Grammar Treatment for Language Developmental Disorders

(DLDTreatment Trial)

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

150 Participants Needed

Trial Summary

What is the purpose of this trial?

The goal of this project is to compare the relative effectiveness of two novel treatments to improve the knowledge of the passive sentence structure of school-age (8-11-year-old) children with developmental language disorder (DLD). Treatment 1 is an implicit approach to promoting children's automatic grammar learning and Treatment 2 is a more conventional explicit approach in which participants are taught the rules underlying the grammar. Treatment 1 involves children listening to an examiner produce a target sentence 20 times during each training session while describing a picture. The children will then see a picture and be asked to describe the action taking place. Treatment 2 involves children listening to an examiner describe the action occurring in a picture using a sentence pattern targeted to the child's deficit. The child will then be asked who did the action in the sentence and who received the action, after which the examiner will provide specific feedback about why the child's response was correct or incorrect. The expectation is that over a short period children will begin to use their targeted sentence pattern after hearing the examiner produce it many times. Children will complete four outcome measures (syntactic knowledge, sentence comprehension, sentence chunking, narrative comprehension/ production) prior to treatment, immediately after treatment, and five weeks after treatment. Children will be randomly assigned to one of the two treatments. Both treatments will be delivered 20 times over 10 weeks. The investigators anticipate that the children receiving Treatment 1 will show stronger gains in knowledge across the four outcome measures.

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.

What data supports the effectiveness of the Grammar Treatment for language developmental disorders?

Research shows that explicit grammar interventions, like the SHAPE CODING system, significantly improve past tense production in children with developmental language disorders. These improvements were maintained for weeks after the intervention, suggesting the treatment is effective for enhancing specific grammar skills. ^{1 2 3 4 5}

How does the Grammar Treatment differ from other treatments for language developmental disorders?

The Grammar Treatment is unique because it uses an explicit intervention approach, combining metalinguistic training and grammar facilitation techniques, such as the SHAPE CODING system, to improve specific grammatical skills like past tense marking in children with developmental language disorder. This approach is distinct from other treatments as it focuses on systematic cueing and repeated practice to enhance grammatical learning. ^{2 4 5 6 7}

Eligibility Criteria

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

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]

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]

References

1. United States pubmed.ncbi.nlm.nih.gov

Focused Stimulation Intervention in 4- and 5-Year-Old Children With Developmental Language Disorder: Exploring Implementation in Clinical Practice. [2020]

2. United States pubmed.ncbi.nlm.nih.gov

The Effectiveness of Two Grammar Treatment Procedures for Children With SLI: A Randomized Clinical Trial. [2018]

3. Ireland pubmed.ncbi.nlm.nih.gov

Effect of different treatments in young children with language problems. [2015]

4. United States 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. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Explicit Grammar Intervention in Young School-Aged Children With Developmental Language Disorder: An Efficacy Study Using Single-Case Experimental Design. [2020]

6. United States pubmed.ncbi.nlm.nih.gov

Five overarching factors central to grammatical learning and treatment in children with developmental language disorder. [2020]

7. United States pubmed.ncbi.nlm.nih.gov

The Changing View of Input in the Treatment of Children With Grammatical Deficits. [2022]