Conversational Recasting for Language Developmental Disorders

Overseen By Rebecca Vance, MS

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: University of Arizona

Disqualifiers: Other handicapping conditions, other disorders, others

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

Compensation: Varies

Number of Visits: 6

Duration: 6 weeks

32 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores the best ways to teach grammar to preschool children with developmental language disorders. Researchers are testing two methods to determine which helps children learn grammar more effectively: starting with grammar they sometimes use correctly or starting with grammar they rarely use. Children will receive one-on-one sessions for six weeks, with progress checks throughout and after the treatment. This trial may suit a child who is a native English speaker, has passed a hearing screening, and shows signs of difficulty with grammar. The primary treatment being tested is Conversational Recasting, a therapy focused on correcting morphological errors in speech. As an unphased trial, this study offers a unique opportunity to contribute to educational research and potentially improve language teaching methods for children.

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 teaching method is safe for children with developmental language disorders?

Research has shown that conversational recasting, a technique to assist children with language disorders, is generally safe. This method involves repeating a child's words with correct grammar, aiding in their learning of proper language use over time.

Studies have found that conversational recasting is more effective than some other methods, such as imitative treatment, for children with specific language issues. However, these studies primarily focus on effectiveness rather than risks. No specific evidence indicates significant negative effects from using conversational recasting.

This trial is in the "Not Applicable" phase, meaning the treatment is still being tested for effectiveness, not safety. While the treatment is new and promising, information on negative outcomes remains limited. However, its use in educational settings suggests it is generally considered safe. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about conversational recasting for language developmental disorders because it offers a personalized approach to language learning. Unlike traditional speech therapy, which often employs a one-size-fits-all method, conversational recasting tailors treatment based on each child's current grammatical abilities. This method emphasizes natural language use, helping children improve their grammar by focusing on forms they struggle with and gradually advancing to more challenging ones. By targeting specific grammatical forms and adapting as the child progresses, conversational recasting has the potential to be more effective and engaging than standard interventions.

What evidence suggests that Conversational Recasting might be an effective treatment for language developmental disorders?

Research has shown that conversational recasting effectively helps children develop their grammar. Studies indicate that children often learn grammar faster with this method. Adults repeat a child's incorrect sentence in the correct way, aiding the child in learning the correct form. This trial will compare two approaches: the "Hard first" arm, where children receive treatment for a grammatical form used accurately less than 30% of the time, and the "Easy first" arm, where treatment targets a grammatical form used correctly at least 60% of the time. This technique has improved language skills in children with language development disorders, although its effectiveness can vary depending on the specific grammar being taught. Overall, conversational recasting has a strong track record for helping children learn grammar. ^{1 6 7 8 9}

Are You a Good Fit for This Trial?

This trial is for native English-speaking preschool children aged 4-6 with developmental language disorders. They must be able to attend daily treatment, have normal hearing, specific scores on language and cognition tests, clear speech articulation, and frequent grammar mistakes that need correction.

Inclusion Criteria

Articulations skills sufficient to judge use of language targets

I am a native English speaker.

Passed a pure-tone hearing screening

Exclusion Criteria

Enrolled in outside treatment

I show signs of having other health conditions.

Parent report of other handicapping conditions

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Children receive one-on-one behavioral treatment focusing on grammatical forms over a six-week period

6 weeks

5 sessions per week

Follow-up

Participants are monitored for retention of trained and untrained grammatical forms approximately six weeks after treatment ends

6 weeks

1 session

What Are the Treatments Tested in This Trial?

Interventions

• Conversational recasting

Trial Overview The study is testing conversational recasting as a teaching method to help children learn parts of grammar they struggle with. Over six weeks, the effectiveness of starting with easier or harder grammatical forms will be compared by assessing the children's use of these forms during and after treatment.

How Is the Trial Designed?

Group I: Easy first Experimental Treatment 1 Intervention

Children are treated for an emergent grammatical form that is used correctly at least 60% during three pre-treatment probe sessions. This form is treated until children generalize it's use an average of 90% or more across 3 probe sessions. Their treatment target is then switched to a grammatical form that is used less than 30% correct across 3 pre-treatment probe sessions.

Group II: Hard first Active Control 1 Intervention

Children are treated for a grammatical form that is used accurately less than 30% of the time during 3 pre-treatment probe sessions. This form is treated until children generalize it's use an average of 90% or more across 3 probe sessions. Their treatment target is then switched to a grammatical form that is used less than 30% correct across 3 pre-treatment probe sessions.

Who Is Running the Clinical Trial?

University of Arizona

Lead Sponsor

Trials

545

Recruited

161,000+

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]

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 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]

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]

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]

Noncorrective recasts during therapy sessions significantly predict both short-term and long-term improvements in children's use of the target grammatical form, indicating their effectiveness in language learning.

Recasts of subjectless sentences were linked to poorer outcomes, suggesting that the type of utterance matters in the recasting process and should be considered in clinical practices.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Within-treatment factors as predictors of outcomes following conversational recasting. Hassink, JM., Leonard, LB.[2021]

Citations

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

What Matters When Providing Conversational Recast ... Conversational recasting treatment is generally effective. However, different versions of this treatment and different targets may yield different outcomes ...

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

The Efficacy of Recasts in Language Intervention This systematic review and meta-analysis critically evaluated the research evidence on the effectiveness of conversational recasts in grammatical development

3. pubs.asha.org pubs.asha.org/doi/abs/10.1044/2024_AJSLP-24-00138

What Matters When Providing Conversational Recast ... Conversational recasting treatment is generally effective. However, different versions of this treatment and different targets may yield different outcomes ...

4. pubs.asha.org pubs.asha.org/doi/10.1044/2023_LSHSS-23-00049

Less Versus More: The Effect of Recast Length in ... This study tests the potential effect of clinicians' recast length on child learning during a recast treatment.

5. researchgate.net researchgate.net/publication/14359981_Effects_of_Imitative_and_Conversational_Recasting_Treatment_on_the_Acquisition_of_Grammar_in_Children_With_Specific_Language_Impairment_and_Younger_Language-Normal_Children

(PDF) Effects of Imitative and Conversational Recasting ... The results indicated: (a) Target acquisition was more rapid under conversational recast treatment for both groups. (b) This outcome held for targets absent ...

6. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/39761110/

What Matters When Providing Conversational Recast ... These conditions resulted in probe performance that was between 47% and 84% worse than performance of children who received enhanced ...

7. 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.

8. withpower.com withpower.com/trial/phase-language-disorders-8-2021-86c12?condition=&query=IDEAL2+Intervention&overallStatus=Recruiting&hasNoPlacebo=false

Recast Therapy vs. Book Reading for Developmental ... Conversational recast treatment was found to be more effective than imitative treatment for helping both children with specific language impairment (SLI) and ...

9. researchgate.net researchgate.net/publication/384535901_What_Matters_When_Providing_Conversational_Recast_Treatment_A_Multilevel_Modeling_Analysis

What Matters When Providing Conversational Recast ... These conditions resulted in probe performance that was between 47% and 84% worse than performance of children who received Enhanced ...