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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.
Children between 4 years, 0 months and 6 years 11 months are eligible. A diagnosis of developmental language disorders will be confirmed as normal nonverbal cognitive function, passing a pure-tone audiometric screening, and a test score consistent with developmental language disorder on a standardized language test, and parent report of no other diagnosed handicapping condition. Speech skills and vocabulary skills will be described via standardized testing.
Children enrolled in treatment are seen for up to 28 consecutive weekdays. The study starts with three days of baseline assessment of morpheme use for potential treatment targets. Two are selected for study, with one treated and one tracked over the course of treatment. Treatment is embedded in child-friendly activities like games, book reading, and craft activities. Children are prompted to use the treated morpheme in conversation. Immediately following this attempt, the treating clinician repeats the child's utterance, correcting any ungrammatical forms. Half of the children will also receive explanations of what the key words in sentences mean (e.g., to twirl means to turn around fast). Generalization to untreated contexts is assessed 2-3 times weekly. Retention of learning is measured about six weeks after the end of treatment.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Grammar treatment including semantic support | Experimental | Children receiving grammatical treatment will also receive a simple explanation concerning the meaning of verbs used to elicit grammatical forms. |
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| Grammatical treatment excluding semantic support | Active Comparator | Children receiving grammatical treatment will not receive any explanation concerning the meaning of verbs used to elicit grammatical forms. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Enhanced Conversational Recast treatment | Behavioral | In the context of child-friendly activities, the clinician prompts the child to attempt to use the grammatical form targeted in the treatment. The clinician immediately restates the child's attempt (i.e., the recast), correcting any ungrammatical elements. Clinicians elicit and recasts 24 utterances per session. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in the Use of Treated Grammatical Forms in Untreated Contexts | Clinicians elicit ten uses of the trained grammatical form using toys, activities, and vocabulary with-held from treatment sessions. This is done in a conversational interaction between the clinician and child during play or stories using toys and is referred to as a 'generalization probe'. Because children begin treatment with different levels of pretreatment use, measures like percent use at the end of treatment do not accurately reflect treatment effects. Instead, for each child, data from three generalization probes obtained over a week at the end of treatment are averaged. This average, minus the average of three consecutive pre-treatment probe sessions, divided by the standard deviation of the three end-treatment probes constitutes a Generalization d. This reflects for the amount of change each individual child showed from their pre-treatment baseline, in units of standard deviation. The Generalization d serves as the dependent measure for group statistical analysis. | Three days over the course of the final week (week 5) of treatment |
| Change in the Use of Untreated Grammatical Forms in Untreated Contexts | Clinicians elicit ten uses of the trained grammatical form using toys, activities, and vocabulary with-held from treatment sessions. This is done in a conversational interaction between the clinician and child during play or stories using toys and is referred to as a 'generalization probe'. Because children begin treatment with different levels of pretreatment use, measures like percent use at the end of treatment do not accurately reflect treatment effects. Instead, for each child, data from three generalization probes obtained over a week at the end of treatment are averaged. This average, minus the average of three consecutive pre-treatment probe sessions, divided by the standard deviation of the three end-treatment probes constitutes a Generalization d. This reflects the amount of change each individual child showed from their pre-treatment baseline, in units of standard deviation. The Generalization d serves as the dependent measure for group statistical analysis. | Three days over the course of the final week (week 5) of treatment |
| Retention of Trained Grammatical Forms |
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Inclusion Criteria:
Language scores consistent with a developmental language disorder nonverbal cognitive scores consistent with normal-range intellectual functioning
Exclusion Criteria:
hearing loss Intellectual disability Other handicapping conditions
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The University of Arizona | Tucson | Arizona | 85721 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 24700145 | Background | Plante E, Ogilvie T, Vance R, Aguilar JM, Dailey NS, Meyers C, Lieser AM, Burton R. Variability in the language input to children enhances learning in a treatment context. Am J Speech Lang Pathol. 2014 Nov;23(4):530-45. doi: 10.1044/2014_AJSLP-13-0038. | |
| 27701629 | Background | Meyers-Denman CN, Plante E. Dose Schedule and Enhanced Conversational Recast Treatment for Children With Specific Language Impairment. Lang Speech Hear Serv Sch. 2016 Oct 1;47(4):334-346. doi: 10.1044/2016_LSHSS-15-0064. |
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| ID | Title | Description |
|---|---|---|
| FG000 | Semantic Support | Children are provided a brief definition of the verb they will hear in the recast (i.e., restatement of the child's utterance, correcting ungrammatical portions) prior to clinician administration of the recast. |
| FG001 | No Semantic Support | Children are not provided information on the meaning of the verb they will hear in the recast (i.e., restatement of the child's utterance, correcting ungrammatical portions) prior to clinician administration of the recast. |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
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Children are provided with 10 opportunities on each of 3 consecutive days to use grammatical forms that might be selected for treatment.
| ID | Title | Description |
|---|---|---|
| BG000 | Grammar Treatment Including Semantic Support | Children receiving grammatical treatment will also receive a simple explanation concerning the meaning of verbs used to elicit grammatical forms. Enhanced Conversational Recast treatment: In the context of child-friendly activities, the clinician prompts the child to attempt to use the grammatical form targeted in the treatment. The clinician immediately restates the child's attempt (i.e., the recast), correcting any ungrammatical elements. Clinicians elicit and recasts 24 utterances per session. |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Change in the Use of Treated Grammatical Forms in Untreated Contexts | Clinicians elicit ten uses of the trained grammatical form using toys, activities, and vocabulary with-held from treatment sessions. This is done in a conversational interaction between the clinician and child during play or stories using toys and is referred to as a 'generalization probe'. Because children begin treatment with different levels of pretreatment use, measures like percent use at the end of treatment do not accurately reflect treatment effects. Instead, for each child, data from three generalization probes obtained over a week at the end of treatment are averaged. This average, minus the average of three consecutive pre-treatment probe sessions, divided by the standard deviation of the three end-treatment probes constitutes a Generalization d. This reflects for the amount of change each individual child showed from their pre-treatment baseline, in units of standard deviation. The Generalization d serves as the dependent measure for group statistical analysis. | One child was withdrawn from the study due to excessive absentee-ism. | Posted | Mean | Standard Deviation | Generalization d | Three days over the course of the final week (week 5) of treatment |
5 months
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Semantic Support | Children are provided a brief definition of the verb they will hear in the recast (i.e., restatement of the child's utterance, correcting ungrammatical portions) prior to clinician administration of the recast. |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Elena Plante, PhD | University of Arizona | 520-621-5080 | eplante@arizona.edu |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Sep 8, 2025 | Jan 5, 2026 | Prot_SAP_000.pdf |
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Hybrid single subject/group design
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Caregivers are not informed of their child's treatment target until after treatment concludes.
The clinician measuring retention of learning has not treated the children
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Clinicians elicit ten uses of the trained grammatical form using toys, activities, and vocabulary with-held from treatment sessions. This is done in a conversational interaction between the clinician and child during play or stories using toys and is referred to as a 'retention probe' when done, as here, after a period of no treatment. The dependent measure is the number correct out of 10 opportunities for use of the grammatical form.
| 1 day, 1-2 months after the end of treatment |
| Retention of Untrained Grammatical Forms | Clinicians elicit ten uses of the trained grammatical form using toys, activities, and vocabulary with-held from treatment sessions. This is done in a conversational interaction between the clinician and child during play or stories using toys and is referred to as a 'retention probe' when done, as here, after a period of no treatment. The dependent measure is the number correct out of 10 opportunities for use of the grammatical form. | 1 day, 1-2 months from the end of treatment |
| 31343897 | Background | Plante E, Mettler HM, Tucci A, Vance R. Maximizing Treatment Efficiency in Developmental Language Disorder: Positive Effects in Half the Time. Am J Speech Lang Pathol. 2019 Aug 9;28(3):1233-1247. doi: 10.1044/2019_AJSLP-18-0285. Epub 2019 Jul 25. |
| 38039976 | Background | Sweeney L, Plante E, Mettler HM, Hall J, Vance R. Less Versus More: The Effect of Recast Length in Treatment of Grammatical Errors. Lang Speech Hear Serv Sch. 2024 Jan 11;55(1):152-165. doi: 10.1044/2023_LSHSS-23-00049. Epub 2023 Dec 1. |
| BG001 | Grammatical Treatment Excluding Semantic Support | Children receiving grammatical treatment do not receive any explanation concerning the meaning of verbs used to elicit grammatical forms. Enhanced Conversational Recast treatment: In the context of child-friendly activities, the clinician prompts the child to attempt to use the grammatical form targeted in the treatment. The clinician immediately restates the child's attempt (i.e., the recast), correcting any ungrammatical elements. Clinicians elicit and recasts 24 utterances per session. |
| BG002 | Total | Total of all reporting groups |
| daily use of grammatical forms |
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| Participants |
| Participants |
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| Age, Continuous | Mean | Standard Deviation | years | Participants |
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| Sex: Female, Male | One child was withdrawn due to excessive absences. | Count of Participants | Participants | Participants |
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| Race (NIH/OMB) | Count of Participants | Participants | Participants |
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| Ethnicity (NIH/OMB) | Count of Participants | Participants | Participants |
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| Region of Enrollment | Children are provided with 10 opportunities to use grammatical forms each day for three days pretreatment to determine possible treatment targets. | Number | participants | Participants |
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| Average percent use of grammatical forms | Average number of times the grammatical form was used correctly, out of 10 opportunities each session, over 3 consecutive sessions. The numbers are expected to be small because grammatical forms chosen for treatment were those rarely if ever used correctly prior to treatment. | The values are identical, primarily because we balance the groups for pretreatment use. | Mean | Standard Deviation | Average percent correct use over 3 days | Participants |
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| ID | Title | Description |
|---|---|---|
| OG000 | Semantic Support | Children are provided a brief definition of the verb they will hear in the recast (i.e., restatement of the child's utterance, correcting ungrammatical portions) prior to clinician administration of the recast. |
| OG001 | No Semantic Support | Children are not provided information on the meaning of the verb they will hear in the recast (i.e., restatement of the child's utterance, correcting ungrammatical portions) prior to clinician administration of the recast. |
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| Primary | Change in the Use of Untreated Grammatical Forms in Untreated Contexts | Clinicians elicit ten uses of the trained grammatical form using toys, activities, and vocabulary with-held from treatment sessions. This is done in a conversational interaction between the clinician and child during play or stories using toys and is referred to as a 'generalization probe'. Because children begin treatment with different levels of pretreatment use, measures like percent use at the end of treatment do not accurately reflect treatment effects. Instead, for each child, data from three generalization probes obtained over a week at the end of treatment are averaged. This average, minus the average of three consecutive pre-treatment probe sessions, divided by the standard deviation of the three end-treatment probes constitutes a Generalization d. This reflects the amount of change each individual child showed from their pre-treatment baseline, in units of standard deviation. The Generalization d serves as the dependent measure for group statistical analysis. | One child was withdrawn due to excessive absenteeism. | Posted | Mean | Standard Deviation | Generalization d | Three days over the course of the final week (week 5) of treatment |
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| Primary | Retention of Trained Grammatical Forms | Clinicians elicit ten uses of the trained grammatical form using toys, activities, and vocabulary with-held from treatment sessions. This is done in a conversational interaction between the clinician and child during play or stories using toys and is referred to as a 'retention probe' when done, as here, after a period of no treatment. The dependent measure is the number correct out of 10 opportunities for use of the grammatical form. | The analysis compares the mean performance at the end of treatment (3 data points) to retention performance 1-2 months post treatment (1 data point). One child was withdrawn due to excessive absenteeism. | Posted | Mean | Standard Deviation | percentage of correct use | 1 day, 1-2 months after the end of treatment |
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| Primary | Retention of Untrained Grammatical Forms | Clinicians elicit ten uses of the trained grammatical form using toys, activities, and vocabulary with-held from treatment sessions. This is done in a conversational interaction between the clinician and child during play or stories using toys and is referred to as a 'retention probe' when done, as here, after a period of no treatment. The dependent measure is the number correct out of 10 opportunities for use of the grammatical form. | The analysis compares the mean performance at the end of treatment (3 data points) to retention performance 1-2 months post treatment (1 data point). One child was withdrawn due to excessive absenteeism. | Posted | Mean | Standard Deviation | Percentage of correct use | 1 day, 1-2 months from the end of treatment |
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| 0 |
| 12 |
| 0 |
| 12 |
| 0 |
| 12 |
| EG001 | No Semantic Support | Children are not provided information on the meaning of the verb they will hear in the recast (i.e., restatement of the child's utterance, correcting ungrammatical portions) prior to clinician administration of the recast. | 0 | 12 | 0 | 12 | 0 | 12 |
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| Native Hawaiian or Other Pacific Islander |
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| Black or African American |
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| White |
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| More than one race |
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| Unknown or Not Reported |
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| Unknown or Not Reported |
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