We Have to Talk About Something: Why NOT Talk About the Curriculum? A Guide to Embedding Language Interventions in Curricular Content.

PURPOSE: Children with developmental language disorder frequently have difficulty with both academic success and language learning and use. This clinical focus article describes core principles derived from a larger program of research (National Science Foundation 1748298) on language intervention combined with science instruction for preschoolers. It serves as an illustration of a model for integrating language intervention with curricular content delivery. METHOD: We present a five-step model for a speech-language pathologist and other school professionals to follow to (a) understand the grade-level core curriculum objectives; (b) align intervention targets with the curriculum; (c) select a therapy approach that aligns with both goals and curricular content, and (d) methods for implementing the intervention; and (e) verify that both the intervention and the curriculum have been provided in accordance with best practices. We apply this model to the Next Generation Science Standards, a science curriculum popular in the United States, and to grammar and vocabulary interventions, two areas of difficulty for children with developmental language disorders, though it would be possible to extend the steps to other curricular areas and intervention targets. CONCLUSIONS: We conclude by discussing the barriers and benefits to adopting this model. We recognize that both speech-language pathologists and teachers may have limited time to implement language intervention within a general education curriculum, but we suggest that the long-term benefits outweigh the barriers.

Varying Syntax to Enhance Verb-Focused Intervention for 30-Month-Olds With Language Delay: A Concurrent Multiple Baseline Design.

PURPOSE: The purpose of this study is to determine if 2.5-year-olds with language delay would learn verbs (spill) when presented with varying syntactic structure ("The woman is spilling the milk"/"The milk is spilling"; milk = patient or theme) in a therapeutic context. Children with language delay have proportionally small inventories of verbs, which limits expressive language development. Children who have typical language development learn verbs more robustly when presented with alternating arguments than with a single argument structure. METHOD: Three toddlers with expressive language delay (29-30 months of age) participated in a verb-focused treatment study using a concurrent multiple baseline design. Participants were shown action videos accompanied by sentences with varied argument structure for each target verb. To assess learning pre- and posttreatment, participants were asked to demonstrate actions corresponding to each verb. RESULTS: Visual inspection and tau analyses reveal significant posttreatment gains of target verbs taught with varying argument structures. CONCLUSIONS: Our results indicate that learning verbs with high variability of argument roles may facilitate a strong link between lexical representations of verbs and their syntactic structures. Using argument structure variability to teach verbs as an intervention strategy has great potential and should be tested further in larger group studies.

Preparing Student Clinicians to Provide Recast Therapy on Complement Clauses: A Training Program.

PURPOSE: This study reports on a program to train student clinicians to provide recast therapy on complement clauses to children with developmental language disorder (DLD). To determine the efficacy of the program, we conducted secondary data analysis based on Owen Van Horne et al. (2023) and examined student clinicians' recasts after training and children's progress after treatment. METHOD: Three student clinicians received a two-stage training, followed by a real intervention program targeting complement clauses in six children with DLD. A third of the intervention sessions were coded for the total number and number of unique verbs in complement clauses provided by the student clinicians. An elicited production task was completed to test children's knowledge of the target structure. RESULTS: On average, student clinicians provided 30 targeted recasts to each child during each intervention session. They provided a greater number of and more variable input for that compared to WH complements. Children demonstrated significant improvement only in WH, but not in that, complements. CONCLUSIONS: A targeted training program could strengthen clinicians' ability to provide recast therapy on complex syntax; however, future refinements should shorten and broaden training to include more targets. A mismatch between input patterns and learning patterns was observed. WH complement input is more stable than that input, given the less variable complement-taking verbs provided by the student clinicians and the overtness of the WH word as a stable complementizer, which may have facilitated the identification and extraction of the target syntactic structure.

Recast Therapy for Treating Syntax in Bilingual Children With Developmental Language Disorder: A Feasibility and Early Efficacy Study Examining the Role of Language of Intervention on Outcomes.

PURPOSE: The purpose of this study is to examine the feasibility of the delivery of complex syntax recast therapy via telepractice to Spanish-English bilingual children and provide preliminary evidence of the efficacy of this approach. METHOD: Fifteen bilingual children with developmental language disorders were stratified based on language proficiency and randomized to one of three treatment conditions: Spanish only (n = 5), English only (n = 6), or Spanish + English (n = 4). Using a within-subject design, we hypothesized that we could document treatment efficacy based on change in the treated structure in the absence of change in an untreated comparison structure. All 15 children completed ~16 hr of treatment via telepractice and participated in pre- and posttesting of their production of conditional adverbs (treated structure) and subject relative clauses (untreated structure) carried out by a masked assessor. RESULTS: Analyses included all participants. Treatment fidelity was high, and participant attendance was remarkable, indicating feasibility. Regarding efficacy, recast therapy led to group-level gains on treated syntactic structures that exceeded those observed for the untreated comparison structure. For the 11 children who received therapy in only one language, approximately equal gains were observed in both the treated and untreated languages for conditional adverbials. CONCLUSIONS: Preliminary evidence suggests that for highly overlapping structures like conditional adverbials, recast therapy is effective and leads to change in both of the child's languages. Larger studies are required to understand how language of administration and proficiency may affect outcomes. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.23739996.

Teaching little kids big sentences: A randomized controlled trial showing that children with DLD respond to complex syntax intervention embedded within the context of preschool/kindergarten science instruction.

BACKGROUND: The language of the science curriculum is complex, even in the early grades. To communicate their scientific observations, children must produce complex syntax, particularly complement clauses (e.g., I think it will float; We noticed that it vibrates). Complex syntax is often challenging for children with developmental language disorder (DLD), and thus their learning and communication of science may be compromised. AIMS: We asked whether recast therapy delivered in the context of a science curriculum led to gains in complement clause use and scientific content knowledge. To understand the efficacy of recast therapy, we compared changes in science and language knowledge in children who received treatment for complement clauses embedded in a first-grade science curriculum to two active control conditions (vocabulary + science, phonological awareness + science). METHODS & PROCEDURES: This 2-year single-site three-arm parallel randomized controlled trial was conducted in Delaware, USA. Children with DLD, not yet in first grade and with low accuracy on complement clauses, were eligible. Thirty-three 4-7-year-old children participated in the summers of 2018 and 2019 (2020 was cancelled due to COVID-19). We assigned participants to arms using 1:1:1 pseudo-random allocation (avoiding placing siblings together). The intervention consisted of 39 small-group sessions of recast therapy, robust vocabulary instruction or phonological awareness intervention during eight science units over 4 weeks, followed by two science units (1 week) taught without language intervention. Pre-/post-measures were collected 3 weeks before and after camp by unmasked assessors. OUTCOMES & RESULTS: Primary outcome measures were accuracy on a 20-item probe of complement clause production and performance on ten 10-item unit tests (eight science + language, two science only). Complete data were available for 31 children (10 grammar, 21 active control); two others were lost to follow-up. Both groups made similar gains on science unit tests for science + language content (pre versus post, d = 2.9, p < 0.0001; group, p = 0.24). The grammar group performed significantly better at post-test than the active control group (d = 2.5, p = 0.049) on complement clause probes and marginally better on science-only unit tests (d = 2.5, p = 0.051). CONCLUSIONS & IMPLICATIONS: Children with DLD can benefit from language intervention embedded in curricular content and learn both language and science targets taught simultaneously. Tentative findings suggest that treatment for grammar targets may improve academic outcomes. WHAT THIS PAPER ADDS: What is already known on the subject We know that recast therapy focused on morphology is effective but very time consuming. Treatment for complex syntax in young children has preliminary efficacy data available. Prior research provides mixed evidence as to children's ability to learn language targets in conjunction with other information. What this study adds This study provides additional data supporting the efficacy of intensive complex syntax recast therapy for children ages 4-7 with Developmental Language Disorder. It also provides data that children can learn language targets and science curricular content simultaneously. What are the clinical implications of this work? As SLPs, we have to talk about something to deliver language therapy; we should consider talking about curricular content. Recast therapy focused on syntactic frames is effective with young children.

Dissociation Between Linguistic and Nonlinguistic Statistical Learning in Children with Autism.

Statistical learning (SL), the ability to detect and extract regularities from inputs, is considered a domain-general building block for typical language development. We compared 55 verbal children with autism (ASD, 6-12 years) and 50 typically-developing children in four SL tasks. The ASD group exhibited reduced learning in the linguistic SL tasks (syllable and letter), but showed intact learning for the nonlinguistic SL tasks (tone and image). In the ASD group, better linguistic SL was associated with higher language skills measured by parental report and sentence recall. Therefore, the atypicality of SL in autism is not domain-general but tied to specific processing constraints related to verbal stimuli. Our findings provide a novel perspective for understanding language heterogeneity in autism.

Editorial Perspective: Maximising the benefits of intervention research for children and young people with developmental language disorder (DLD) - a call for international consensus on standards of reporting in intervention studies for children with and at risk for DLD.

Current methods for reporting interventions do not allow key questions of importance to practitioners, service providers, policy-makers and people with DLD to be answered, and hence limit the implementation of effective interventions in the real world. To extend the existing EQUATOR guidelines to the context of speech language therapy/pathology for children with language disorder and to provide more specific guidance on participants, interventions and outcomes within the CONSORT checklist (used to improve the reporting of randomised controlled trials) and TIDieR (Template for Intervention Description and Replication) to ensure consistency of reporting. We will develop a core team to include representatives from each of the key groups who will either use or be influenced by the final reporting guidance across different countries. To achieve each set of aims, we will conduct reviews of the literature (which present typologies of intervention characteristics in (D)LD and related disorders); carry out focus groups; and use systematic consensus methods such as the Delphi technique, nominal group technique or consensus development conferences. Through the development and adoption of standard intervention reporting criteria, we anticipate that we will overcome the numerous barriers for practitioners, services and policy-makers in applying intervention evidence to practice. We believe that establishing international consensus on reporting guidelines would significantly accelerate progress in DLD research and the ease with which it can be used in clinical practice, by capitalising on the growth in intervention studies to enable international collaboration and new methodologies of data pooling, meta-analyses and cross-study comparisons.

Approach to Radical Hysterectomy for Cervical Cancer in Pregnancy: Surgical Pathway and Ethical Considerations.

INTRODUCTION: Cervical cancer is currently the fourth most common cancer in women and in the poorest countries this neoplasia still represents a widespread and potentially lethal disease. We present a rare case of cervical cancer in pregnancy, analyzing the historical changes behind the procedure of radical hysterectomy for cervical cancer and discussing variations in surgical techniques and anatomical definitions that have since been proposed. RESULTS: We present the case of a 33-year-old patient who attended with vaginal bleeding in the second trimester of pregnancy. Examination revealed an abnormal looking cervix, with investigations concluding stage IIb squamous cell carcinoma. Following extensive discussion regarding management options, the patient went on to have a peripartum foetocidal type III nerve sparing radical Wertheim hysterectomy at 18 weeks gestation with conservation and transposition of the ovaries above the level of the pelvic brim. The patient recovered well without significant morbidity and received further input from fertility and psychological medical teams in addition to adjuvant treatment within the department of clinical oncology. DISCUSSION: This case represents several elements of great interest and learning. Notably, we highlight this both due to the surgical challenges that a gravid uterus presents in the execution of a radical hysterectomy; and regarding the compassionate care demonstrated by the team - not only in supporting the patient and her partner in a period of profound turmoil in terms of the management of their cancer diagnosis and unborn child, but also regarding the uncertainty in consideration of the oncological and fertility related outcomes. CONCLUSION: This manuscript adds to the growing literature on the appropriate use of radical surgery for cervical cancer, more specifically during pregnancy and in consideration of such ethical dilemma, where management guidelines do not exist to aid clinicians further in their provision of treatment.

Classification accuracy of the Quick Interactive Language Screener for preschool children with and without developmental language disorder.

INTRODUCTION: This research examined the classification accuracy of the Quick Interactive Language Screener (QUILS) for identifying preschool-aged children (3;0 to 6;9) with developmental language disorder (DLD). We present data from two independent samples that varied in prevalence and diagnostic reference standard. METHODS: Study 1 included a clinical sample of children (54 with DLD; 13 without) who completed the QUILS and a standardized assessment of expressive grammar (Syntax subtest from the Diagnostic Evaluation of Language Variation-Norm Referenced; Structured Photographic Expressive Language Test-Preschool 2nd Edition; or Structured Photographic Expressive Language Test-3 rd Edition). Study 2 included a community sample of children (25 with DLD; 101 without) who completed the QUILS and the Auditory Comprehension subtest of the Preschool Language Scales-5th Edition (PLS-5; Zimmerman et al., 2011). Discriminant analyses were conducted to compare classification accuracy (i.e., sensitivity and specificity) using the normreferenced cut score (< 25th percentile) with empirically derived cut scores. RESULTS: In Study 1, the QUILS led to low fail rates (i.e., high specificity) in children without impairment and statistically significant group differences as a function of children's clinical status; however, only 65% of children with DLD were accurately identified using the norm-referenced cutoff. In Study 2, 76% of children with DLD were accurately identified at the 25th percentile cutoff and accuracy improved to 84% when an empirically derived cutoff (<32nd percentile) was applied. CONCLUSIONS: Findings support the clinical application of the QUILS as a component of the screening process for identifying the presence or absence of DLD in community samples of preschool-aged children.

The generative potential of mess in community-based participatory research with young people who use(d) drugs in Vancouver.

Community-based participatory research (CBPR) is increasingly standard practice for critical qualitative health research with young people who use(d) drugs in Vancouver, Canada. One aim of CBPR in this context is to redress the essentialization, erasure, and exploitation of people who use(d) drugs in health research. In this paper, we reflect on a partnership that began in 2018 between three university researchers and roughly ten young people (ages 17-28) who have current or past experience with drug use and homelessness in Greater Vancouver. We focus on moments when our guiding principles of shared leadership, safety, and inclusion became fraught in practice, forcing us in some cases to re-imagine these principles, and in others to accept that certain ethical dilemmas in research can never be fully resolved. We argue that this messiness can be traced to the complex and diverse positionalities of each person on our team, including young people. As such, creating space for mess was ethically necessary and empirically valuable for our CBPR project.

Turn the Page, Speech-Language Pathologists: Adequate, Authentic, and Accurate Representation as a Consideration in the Selection of Picture Books for Use in Treatment.

Purpose This tutorial discusses what it means to be a culturally responsive speech-language pathologist (SLP) and then grounds this discussion in strategies that SLPs can engage in to diversify the books and other materials that they use in clinical practice. Method We motivate the tutorial by reviewing policy statements and theoretical information from allied literature. Then, we suggest some ways that SLPs can reflect on their practice to enact an antiracist/culturally responsive approach to treatment, taking the selection of children's literature up as a particular example. We identified strategies that have been suggested across a variety of fields and illustrate these strategies with examples. We both provide recommendations for how to select picture books and also suggest ways to implement these suggestions with accountability. Conclusions There is a need for SLPs to reflect on how to be culturally responsive in their practice and to review their materials selection practices with regard to how materials reflect the composition of their caseloads. As a predominantly White profession serving diverse caseloads, we have an ethical obligation to review our choice of materials and align them with culturally responsive practices.

Diet and nutrition in patients who have received pelvic radiotherapy: A mixed-methods study to explore dietary habits, nutritional awareness, and experiences of nutritional care.

OBJECTIVES: Individuals who have survived cancer may benefit from dietary modifications to improve quality of life and future health outcomes. The aim of this study was to explore dietary habits and experiences of nutritional support in patients with a cancer diagnosis who have received radiotherapy to the pelvic area. METHODS: A mixed-methods approach was used. Individuals diagnosed with a pelvic cancer (anal, bladder, rectal, and cancers of the reproductive organs), either undergoing or having completed pelvic radiotherapy 6 to 24 mo previously, were invited to participate in a postal survey. A purposive subsample was also invited to take part in telephone interviews. Thematic analysis of interview data was undertaken and integrated with data from quantitative analysis. RESULTS: The survey was completed by 254 (38%) respondents. Two-thirds of respondents (170) reported dietary changes since diagnosis; most notable changes were reduction of sugary foods (48%) and alcohol (41%). Receipt of support from the health care team was significantly associated with dietary change (odds ratio, 3.26; 95% confidence interval, 1.58-6.75); however, only 43% (108) had received dietary support from the health care team. Of the respondents, 68% (171) said they would like to receive additional dietary support. The effect of the condition on diet was highlighted in the theme "Impact of diagnosis and treatments on dietary choices." Self-management of disease was influenced by personal resources, social resources, comorbidities and disabilities, influence of work, regaining normality, and barriers to dietary changes. CONCLUSION: Lack of routine provision of nutritional care to patients after a cancer diagnosis and patient interest in this area highlighted unmet needs in managing diet-related problems and leading a healthy future lifestyle.

The Challenge of Rich Vocabulary Instruction for Children With Developmental Language Disorder.

Purpose The aims of the study were to explore responses of children with developmental language disorder (DLD) to rich vocabulary instruction and to identify potential factors that contribute to outcomes. Method Children with DLD participated in a language intervention embedded within a science camp. Using parent and clinician reports, standardized tests, probes, notes, and video, we derived descriptions of seven of the campers who received a vocabulary intervention that incorporated principles of rich instruction. We present them here as a case series. Results Five cases responded to the intervention with modest gains in Tier 2 science vocabulary and science knowledge. One case demonstrated no response, and another was unable to complete the intervention. The latter two cases presented with triple risks: DLD, executive function deficits, and stressors associated with poverty. In comparison, the best responder also lived in poverty and had DLD, but he had intact executive function, strengths in extant vocabulary, stronger knowledge of science, better engagement in the science and language intervention activities, and was older. Other factors that seemed to contribute to outcomes included the complexity of the word forms and dosage. Conclusions Translating research on rich instruction to clinical practice is challenging. This case series motivated hypotheses about the nature of the challenge and what to do about it, the primary one being that the modest success of rich vocabulary instruction for children with DLD is not a limitation of the approach itself but rather a reflection of the difficulty of delivering the intervention while tailoring the targets, approach, and dosage to the needs of individual children with DLD. Supplemental Material https://doi.org/10.23641/asha.13667699.

Forum on Morphosyntax Assessment and Intervention for Children.

Purpose This forum consists of articles that address the need for and approaches to assessment and treatment of morphology and syntax in children. Drawing on papers submitted by diverse laboratories working with multiple populations, this forum includes several articles describing different approaches to treatment, guidelines for goal setting, and assessment methods. Populations described include monolingual and bilingual children who speak English, Dutch, and Spanish, who use oral language and/or augmentative and alternative communication to communicate. Conclusion The current tools available to support traditional grammar therapy are changing and increasing. An emphasis on manualized treatments, treatments that include drill and explicit instruction, and assessment and treatment tools for a variety of populations across a wide age span are included here. Further work is needed to fully develop these promising tools and approaches for the most effective use.

Individual Differences in Verb Bias Sensitivity in Children and Adults With Developmental Language Disorder.

A number of experiments support the hypothetical utility of statistical information for language learning and processing among both children and adults. However, tasks in these studies are often very general, and only a few include populations with developmental language disorder (DLD). We wanted to determine whether a stronger relationship might be shown when the measure of statistical learning is chosen for its relevance to the language task when including a substantial number of participants with DLD. The language ability we measured was sensitivity to verb bias - the likelihood of a verb to appear with a certain argument or interpretation. A previous study showed adults with DLD were less sensitive to verb bias than their typical peers. Verb bias sensitivity had not yet been tested in children with DLD. In Study 1, 49 children, ages 7-9 years, 17 of whom were classified as having DLD, completed a task designed to measure sensitivity to verb bias through implicit and explicit measures. We found children with and without DLD showed sensitivity to verb bias in implicit but not explicit measures, with no differences between groups. In Study 2, we used a multiverse approach to investigate whether individual differences in statistical learning predicted verb bias sensitivity in these participants as well as in a dataset of adult participants. Our analysis revealed no evidence of a relationship between statistical learning and verb bias sensitivity in children, which was not unexpected given we found no group differences in Study 1. Statistical learning predicted sensitivity to verb bias as measured through explicit measures in adults, though results were not robust. These findings suggest that verb bias may still be relatively unstable in school age children, and thus may not play the same role in sentence processing in children as in adults. It would also seem that individuals with DLD may not be using the same mechanisms during processing as their typically developing (TD) peers in adulthood. Thus, statistical information may differ in relevance for language processing in individuals with and without DLD.

Use of Recast Intervention to Teach Causal Adverbials to Young Children With Developmental Language Disorder Within a Science Curriculum: A Single Case Design Study.

Purpose Language serves as an essential resource to learn about cause and effect throughout childhood. Causal adverbial sentences use causal conjunctions (e.g., because, so) to join 2 clauses to express cause-effect relationships ( Diessel & Hetterle, 2011 ). Causal adverbial sentences are frequently used to explain causal relationships in academic contexts, such as elementary school science and social studies classes ( Kinzie et al., 2014 ; J. Williams et al., 2014 ). Children with developmental language disorder (DLD) are at risk for failure in these academically relevant language skills. Here, we investigated the effect of language intervention focused on causal adverbials on both causal adverbials and acquisition of science content in young children with DLD. Method A multiple-probe design was used to examine the effect of language intervention using recasts on production of causal adverbials and acquisition of science content for 7 preschool/kindergarten children with DLD. Child production of causal adverbials and an untreated control structure were analyzed. Results Six of 7 participants exhibited gains in production of causal adverbials containing because, with effect sizes ranging from small to large. Performances on daily probes of science content learning and science unit tests indicate that participants are able to learn science content, but the magnitude of gains may not relate to skill in causal adverbial production. Conclusion Language intervention for young children with DLD can effectively treat complex syntactic targets such as causal adverbials in the context of science instruction, but it is unclear whether this can affect science content learning.

Buparlisib with thoracic radiotherapy and its effect on tumour hypoxia: A phase I study in patients with advanced non-small cell lung carcinoma.

BACKGROUND: Pre-clinically, phosphoinositide 3-kinase (PI3K) inhibition radiosensitises tumours by increasing intrinsic radiosensitivity and by reducing tumour hypoxia. We assessed whether buparlisib, a class 1 PI3K inhibitor, can be safely combined with radiotherapy in patients with non-small cell lung carcinoma (NSCLC) and investigated its effect on tumour hypoxia. METHODS: This was a 3 + 3 dose escalation and dose expansion phase I trial in patients with advanced NSCLC. Buparlisib dose levels were 50 mg, 80 mg and 100 mg once daily orally for 2 weeks, with palliative thoracic radiotherapy (20 Gy in 5 fractions) delivered during week 2. Tumour hypoxic volume (HV) was measured using 18F-fluoromisonidazole positron-emission tomography-computed tomography at baseline and following 1 week of buparlisib. RESULTS: Twenty-one patients were recruited with 9 patients evaluable for maximum tolerated dose (MTD) analysis. No dose-limiting toxicity was reported; therefore, 100 mg was declared the MTD, and 10 patients received this dose in the expansion phase. Ninety-four percent of treatment-related adverse events were ≤grade 2 with fatigue (67%), nausea (24%) and decreased appetite (19%) most common per patient. One serious adverse event (grade 3 hypoalbuminaemia) was possibly related to buparlisib. No unexpected radiotherapy toxicity was reported. Ten (67%) of 15 patients evaluable for imaging analysis were responders with 20% median reduction in HV at the MTD. CONCLUSION: This is the first clinical trial to combine a PI3K inhibitor with radiotherapy in NSCLC and investigate the effects of PI3K inhibition on tumour hypoxia. This combination was well tolerated and PI3K inhibition reduced hypoxia, warranting investigation into whether this novel class of radiosensitisers can improve radiotherapy outcomes.

Deficits in the Use of Verb Bias Information in Real-Time Processing by College Students With Developmental Language Disorder.

Purpose This study examined whether college students with developmental language disorder (DLD) showed similar sensitivity to verb bias information during real-time sentence processing as typically developing (TD) peers. Method Seventeen college students with DLD and 16 TD college students participated in a mouse-tracking experiment that utilized the visual world paradigm to examine real-time sentence processing. In experimental trials, participants chose 1 of 2 pictured interpretations of a sentence. Measures of interest were the choice of interpretation and the amount of competition from the unchosen picture as measured by mouse curvature. Results Choice of interpretation and mouse movements by college students with DLD suggested less sensitivity to verb bias information than their TD peers. Conclusion College students with DLD showed less evidence of sensitivity to verb bias information than their TD peers in this task. Their performance may reflect the use of compensatory processing strategies and may be related to poor comprehension abilities often observed in this population.

Effects of a Complexity-Based Approach on Generalization of Past Tense -ed and Related Morphemes.

Purpose: In a previous article, we reported that beginning treatment for regular past tense -ed with certain types of verbs led to greater generalization in children with developmental language disorder than beginning treatment with other types of verbs. This article provides updated data from that study, including the addition of data from 3 children, results from naturalistic language samples, and data from a third time point. Method: Twenty 4- to 9-year-old children with developmental language disorder (10 per condition) were randomly assigned to receive language intervention in which the verbs used to teach regular past tense -ed were manipulated. Half received easy first intervention, beginning with highly frequent, telic, phonologically simple verbs, and half received hard first intervention, beginning with less frequent, atelic, and phonologically complex verbs. The design used a train-to-criterion approach, with children receiving up to 36 visits. Performance was assessed using elicited production probes and language samples before intervention, immediately following intervention and 6-8 weeks later. Results: Children in the hard first group showed greater gains on the use of regular past tense -ed in both structured probes (at immediate post only) and in language samples (at both immediate and delayed post). Gains attributable to therapy were not observed in untreated morphemes. Conclusions: This study suggests that the choice of therapy materials, with an eye on the role that treatment stimuli play in generalization, is important for treatment efficacy. Clinicians should consider early selection of atelic, lower-frequency, phonologically complex verbs when teaching children to use regular past tense -ed. Further work expanding this to other morphemes and a larger population is needed to confirm this finding.

Individual and Developmental Differences in Distributional Learning.

Purpose: This study examined whether children and adults with developmental language disorder (DLD) could use distributional information in an artificial language to learn about grammatical category membership similarly to their typically developing (TD) peers and whether developmental differences existed within and between DLD and TD groups. Method: Sixteen children ages 7-9 with DLD, 26 age-matched TD children, 17 college students with DLD, and 17 TD college students participated in this task. We used an artificial grammar learning paradigm in which participants had to use knowledge of category membership to determine the acceptability of test items that they had not heard during a training phase. Results: Individuals with DLD performed similarly to TD peers in distinguishing grammatical from ungrammatical combinations, with no differences between age groups. The order in which items were heard at test differentially affected child versus adult participants and showed a relation with attention and phonological working memory as well. Conclusion: Differences in ratings between grammatical and ungrammatical items in this task suggest that individuals with DLD can form grammatical categories from novel input and more broadly use distributional information. Differences in order effects suggest a developmental timeline for sensitivity to updating distributional information.