Translating Enhanced Conversational Recast to a Telepractice Setting

Less Versus More: The Effect of Recast Length in Treatment of Grammatical Errors

PURPOSE

Although conversational recast treatment is generally efficacious, there are many ways in which the individual components of the treatment can be delivered. Some of these are known to enhance treatment, others appear to interfere with learning, and still others appear to have no impact at all. This study tests the potential effect of clinicians' recast length on child learning during a recast treatment.

METHOD

Twenty-six preschool children were treated for grammatical errors using Enhanced Conversational Recast Treatment. Half heard recasts of four or fewer words (Short Recast condition), and half heard recasts of five or more words (Extended Recast condition). Outcome measures included generalization of the treated grammatical form, spontaneous use of these forms, change in mean length of utterances in words, and the number of children in each condition who showed a clinically meaningful response.

RESULTS

There was strong evidence of improvements in the use of grammatical forms targeted by the treatment compared with forms that were tracked but not treated. Twenty children (11 in the Short Recast condition and nine in the Extended Recast condition) showed a clinically meaningful response. There was minimal support for the hypothesis that the length of clinician utterance influenced either progress on a grammatical form targeted by the treatment or on the child's mean length of utterance in words.

CONCLUSIONS

The study adds to the evidence for the efficacy of Enhanced Conversational Recast Treatment. However, there is little evidence that clinicians need to regulate the length of the recast they provide to children.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.24653613.

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

PURPOSE

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 and provide preliminary evidence of the efficacy of this approach.

METHOD

Fifteen bilingual children with developmental language disorders were stratified based on language proficiency and randomized to one of three treatment conditions: Spanish only (n = 5), English only (n = 6), or Spanish + English (n = 4). Using a within-subject design, we hypothesized that we could document treatment efficacy based on change in the treated structure in the absence of change in an untreated comparison structure. All 15 children completed ~16 hr of treatment via telepractice and participated in pre- and posttesting of their production of conditional adverbs (treated structure) and subject relative clauses (untreated structure) carried out by a masked assessor.

RESULTS

Analyses included all participants. Treatment fidelity was high, and participant attendance was remarkable, indicating feasibility. Regarding efficacy, recast therapy led to group-level gains on treated syntactic structures that exceeded those observed for the untreated comparison structure. For the 11 children who received therapy in only one language, approximately equal gains were observed in both the treated and untreated languages for conditional adverbials.

CONCLUSIONS

Preliminary evidence suggests that for highly overlapping structures like conditional adverbials, recast therapy is effective and leads to change in both of the child's languages. Larger studies are required to understand how language of administration and proficiency may affect outcomes.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.23739996.

Prologue to the Forum: Speech and Language Tele-Intervention: The Future Is Now

PURPOSE

This prologue introduces the LSHSS Forum: Speech and Language Tele-Intervention: The Future Is Now. The aims of the forum are (a) to report on the process of moving established in-person interventions to virtual delivery and (b) to provide speech-language pathologists (SLPs) with empirically based guidance on designing and implementing tele-interventions, in order to support academic success for school-age children with speech and language needs. The included articles explore the process, benefits, and challenges of providing intervention in speech, language, and literacy domains in a virtual environment with children.

CONCLUSION

Although there are some logistical challenges, established treatments such as those targeting morphosyntax as well as communication partner training can be adapted for successful delivery online. In addition, the forum supports the delivery of an app-based articulation-focused intervention. SLPs report a number of challenges in relation to adapting and delivering interventions through telepractice, and parents express concerns in relation to SLPs' online evaluation of complex speech sound difficulties for children born with cleft lip and palate. Finally, using the principles of Minimal Intervention Needed for Change, a systematic approach to the adaptation of evidence-based interventions for online delivery, is outlined.