groups. Both control groups ...

5. asha.org asha.org/practice-portal/clinical-topics/articulation-and-phonology/?srsltid=AfmBOopUi9O7z0Jn8CkJ9Za8VRzdBGRvKOTV3uzNe9ca_luAmU7RLu-L

Speech Sound Disorders: Articulation and Phonology Poor speech sound production skills in kindergarten children have been associated with lower literacy outcomes, especially in children with concomitant language ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9987562/

Speech-language disorder severity, academic success ... Research points to negative associations between educational success, socioemotional functioning, and the severity of symptoms in some speech-language ...

7. withpower.com withpower.com/trial/phase-disease-7-2020-4c4b9

Phonological Pattern Learning for Language Disorder in Toddlers The research does not provide specific safety data for the phonological pattern learning treatment in toddlers, but it does not report any adverse effects in ...

8. mdpi.com mdpi.com/2076-328X/15/9/1234

Developmental Language Disorder and Risk of Dyslexia ... Many studies suggest that children with Dyslexia may also struggle with oral language skills, while those with DLD may also face challenges in word decoding.

9. apps.asha.org apps.asha.org/EvidenceMaps/Maps/LandingPage/82816e2d-0cc2-4dfa-948b-369175088a12

Spoken Language Disorders For specific language skills, sensitivity ranged between 56%-94% (median of 86%) and specificity between 58%-90% (median of 70%). Three ...

10. clinicaltrials.gov clinicaltrials.gov/study/NCT04558541

Study Details | NCT04558541 | A Developmental ... Assess whether children with developmental language disorder (DLD) are sensitive to different phonological patterns that are predicted to align with development ...