Sentence Recast for Language Developmental Disorders

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: University of Houston

Disqualifiers: Sensory-motor concerns, psychiatric disorders

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

Compensation: Varies

Number of Visits: Unknown

Duration: 9 weeks

40 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to help young bilingual children with Developmental Language Disorder (DLD) improve their language skills. Researchers are exploring whether therapy in one language (Spanish or English) or a mix of both languages proves more effective. The treatment uses a technique called Sentence Recast, where a speech therapist aids children by repeating sentences in a slightly different form to enhance understanding. The trial seeks emergent bilingual children, aged 4 to 6, who already speak simple sentences in Spanish or English and have experienced language challenges noted by parents or schools. Participants should also have basic hearing abilities and average nonverbal intelligence. As an unphased trial, this study offers a unique opportunity for children to receive innovative language support tailored to their bilingual needs.

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 prior data suggests that this method is safe for children with Developmental Language Disorder?

Research has shown that Sentence Recast therapy is generally safe and well-tolerated for children with language developmental disorders. Studies have found that this therapy helps children learn grammar more effectively than other methods. A trained speech language pathologist (SLP) repeats a child's sentence in a corrected form, aiding the child in learning the correct structure.

Although specific safety details for Sentence Recast are not provided in the studies, the therapy does not involve surgery or medication, suggesting a low risk of side effects. Past studies have used it successfully without reports of negative outcomes. This makes it a promising option for improving language skills in children with developmental language disorders, including those who speak more than one language. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about Sentence Recast for language developmental disorders because it offers a unique bilingual approach. Unlike traditional monolingual therapies, which typically focus on a single language, this method involves two strategies: monolingual therapy, conducted solely in the child's dominant language, and interleaved therapy, which actively incorporates the child's non-dominant language. This approach aims to enhance language flexibility and engagement by capturing the child's attention and varying linguistic structures. Researchers hope this method will improve language skills more effectively than current standard treatments by making therapy sessions more interactive and personalized.

What evidence suggests that this trial's treatments could be effective for Developmental Language Disorder?

Research has shown that conversational recast treatment helps children with language disorders learn grammar faster and more effectively than other methods. Studies found that recasting, which involves repeating a child's sentence with corrections, outperformed methods that did not use this technique. Early, intensive treatment improved young children's ability to understand and use speech sounds. This trial will compare two approaches: monolingual therapy, where children receive recast therapy in their dominant language, and interleaved therapy, where children receive recast therapy in both their dominant and non-dominant languages. This suggests that both single-language and mixed-language recast therapies could help bilingual children with Developmental Language Disorder improve their language skills. ^{1 2 6 7 8}

Are You a Good Fit for This Trial?

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.

Exclusion Criteria

My child does not have major sensory-motor or psychiatric issues.

Timeline for a Trial Participant

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

What Are the Treatments Tested in This Trial?

Interventions

• Sentence Recast

Trial Overview 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.

How Is the Trial Designed?

Group I: Monolingual therapy Experimental Treatment 1 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 therapy Experimental Treatment 1 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.

Who Is Running the Clinical Trial?

University of Houston

Lead Sponsor

Trials

155

Recruited

48,600+

National Institute on Deafness and Other Communication Disorders (NIDCD)

Collaborator

Trials

377

Recruited

190,000+

University of Delaware

Collaborator

Trials

167

Recruited

25,700+

Published Research Related to This Trial

In a study involving 47 preschool children with developmental language disorder, spontaneous repetition of clinician-modeled morphemes was found to significantly correlate with improved production of those morphemes during treatment.

Children who frequently and correctly repeated targeted morphemes not only showed better performance in using those forms but also had larger treatment effect sizes, suggesting that these repetitions may help them learn and master language structures more effectively.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Role of Spontaneous Repetitions During Treatment of Morphosyntactic Forms for Children With Developmental Language Disorder. Nicholas, K., Plante, E., Gómez, R., et al.[2023]

The study involved 26 children (13 with developmental language disorders and 13 typically developing) and found that both groups were more accurate in producing subject-focused relative clauses compared to object-focused ones.

Children with developmental language disorders required significantly more practice to achieve consistent performance in producing both types of relative clauses, indicating that while the combined priming and recasting approach is promising, additional support may be necessary for these learners.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

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. Wada, R., Gillam, SL., Gillam, RB.[2021]

Enhanced conversational recast treatment effectively improved the correct usage of targeted morphemes in preschoolers with developmental language disorder, regardless of whether they received treatment individually or in a small group setting (n = 20).

However, children in the group condition did not show significant improvement in using their partner's target morpheme, suggesting that simply hearing the target modeled is not enough for learning; active engagement with the recast is crucial for effective treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Individual Versus Small Group Treatment of Morphological Errors for Children With Developmental Language Disorder. Eidsvåg, SS., Plante, E., Oglivie, T., et al.[2023]

Integrating speech and grammatical interventions using recast treatment showed positive effects on speech-comprehensibility in 4 out of 6 children with Down syndrome, indicating a potential benefit of this combined approach.

Five out of 6 participants demonstrated growth in mean length of utterance (MLU) during generalization sessions, suggesting that this method may effectively enhance both speech clarity and grammatical skills in children with Down syndrome.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Simultaneous treatment of grammatical and speech-comprehensibility deficits in children with Down syndrome. Camarata, S., Yoder, P., Camarata, M.[2022]

In a study of 105 preschool-age children with developmental language disorder, specific pre-intervention test scores (SPELT-P 2 and Peabody Picture Vocabulary Test) were found to predict how well children responded to Enhanced Conversational Recast treatment for grammatical deficits.

Children with a SPELT-P 2 score above 75 and a high Peabody score (> 100) showed the greatest improvement, while those with a SPELT-P 2 score below 75 had the least benefit, highlighting the importance of individual differences in treatment response.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Predictors of Treatment Response for Preschool Children With Developmental Language Disorder. Kapa, LL., Meyers-Denman, C., Plante, E., et al.[2023]

A systematic review and meta-analysis of 35 articles found strong support for the effectiveness of conversational recasts in improving grammatical development in children with language impairments, with average effect sizes of 0.96 for proximal measures and 0.76 for distal measures.

Despite variability in study quality, the evidence suggests that recasts can significantly enhance grammatical skills, indicating they are a beneficial component of language intervention strategies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The efficacy of recasts in language intervention: a systematic review and meta-analysis. Cleave, PL., Becker, SD., Curran, MK., et al.[2022]

Children with developmental language disorder who take longer than 10 days to correctly answer treatment items are unlikely to benefit from Enhanced Conversational Recast therapy, indicating a need for timely assessment of treatment effectiveness.

The study found that generalization of language skills after treatment is closely linked to accuracy achieved during treatment, but achieving less than 100% accuracy during therapy does not guarantee future generalization, suggesting that clinicians should aim for consistent high accuracy before concluding treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Data-Informed Guideposts for Decision Making in Enhanced Conversational Recast Treatment. Hall, J., Plante, E.[2022]

Conversational recast treatment was found to be more effective than imitative treatment for helping both children with specific language impairment (SLI) and those with normal language skills acquire new language targets more quickly.

Children with SLI can learn grammatical structures as efficiently as their language-normal peers when given tailored language input that matches their developmental levels, suggesting that effective treatment strategies can bridge the gap in language acquisition.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of imitative and conversational recasting treatment on the acquisition of grammar in children with specific language impairment and younger language-normal children. Nelson, KE., Camarata, SM., Welsh, J., et al.[2019]

In a study involving 21 children with specific language impairment, both imitative and conversational recast interventions were effective in teaching grammatical morphemes and complex sentences, but conversational methods required fewer repetitions for children to use language spontaneously.

Conversational-interactive interventions not only led to quicker transitions from prompted to spontaneous speech but also resulted in a greater number of spontaneous language productions compared to imitative interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparison of conversational-recasting and imitative procedures for training grammatical structures in children with specific language impairment. Camarata, SM., Nelson, KE., Camarata, MN.[2019]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC4450887/

The Efficacy of Recasts in Language Intervention Two early studies found that recasting produced better results than interventions in which child utterances were not recast (Bradshaw, Hoffman, & Norris, 1998; ...

2. pubs.asha.org pubs.asha.org/doi/abs/10.1044/1058-0360.0803.273

Sentence Recast Use by Parents of Children With Typical ... Specifically, parents of children with SLI have been shown to produce fewer recasts than do parents of younger children with TL. Because recasts have been shown ...

3. sciencedirect.com sciencedirect.com/science/article/pii/S0021992423000266

Effects in language development of young children with ... This study tests the hypothesis that children with LD show progress in their receptive and expressive language during intervention.

4. withpower.com withpower.com/trial/phase-language-development-disorders-10-2024-7e097?condition=&query=Language+Therapy&overallStatus=Recruiting&hasNoPlacebo=false

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.

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

Efficacy of the Treatment of Developmental Language Disorder Results. Early intensive intervention in three- and four-year-old children has a positive effect on phonological expressive and receptive skills ...

6. pubs.asha.org pubs.asha.org/doi/abs/10.1044/2023_JSLHR-22-00452

Recast Therapy for Treating Syntax in Bilingual Children ... The purpose of this study is to examine the feasibility of the delivery of complex syntax recast therapy via telepractice to Spanish–English bilingual children.

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11903015/

What Matters When Providing Conversational Recast ... Here, we directly compare multiple variations of conversational recasting to determine how modifications to delivery and target impact treatment outcomes.

8. mdpi.com mdpi.com/2076-3425/11/3/407

Efficacy of the Treatment of Developmental Language ... T3 = 6 months after treatment, Primary outcomes: Expressive and receptive language (CASL [119]); backward masking. Secondary outcomes: sentence comprehension ...