Developmental Language Disorder (DLD) affects approximately seven percent of the population and is characterized by grammatical deficits that cascade into lifelong academic challenges and under-employment. Current treatments for DLD produce good outcomes under ideal, high intensity conditions or when parents have been trained to deliver therapy using intense coaching methods; however, current publicly funded service delivery systems and private-pay reimbursement models do not support treatment being delivered in this ideal fashion for children older than three. This project will examine alternative methods of delivering treatment that may be more feasible under typical conditions and will identify implementation barriers, with the goal of improving long-term outcomes for children with DLD. We hypothesize that feasibility and palatability will influence dose, which will in turn affect the overall language outcomes.

Inclusion Criteria:

Child with DLD

• Age: 4-9 years old

• Primarily English speaking: as documented by 20% or less exposure to another language, per parent report on the MAPLE

• Diagnosed with DLD as documented by standard score below 85 on the Diagnostic Evaluation of Language Variation - Norm Referenced (DELV-NR) composite, a dialect neutral assessment (Seymour, Roeper, de Villiers, & De Villiers, 2005).

• Nonverbal Intelligence Quotient (IQ) within typical range as documented by a t-score at or above 35 on the Developmental Abilities Scale (DAS), matrices similarities subscale, (Elliott, 2007).

• Hearing within the typical range: Pass screening at 25 dB for 1, 2, 4 kHz; OR scores within the typical range via SoundScouts hearing screening app; OR clear hearing assessment from an audiologist, otolaryngologist, medical doctor, or other professional.

• No diagnosis of Autism: Cutoff score of 15 on the Social Communication Questionnaire, (Rutter, Bailey, & Lord, 2003)

• No diagnosis of significant sensory-motor concerns or significant psychiatric disorders per parent report

• Able to benefit from treatment:

  • Score below 60% correct on experimenter developed elicited production probes of passives and object relative clauses
  • Producing simple transitive sentences (SVO) and mean length of utterance (MLU) of 2.5 on 100 utterance language sample

Caregiver

• Serves as the primary caregiver for an eligible child (may include grandparents, etc.)
• Basic literacy skills per self-report
• Willing to participate in caregiver training and caregiver-based treatments if child is assigned to that condition
• Willing to participate in questionnaires and structured interviews during post-test

Summary results of the primary outcomes for Aims 1 & 2 (elicited production and eye-gaze) will be uploaded within 12 months of the last data collection point for the final participant.

We will track and provide information about participant flow. At each phase of participation, we will aggregate and report the following information:

1. non-qualifiers: available screening information and reason for not continuing;
2. qualifying participants who continue in the study: screening & pretest information, by treatment group;
3. participants who complete the study: post-test scores, by treatment group;
4. participants who drop out: reasons given for dropout, along with any adverse events;

It is not possible to fully de-identify the interviews utilized in the mixed methods study (Aim 3). Thus, these data will not be shared. Additional data at the individual participant level may be sharable upon request and IRB approval for particular access.

1 year after final data collection is complete

IRB approval for access to data

The outcomes assessor is unaware of the arm to which the child has been assigned and is also unaware of which of two targets are the treatment target.