Recast Therapy vs. Book Reading for Developmental Language Disorder

Recruiting at 1 trial location

Overseen By Amanda O Van Horne, PhD CCC-SLP

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: University of Delaware

Disqualifiers: Autism, Sensory-motor, Psychiatric, others

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

Compensation: Varies

Number of Visits: 19

Duration: 10 weeks

160 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to find better ways to help children with Developmental Language Disorder (DLD), a condition that can lead to lifelong challenges in school and work due to difficulties with grammar. Researchers are testing two treatments: Recast Therapy, which involves repeating sentences with corrections, and Syntax Stories, which use books designed to teach specific sentence structures. Either a professional speech therapist or a trained caregiver will deliver both methods to determine which approach works best under typical conditions. Children who might be a good fit for this trial are those aged 4-9, primarily English-speaking, with a confirmed DLD diagnosis, and who do not have autism or significant sensory-motor or psychiatric issues.

As an unphased trial, this study offers a unique opportunity to contribute to innovative research that could improve language support for children with DLD.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that conversational recasting, a key component of Recast Therapy, is generally effective and usually free of negative side effects. This treatment involves repeating and expanding on children's speech to enhance their language skills. Studies have not identified any safety concerns with this method. However, specific safety data for Recast Therapy remains limited, indicating it is well-tolerated but not extensively studied for negative effects.

Syntax Stories involves reading specially designed books to children to aid their language development. Although specific safety data for Syntax Stories is also lacking, its nature as a storytelling activity suggests it poses minimal safety risks.

Both treatments appear well-tolerated, as they involve natural activities like speaking and reading. While specific safety data is limited, the non-invasive and educational nature of these treatments suggests they are safe for children with developmental language disorder. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores innovative ways to address Developmental Language Disorder (DLD) through Recast Therapy and Syntax Stories. Unlike traditional speech therapy methods, Recast Therapy involves either clinicians or caregivers providing immediate feedback to children by correctly reformulating their speech, which may enhance language learning through active engagement. Syntax Stories, on the other hand, use specially scripted books to target specific syntax improvements, offering a structured yet creative approach to language development. This trial seeks to understand the effectiveness of involving caregivers directly in the therapy process, potentially increasing accessibility and consistency of treatment at home. By comparing these methods, researchers aim to determine the best strategies for improving language skills in children with DLD, potentially offering new avenues for treatment beyond conventional speech therapy.

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

This trial will compare Recast Therapy with Syntax Stories for children with Developmental Language Disorder (DLD). Studies have shown that Recast Therapy, one of the treatments in this trial, effectively helps children improve their grammar. This therapy involves correcting a child's sentence by repeating it correctly, allowing them to learn proper grammar by example. Research suggests that different versions of this therapy can either aid or hinder learning, so customizing the approach for each child is important.

Syntax Stories, another treatment option in this trial, use specially written books to teach sentence structure. Research shows they positively impact language skills. These stories are designed to make learning grammar more engaging. While the benefits are clearer for areas like vocabulary, this method offers a fun way to boost language abilities. ^{1 2 6 7 8}

Are You a Good Fit for This Trial?

This trial is for children aged 4-9 with Developmental Language Disorder (DLD), primarily English-speaking, and without autism or significant sensory-motor or psychiatric disorders. They must have a DLD diagnosis confirmed by specific language tests, hearing within the typical range, and caregivers willing to participate in training.

Inclusion Criteria

I am willing to undergo caregiver training if needed.

My child is between 4 and 9 years old and has DLD.

You can form basic sentences using a subject, verb, and object, and your average sentence length is at least 2.5 words per sentence.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2 weeks

1 visit (in-person)

Treatment

Children receive recast therapy or illustrated syntax stories provided by clinicians or caregivers over a 10-week period

10 weeks

16 visits (in-person) for clinician-provided therapy; caregiver-provided therapy scheduled at convenience

Follow-up

Participants are monitored for safety and effectiveness after treatment

2-4 weeks

2 visits (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• Recast Therapy
• Syntax Stories

Trial Overview The study is testing two treatments for DLD: Recast Therapy where clinicians repeat children's phrases with grammatical improvements, and Syntax Stories which involves reading specially designed stories to improve grammar. The goal is to find feasible methods that can be used in typical service conditions.

How Is the Trial Designed?

Group I: Recast Therapy Provided by a Caregiver Experimental Treatment 1 Intervention

Caregivers will receive two training sessions on how to provide recast therapy and demonstrate their skill at providing recast therapy with support from the clinician. Caregivers will then provide recast therapy at a rate of 1 recast per minute to their children for a minimum of 16 hrs (960 exposures) scheduled at their own convenience.

Group II: Recast Therapy Provided By Clinician Experimental Treatment 1 Intervention

Children will be exposed to recasts at a rate of 1/minute. Treatment will be provided 2x/week for 8 weeks for a total of 16 visits (960 recasts). 2 additional weeks are allocated for make up visits. Treatment will be provided by a trained, certified, licensed Speech Language Pathologist (SLP).

Group III: Illustrated Syntax Stories Provided by a Caregiver Experimental Treatment 1 Intervention

Caregivers will receive two training sessions on how to provide read illustrated syntax stories to their children and demonstrate their skill at reading these stories with support from the clinician. Caregivers will then read these stories to their children for a minimum of 32 book readings (960 exposures)

Group IV: Illustrated Syntax Stories Provided by Clinician Experimental Treatment 1 Intervention

Children will be listen to books that are specially scripted to promote the use of a particular syntax target. Treatment will be provided 2x/week for 8 weeks for a total of 16 visits (960 exposures), with 2 books read at each visit. 2 additional weeks are allocated for make up visits. Treatment will be provided by a trained, certified, licensed SLP.

Who Is Running the Clinical Trial?

University of Delaware

Lead Sponsor

Trials

167

Recruited

25,700+

National Institute on Deafness and Other Communication Disorders (NIDCD)

Collaborator

Trials

377

Recruited

190,000+

University of Maryland, College Park

Collaborator

Trials

163

Recruited

46,800+

Published Research Related to This Trial

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]

The Play and Language (PAL) intervention, combining play therapy and language facilitation techniques, showed promising results in improving communication skills in preschool children with developmental language disorders (DLD) over a 2-week intensive program involving five participants.

Most children in the study increased their speech intelligibility and vocabulary, while also experiencing a significant reduction in challenging behaviors, with 11 out of 14 behaviors returning to normal levels, indicating the potential effectiveness of this combined approach.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Collaboration Between Child Play Therapy and Speech-Language Pathology: Case Reports of a Novel Language and Behavior Intervention. Loeb, DF., Davis, ES., Lee, T.[2021]

The study demonstrated that three individuals with classic Rett syndrome, aged 15 to 47, were able to learn new communication behaviors using functional assessment and functional communication training methods.

These findings suggest that individuals with Rett syndrome can effectively use voice-output switches to communicate, highlighting the potential for developing evidence-based communication interventions for this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Functional communication training in rett syndrome: a preliminary study. Byiers, BJ., Dimian, A., Symons, FJ.[2014]

In a study involving five children aged 4 to 5 years, explicit referencing of print concepts during shared storybook reading significantly improved their knowledge of these concepts, indicating effective learning strategies for children with language impairments.

The results suggest that incorporating simple, non-evocative referencing strategies into language therapy can enhance literacy skills, providing speech-language pathologists with a practical tool for supporting children's development.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Increasing print awareness in preschoolers with language impairment using non-evocative print referencing. Lovelace, S., Stewart, SR.[2007]

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]

A parent-based shared book reading (SBR) intervention over 8 weeks significantly improved mothers' use of specific conversational strategies, such as Shared Book Handling and Captivating Talking, in 20 mother-child dyads with children who have developmental language disorder (DLD).

Children whose mothers participated in the SBR intervention showed notable increases in engagement and verbal production during reading sessions, indicating that the intervention can enhance communicative behaviors, although further research is needed to explore long-term effects and additional strategies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Impacts of a shared book-reading intervention for Italian-speaking children with developmental language disorder. Lavelli, M., Barachetti, C., Majorano, M., et al.[2020]

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]

Citations

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

What Matters When Providing Conversational Recast ... Conclusions: These results suggest that different variations of conversational recasting facilitate or diminish learning by children with DLD ...

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

What Matters When Providing Conversational Recast ... These results suggest that different variations of conversational recasting facilitate or diminish learning by children with DLD.

3. pubs.asha.org pubs.asha.org/doi/10.1044/2025_JSLHR-24-00885

Optimal Dosage Characteristics of Recasting for ... The purpose of this scoping review was to map and summarize currently available evidence about optimal dosage of recasting for developmental language ...

4. pubs.asha.org pubs.asha.org/doi/10.1044/2023_AJSLP-23-00244

Preparing Student Clinicians to Provide Recast Therapy on ... Recast therapy is a highly effective method of treating grammatical difficulties (Cleave et al., 2015). However, it can be challenging to ...

5. ecrhub.org ecrhub.org/publications/preparing-student-clinicians-provide-recast-therapy-complement-clauses-training

Preparing Student Clinicians to Provide Recast Therapy on ... Results: On average, student clinicians provided 30 targeted recasts to each child during each intervention session. They provided a greater number of and more ...

6. withpower.com withpower.com/trial/phase-language-disorders-7-2023-316a1

Language Intervention for Developmental ... The available research does not provide specific safety data for Language Intervention for Developmental Language Disorder or related treatments like Sentence ...

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

Efficacy of the Treatment of Developmental Language Disorder All of the children showed a reduction in the average number of phonological errors on the HAPP-3 test [90] with no significant differences ...

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 ... This N/A medical study run by University of Delaware is evaluating whether Recast Therapy and Syntax Stories will have tolerable side effects & efficacy for ...