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.

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.

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.

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.

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.

Distributional learning aids linguistic category formation in school-age children.

The goal of this study was to determine if typically developing children could form grammatical categories from distributional information alone. Twenty-seven children aged six to nine listened to an artificial grammar which contained strategic gaps in its distribution. At test, we compared how children rated novel sentences that fit the grammar to sentences that were ungrammatical. Sentences could be distinguished only through the formation of categories of words with shared distributional properties. Children's ratings revealed that they could discriminate grammatical and ungrammatical sentences. These data lend support to the hypothesis that distributional learning is a potential mechanism for learning grammatical categories in a first language.

Distributional Learning in College Students With Developmental Language Disorder.

Purpose: This study examined whether college students with developmental language disorder (DLD) could use distributional information in an artificial language to learn about grammatical category membership in a way similar to their typically developing (TD) peers. Method: Seventeen college students with DLD and 17 TD college students participated in this task. We used an artificial grammar in which certain combinations of words never occurred during training. At test, participants had to use knowledge of category membership to determine which combinations were allowable in the grammar, even though they had not been heard. Results: College students with DLD performed similarly to TD peers in distinguishing grammatical from ungrammatical combinations. Conclusion: Differences in ratings between grammatical and ungrammatical items in this task suggest that college students with DLD can form grammatical categories from novel input and more broadly use distributional information.

Quantifying the relative contributions of lexical and phonological factors to regular past tense accuracy.

PURPOSE: Children with specific language impairment (SLI) frequently have difficulty producing the past tense. This study aimed to quantify the relative influence of telicity (i.e. the completedness of an event), verb frequency and stem final phonemes on the production of past tense by school-age children with SLI and their typically-developing (TD) peers. METHOD: Archival elicited production data from children with SLI between the ages of 6-9 and TD peers aged 4-8 were re-analysed. Past tense accuracy was predicted using measures of telicity, verb frequency measures and properties of the final consonant of the verb stem. RESULT: All children were highly accurate when verbs were telic, the inflected form was frequently heard in the past tense and the word ended in a sonorant/non-alveolar consonant. All children were less accurate when verbs were atelic, rarely heard in the past tense or ended in a word final obstruent or alveolar consonant. SLI status depressed overall accuracy rates, but did not influence how facilitative a given factor was. CONCLUSION: Some factors that have been believed to be useful only when children are first discovering past tense, such as telicity, appear to be influential in later years as well.

The role of developmental levels in examining the effect of subject types on the production of auxiliary is in young english-speaking children.

PURPOSE: Prior work (Guo, Owen, & Tomblin, 2010) has shown that at the group level, auxiliary is production by young English-speaking children was symmetrical across lexical noun and pronominal subjects. Individual data did not uniformly reflect these patterns. On the basis of the framework of the gradual morphosyntactic learning (GML) hypothesis, the authors tested whether the addition of a theoretically motivated developmental measure, tense productivity (TP), could assist in explaining these individual differences. METHOD: Using archival data from 20 children between age 2;8 and 3;4 (years;months), the authors tested the ability of 3 developmental measures (TP; finite verb morphology composite, FVMC; mean length of utterance, MLU) to predict use of auxiliary is with different subject types. RESULTS: TP, but not MLU or FVMC, significantly improved model fit. Children with low TP scores produced auxiliary is more accurately with pronominal subjects than with lexical subjects. The facilitative effect of pronominal subjects on the production of auxiliary is, however, was not found in children with high TP scores. CONCLUSION: The finding that the effect of subject types on the production accuracy of auxiliary is changed with children's TP is consistent with the GML hypothesis.

Cognitive state verbs and complement clauses in children with SLI and their typically developing peers.

This study investigated the use of cognitive state verbs (CSVs) and complement clauses in children with specific language impairment (SLI) and their typically developing (TD) peers. In Study 1, conversational samples from 23 children with SLI (M = 6;2), 24 age-matched TD children (M = 6;2) and 21 vocabulary-matched TD children (M = 4;9) were analysed for the proportional use of CSVs, verb types, co-occurrence with complement clauses and syntactic frame types. Children in all three groups had similar performance in all measures. Study 2 compared a subset of children on CSV use in conversational and narrative/expository samples. Conversation elicited more high-frequency verbs, whereas narrative/expository samples elicited more low-frequency verbs. Children with SLI used fewer different verbs and were less likely to combine low-frequency verbs with a complement clause than their TD peers. We conclude that these observed deficits can be attributed to limitations in lexical knowledge rather than a syntactic deficit.