Five Additional Evidence-Based Principles to Facilitate Grammar Development for Children With Developmental Language Disorder

What Matters When Providing Conversational Recast Treatment? A Multilevel Modeling Analysis

PURPOSE

Conversational recasting treatment is generally effective. However, different versions of this treatment and different targets may yield different outcomes for children. Here, we directly compare multiple variations of conversational recasting to determine how modifications to delivery and target impact treatment outcomes.

METHOD

Using Bayesian hierarchical linear mixed modeling, we compared outcome data from 141 children with developmental language disorder (DLD) across 10 versions of recast treatment compared with enhanced conversational recast treatment (a version that incorporates linguistic variability and attentional cues). We also compared data from a subset of 132 children treated for one of five morphological targets to determine the relative difficulty of learning each target.

RESULTS

Results suggest that seven of the 10 treatment conditions resulted in an average decrease in generalization probe performance relative to enhanced conversational recasting alone. These conditions resulted in probe performance that was between 47% and 84% worse than performance of children who received enhanced conversational recasting with no variations. The remaining three conditions were no better or worse than enhanced conversational recasting. One treatment target was easier to remediate, while the other four were no easier or harder to acquire through treatment.

CONCLUSIONS

These results suggest that different variations of conversational recasting facilitate or diminish learning by children with DLD and that clinicians' attention to the form and structure of treatment delivery is necessary to implement best practice for this treatment method. In contrast, clinicians may have more flexibility when selecting targets.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.28055207.

Not All Planes Have Propellers: Using Context Variability to Treat Word Learning in Late Talkers With the Vocabulary Acquisition and Usage for Late Talkers Protocol

PURPOSE

The purpose of this study was to determine if the Vocabulary Acquisition and Usage for Late Talkers (VAULT) intervention could be efficaciously applied to a new treatment target: words a child neither understood nor said. We also assessed whether the type of context variability used to encourage semantic learning (i.e., action or object) would affect learning outcomes.

METHOD

Nineteen primarily English-speaking late-talking toddlers received 8 weeks of VAULT intervention. They were quasirandomly assigned to a condition that highlighted either object or action variability. Individual effect sizes were calculated for target (treated) and control (not treated) words for each child. These were combined to assess group-level comparisons of treatment efficacy and treatment conditions. Generalization of the word-learning ability was assessed by comparing rates of learning on a vocabulary checklist prior to and during intervention. Bayesian statistics (e.g., t tests, analysis of variance) were used for the analyses.

RESULTS

There was strong evidence for a treatment effect showing that children produced more target than control words and moderate evidence that they understood more target than control words. There was strong evidence for generalization. Children learned an average of 6.8 words per week during treatment. There was anecdotal evidence for no difference between treatment conditions.

CONCLUSIONS

VAULT, with a focus on context variability, can be used efficaciously to teach children to say words they do not understand at the start of treatment. The effects were most pronounced in the generalization data. Additionally, children were able to learn later-acquired words.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.28200074.

Exploring Tasmanian speech-language pathologists' perspectives on grammar intervention priorities and protocols for children with developmental language disorder: Preliminary findings from a participatory action research approach

PURPOSE

Children with developmental language disorder are likely to face challenges related to grammar difficulties. Existing empirically supported grammar interventions are typically developed using an expert model without acknowledging the community voices of clinicians who deliver such interventions. This project aims to explore the perspectives of Tasmanian speech-language pathologists on grammar intervention priorities and protocols for developmental language disorder through a participatory action research approach.

METHOD

We report on preliminary evidence gathered through semi-structured interviews with speech-language pathologists who work with children with developmental language disorder with associated grammar difficulties. Qualitative data were analysed through reflexive thematic analysis to determine collaboratively prioritised actions for future research.

RESULT

Responses from speech-language pathologists indicate that: Grammar is viewed as the critical framework for language, providing grammar intervention takes skill and even experienced clinicians are honing their craft, and there are professional tensions and challenges implementing grammar intervention at a contextual level.

CONCLUSION

The speech-langauge pathologists perspectives endorse the need for evidence-based grammar interventions while calling for additional support to embed its use in practice. Future phases of the research project are discussed, including research priorities for ongoing community contributions to drive how the intervention can be best implemented to meet the needs of its intended consumers.