How can we make grammar learning easier for children with language disorders?
Does speech therapy Involving graduated input type variations (GITV) for children with Developmental Language Disorder (DLD) improve their use of grammar?
University of Sydney
10 participants
Apr 1, 2023
Interventional
Conditions
Summary
Children with developmental language disorder (DLD) struggle with the learning, use and/or understanding of grammar. This project examines the efficacy of a theory driven empirically based grammar intervention approach, graduated input type variation (GITV), for young English-speaking children with DLD. The aim is to compare participating children’s performance on both the trained grammar target, and the control grammar item which they will not receive treatment, before and after intervention. During intervention, children will receive input of 30 exemplars provided using two evidence-based procedures, recast and focused stimulation, in which the speech-language pathology student uses a special way of commenting on what is going on and responding to the child’s communication attempts of the target in meaningful contexts during fun activities. Both procedures are typically included in the standard-of-care of children with DLD during language intervention. The relative frequency of the verbs in the input exemplars is manipulated such that in the skewed input stage, one verb appears in a disproportionally higher number of the exemplars, whereas in the balanced input stage, all the verbs appear in similar frequencies. Children will participate in 16 sessions of intervention, twice a week for eight weeks. It is predicted that children will make significant gains in the production of the trained grammar target but show no change in the control grammar item. Children will also demonstrate learning of another grammar item that is structurally similar to the trained grammar target, and maintenance of learning of the target 3 weeks after intervention ends.
Eligibility
Inclusion Criteria9
- Aged aged 5 years 0 months to 7 years 11 months at time of the baseline probe.
- Confirmed diagnosis of developmental language disorder (DLD) using the criteria operationalised in Bishop et al. (2017), including
- a. Performance below the diagnostic cut-off in one or more standardised norm-referenced language tests
- b. Normal hearing
- c. No earlier diagnosis, parental or teacher concern of intellectual disability, or autism spectrum disorder
- d. Parental and/or teacher concern of language difficulties and their impact on the child’s learning and psychosocial development
- English as primary language of the child
- Speech is at least 80% intelligible to the speech-language pathologist unfamiliar to the child
- Normal vision with or without eyeglasses
Exclusion Criteria3
- Concomitant genetic or neurodevelopmental disorder e.g., autism, global developmental delay
- A home language other than English
- Performance on the baseline measures before treatment show a significant upward trend
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Interventions
In this clinical trial, we will examine a new theory driven and empirically based approach on grammar intervention, called graduated input type variation (GITV). The intervention involves evidence-based procedures, recast and focused stimulation, in which the speech language pathologist uses a special way of commenting on what is going on and responding to the child’s communication attempts while playing a toy set, or a game, or reading a book with the child. No tools are required in the use of these procedures. Recast and focused stimulation are different in that the former requires the speech-language pathologist to respond to what the child says by using the grammar target being trained. In focused stimulation, the speech-language pathologist can initiate a comment using the grammar target without having the child say something first. Both procedures are typically included in the standard-of-care of children with language disorders during language intervention. In the intervention phase, the speech-language pathologist will see the child one-on-one THREE TIMES A WEEK FOR 5 WEEKS, for about an hour each time. About half an hour will be spent on the intervention and the remaining time will be spent on the criterion-referenced probes for monitoring progress. We use AN ONLINE format in which ALL sessions ARE CONDUCTED ONLINE. We will use a fidelity checklist to monitor the speech-language pathologist's administration of the intervention protocol and to guide the provision of feedback either during the session or after the session through a review of the video recording by an independent observer. We will keep an attendance record and provide a make up session when the child is unavailable on the scheduled time. In the maintenance session, there will be no intervention. We will re-run the criterion-referenced probes to continue to monitor the child's progress over a period of 6 weeks. There will be three sessions, at 1 week, 3 weeks and 6 weeks post intervention. Each will last about 30 minutes.
Locations(1)
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ACTRN12622001552774