Recruiting

Observational Study

Sponsor:

University of Houston

Code:

NCT06085300

Conditions

Developmental Language Disorder

Language Impairment

Eligibility Criteria

Sex: All

Age: 4 - 6

Healthy Volunteers: Accepted

Interventions

Sentence recast

Study Details

Brief summary:

Of the 12 million children in the USA growing up bilingual, about 1 million experience Developmental Language Disorder (DLD), a disorder in language learning and use. Currently there is no guidance for speech language pathologists (SLPs) as to the language of intervention for bilingual children with DLD with differing degrees of proficiency with English or Spanish. This project will examine the relationship between relative language proficiency and the language of intervention, considering monolingual intervention in English and Spanish and bilingual intervention presented by alternating English and Spanish treatment sessions with the goal of improving language outcomes and thereby strengthening long-term academic achievement.

Conditions

Developmental Language Disorder

Language Impairment

Study ID

NCT06085300

Start date

Aug 8, 2023

Status verified date

Jan, 2025

Completion date

May 1, 2028

Anticipated

Primary completion date

May 1, 2028

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 4 - 6

Healthy Volunteers: Accepted

Inclusion Criteria:

1. parent concerns and/or a history of receiving services in the public schools
2. age-specific cutoffs for the morphosyntax subtests for their best language (English or Spanish) on the Bilingual English Spanish Assessment. The cut-off score for best language for 4-year-olds is 84, for 5-year-olds is 85, and for 6-year-olds is 81. Using the best-language approach, these scores have a sensitivity over 90% and specificity over 80% for children between 4;0 and 6;11 years of age , which is considered acceptable for studies of diagnostic accuracy.
3. nonverbal IQ, as measured by the Kaufman Brief Intelligence Test-2, matrices subtest, will be at or above a standard score of 70.
4. pass a hearing screening test
5. participants must be bilingual, that is children must be producing at least simple sentences in spontaneous speech in both Spanish and English, or understand English and Spanish.
6. participants must be able to benefit from treatment for both conditional adverbial clauses and complement clauses, as evidenced by accuracy below 40% on 10-item elicited production probes in both languages

Exclusion Criteria:

  • 1) children with significant sensory-motor concerns or psychiatric disorders per parent report will not be enrolled.

Study Design

Enrollment

120 participants

Anticipated

Allocation

Randomized

Intervention Model

Crossover

Primary purpose

Treatment

Interventions and Outcome Measures

Arms

experimental: sentence recast in Spanish only

A trained, bilingual SLP will treat the targeted structure at a rate of \~ 1 recast per minute, for 16 hours spread over 9 weeks to obtain a planned dose of 912-1008 recasts (960 +/- 5%). Following evidence on enhanced conversational recasting, the SLP will obtain the child's attention before recasting and systematically vary the lexical items in the recasts. Children receiving monolingual Spanish therapy will have the entire treatment session conducted in Spanish.

experimental: sentence recast in English only

A trained, bilingual SLP will treat the targeted structure at a rate of \~ 1 recast per minute, for 16 hours spread over 9 weeks to obtain a planned dose of 912-1008 recasts (960 +/- 5%). Following evidence on enhanced conversational recasting , the SLP will obtain the child's attention before recasting and systematically vary the lexical items in the recasts. Children receiving monolingual English therapy will have the entire treatment session conducted in English.

experimental: sentence recast - Bilingual (Spanish+English) intervention

Treatment will differ from monolingual therapy in that the child will be seen by two SLPs in keeping with one-person one-language models. This allows us to ensure that the dose in each language is controlled and supports the use of both languages evenly in therapy. Sessions will alternate between English-only therapy and Spanish-only therapy - thus the child will receive 8 hours of therapy treating the selected target in English and 8 hours treating the selected target in Spanish. A child in bilingual therapy will receive approximately 456-504 (480 +/- 5%) recasts in each language for a total of 912-1008 recasts combined.

Interventions

Sentence recast

Recast therapy is a well-established treatment for grammar in children with DLD. In this treatment, the adult repeats the child's own utterance, altering it to include the taught structure. It yields consistent large effect sizes (Hedge's g = 0.7-1.0) when focused on a single target and provided at a high dose (10-20 hrs. of therapy at a rate of \~1 recast/minute or \~600-1000 recasts total) for both morphology and syntax .

Primary outcome measure

  • Accuracy on elicited production probes (conditional or nominal) [ Time Frame: ~1 month before (Pre), 2 weeks before second structure (Mid) and 2 weeks after treatment (Post test) ]

Central Contacts and Locations

Central contacts

Anny Castilla-Earls

713-743-0488annycastilla@uh.edu

Locations

School Districst

Recruiting

Houston, Texas, United States, 77204

More Information

Sponsor

University of Houston

Last update posted

Jan 14, 2025

Last verified

Jan, 2025

Keywords

  • developmental language disorder
  • bilingual children
  • sentence recast
  • Bilingual proficiency
  • Language transfer

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-09. This information was provided to ClinicalTrials.gov by University of Houston on 2025-01-14.