The Efficacy of an Explicit Intervention Approach to Improve Past Tense Marking for Early School-Age Children With Developmental Language Disorder

Abstract

Purpose The aim of the study was to evaluate the efficacy of a theoretically motivated explicit intervention approach to improve regular past tense marking for early school-age children with developmental language disorder (DLD). Method Twenty-one children with DLD (ages 5;9–6;9 [years;months]) were included in a crossover randomized controlled trial (intervention, n = 10; waiting control, n = 11). Intervention included once-weekly sessions over 10 weeks using the SHAPE CODING system, in combination with a systematic cueing hierarchy to teach past tense marking. Once the first group completed intervention, the waiting control group crossed over to the intervention condition. The primary outcome was criterion-referenced measures of past tense marking with standardized measures of expressive and receptive grammar as the secondary outcome. Ancillary analyses on extension and behavioral control measures of morphosyntax were also conducted. Results There was a significant Time × Group interaction ( p < .001) with a significant difference in pre–post intervention improvement in favor of the intervention group ( p < .001, d = 3.03). Further analysis once both groups had received the intervention revealed no improvement for either group on past tense production during the 5-week pre-intervention period, significant improvement pre–post intervention ( p < . 001, d = 1.22), with gains maintained for 5 weeks postintervention. No significant differences were found on pre- to postintervention standardized measures of grammar, or on extension or control measures. Conclusions The efficacy of the theoretically motivated explicit grammar intervention was demonstrated. Results contribute to the evidence base supporting this intervention to improve past tense production in early school-age children with DLD, suggesting it is a viable option for clinicians to select when treating morphosyntactic difficulties for this population. Supplemental Material https://doi.org/10.23641/asha.13345202

Evaluating two different dose frequencies and cumulative intervention intensities to improve past tense production for early school‐aged children with developmental language disorder

“…The current study tested hypotheses by retrospectively comparing results from previously conducted studies. Data from nine children receiving intervention twice per week for 10 weeks as part of a single case experimental design (twice per week = 2PW) (Calder et al, 2020) were compared to data from 20 children who received the same intervention once per week for 10 weeks as part of a randomised controlled trial (once per week = 1PW) (Calder et al, 2021a).…”

“…The Procedural Deficit Hypothesis (Ullman & Pierpoint, 2005) suggests that explicit interventions may be beneficial for children with DLD to improve grammar due to an implicit learning deficit. Recent findings from Calder et al (2018Calder et al ( , 2020Calder et al ( , 2021a suggest explicit grammar intervention combining metalinguistic training and a systematic cueing hierarchy is efficacious for treating production of regular past tense for children aged around 6 years with DLD. The metalinguistic training aspect is based on the SHAPE CODING system (Ebbels, 2007), which uses specific visual cues such as colours, shapes and arrows to explicitly teach children rules of syntax and morphology.…”

“…This criterion-referenced subtest includes 30 items evenly distributed for all possible allomorphs (i.e., 10× [d] verbs, 10× [t] verbs, and 10× [əd] verbs). The GET has been used in several studies to identify intervention targets and/or measure intervention progress (Calder et al, 2018(Calder et al, , 2020(Calder et al, , 2021aSmith-Lock et al, 2013a, 2013b. The results from children with DLD on the GET have been further analysed to explore patterns of morphosyntactic difficulty (Tomas et al, 2015) as well as conduct preliminary psychometric assessment of the measure (Calder et al, 2021b).…”

“…Rather, study enrolment was capped at nine to meet standards for single case reporting (Kratochwill et al, 2012). Participants in the 1PW condition were randomly assigned to either the intervention condition (n = 10) or a waiting control (n = 11) by a researcher blinded to the purpose of the study (Calder et al, 2021a). Of note, one child was exited from the waiting control group prior to receiving intervention, and their data have been excluded from all analyses resulting in 29.…”

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