Enhanced Conversational Recast for Childhood Language Disorders

Overseen By Elena Plante, PhD

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: University of Arizona

Disqualifiers: Hearing loss, Intellectual disability, others

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

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 10

Duration: 6 weeks

24 Participants Needed

Trial Summary

What is the purpose of this trial?

This study will enroll children between the ages of 4 and 6 years of age who exhibit significant difficulty developing language skills without any other handicapping conditions. Children will receive standardized language, hearing, and cognitive testing to confirm a diagnosis of developmental language disorder. Children will be enrolled in a half-day summer camp program for six weeks during which they will receive treatment designed to improve their language skills. Children will be seen again approximately six weeks after the end of treatment to determine how much learning they have retained.

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 data supports the effectiveness of the Enhanced Conversational Recast treatment for childhood language disorders?

Research shows that Enhanced Conversational Recast treatment helps improve grammar in children with language disorders, especially when they have certain pre-intervention test scores. It works well for both individual and small group settings, but children need to reach 100% accuracy in treatment to fully benefit. ^{1 2 3 4 5}

Is Enhanced Conversational Recast therapy safe for children with language disorders?

The studies on Enhanced Conversational Recast therapy focus on its effectiveness for language disorders in children, but they do not report any safety concerns, suggesting it is generally safe for use in this population. ^{1 3 4 6 7}

What makes Enhanced Conversational Recast treatment unique for childhood language disorders?

Enhanced Conversational Recast treatment is unique because it focuses on improving grammatical development through conversational recasts, which involve repeating a child's incorrect sentence in a corrected form. This treatment is flexible, allowing for both individual and small group settings, and emphasizes the importance of attention to the recast or expressive practice to achieve significant gains. ^{1 3 5 7 8}

Eligibility Criteria

This trial is for children aged 4-6 who struggle with language development and have been diagnosed with a developmental language disorder. They should not have other conditions that could affect learning. Participants will be tested to confirm their diagnosis before joining.

Inclusion Criteria

Nonverbal cognitive scores consistent with normal-range intellectual functioning

Language scores consistent with a developmental language disorder

Exclusion Criteria

Intellectual disability

Other handicapping conditions

I have hearing loss.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1 week

1 visit (in-person)

Baseline Assessment

Baseline assessment of morpheme use for potential treatment targets over three days

1 week

3 visits (in-person)

Treatment

Children receive treatment designed to improve language skills through child-friendly activities for six weeks

6 weeks

5 visits per week (in-person)

Follow-up

Participants are monitored for retention of learning approximately six weeks after the end of treatment

6 weeks

1 visit (in-person)

Treatment Details

Interventions

• Enhanced Conversational Recast

Trial Overview The study tests the 'Enhanced Conversational Recast' treatment, which aims to improve language skills in children with language disorders. It involves a six-week half-day summer camp program followed by an assessment six weeks later to measure retained learning.

Participant Groups

Group I: Grammar treatment including semantic support Experimental Treatment 1 Intervention

Children receiving grammatical treatment will also receive a simple explanation concerning the meaning of verbs used to elicit grammatical forms.

Group II: Grammatical treatment excluding semantic support Active Control 1 Intervention

Children receiving grammatical treatment will not receive any explanation concerning the meaning of verbs used to elicit grammatical forms.

Enhanced Conversational Recast is already approved in United States for the following indications:

Approved in United States as Enhanced Conversational Recast for:

• Developmental Language Disorder

Who Is Running the Clinical Trial?

University of Arizona

Lead Sponsor

Trials

545

Recruited

161,000+

Findings from Research

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]

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]

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]

The study demonstrated that delivering complex syntax recast therapy via telepractice is feasible for Spanish-English bilingual children with developmental language disorders, with high treatment fidelity and excellent participant attendance.

Preliminary results indicate that this therapy effectively improved the children's use of conditional adverbs in both languages, suggesting that recast therapy can benefit bilingual children by enhancing their language skills across both Spanish and English.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Recast Therapy for Treating Syntax in Bilingual Children With Developmental Language Disorder: A Feasibility and Early Efficacy Study Examining the Role of Language of Intervention on Outcomes. Castilla-Earls, A., Owen Van Horne, A.[2023]

Enhanced Conversational Recast Treatment effectively improves preschool children's use of targeted grammatical forms, with 20 out of 26 children showing clinically meaningful responses.

The length of the clinician's recast (short vs. extended) did not significantly impact the children's progress, suggesting that clinicians do not need to focus on recast length to achieve effective treatment outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Less Versus More: The Effect of Recast Length in Treatment of Grammatical Errors. Sweeney, L., Plante, E., Mettler, HM., 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]

References

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

Data-Informed Guideposts for Decision Making in Enhanced Conversational Recast Treatment. [2022]

2. United States 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. [2019]

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

Individual Versus Small Group Treatment of Morphological Errors for Children With Developmental Language Disorder. [2023]

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

Predictors of Treatment Response for Preschool Children With Developmental Language Disorder. [2023]

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

The efficacy of recasts in language intervention: a systematic review and meta-analysis. [2022]

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

Recast Therapy for Treating Syntax in Bilingual Children With Developmental Language Disorder: A Feasibility and Early Efficacy Study Examining the Role of Language of Intervention on Outcomes. [2023]

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

Less Versus More: The Effect of Recast Length in Treatment of Grammatical Errors. [2023]

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

Within-treatment factors as predictors of outcomes following conversational recasting. [2021]