An interventional study of Recast Therapy and Syntax Stories in Developmental Language Disorder and Language Impairment, sponsored by University of Delaware. Completed at 2 sites in United States. Open to participants aged 4 Years to 9 Years. Per ClinicalTrials.gov, last updated 2026-05-12.
Sponsored by University of Delaware · Not applicable, Interventional, and Treatment
Developmental Language Disorder (DLD) affects approximately seven percent of the population and is characterized by grammatical deficits that cascade into lifelong academic challenges and under-employment. Current treatments for DLD produce good outcomes under ideal, high intensity conditions or when parents have been trained to deliver therapy using intense coaching methods; however, current publicly funded service delivery systems and private-pay reimbursement models do not support treatment being delivered in this ideal fashion for children older than three. This project will examine alternative methods of delivering treatment that may be more feasible under typical conditions and will identify implementation barriers, with the goal of improving long-term outcomes for children with DLD. We hypothesize that feasibility and palatability will influence dose, which will in turn affect the overall language outcomes.
121 studies on the registry are indexed under Language Development Disorders; 49 are open to participants now.
This study's enrollment of 137 is above the median of 74 across 106 interventional studies indexed under Language Development Disorders.
Browse Language Development Disorders studies →University of Delaware is the lead sponsor of 128 studies on the registry; 22 are open to participants now.
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Inclusion Criteria:
Child with DLD
Able to benefit from treatment:
Caregiver
Children will be exposed to recasts at a rate of 1/minute. Treatment will be provided 2x/week for 8 weeks for a total of 16 visits (960 recasts). 2 additional weeks are allocated for make up visits. Treatment will be provided by a trained, certified, licensed Speech Language Pathologist (SLP).
Behavioral: Recast Therapy
Children will be listen to books that are specially scripted to promote the use of a particular syntax target. Treatment will be provided 2x/week for 8 weeks for a total of 16 visits (960 exposures), with 2 books read at each visit. 2 additional weeks are allocated for make up visits. Treatment will be provided by a trained, certified, licensed SLP.
Behavioral: Syntax Stories
Caregivers will receive two training sessions on how to provide recast therapy and demonstrate their skill at providing recast therapy with support from the clinician. Caregivers will then provide recast therapy at a rate of 1 recast per minute to their children for a minimum of 16 hrs (960 exposures) scheduled at their own convenience.
Behavioral: Recast Therapy
Caregivers will receive two training sessions on how to provide read illustrated syntax stories to their children and demonstrate their skill at reading these stories with support from the clinician. Caregivers will then read these stories to their children for a minimum of 32 book readings (960 exposures)
Behavioral: Syntax Stories
Recast therapy is when a interventionist uses the child's own productions as a platform for restating or recasting the child's speech with corrections or alterations to focus on a particular syntax target.
Also known as: Focused Stimulation
Syntax stories are specially constructed stories read verbatim designed to teach a syntax target.
Also known as: Priming, Book Reading
Change in Accuracy on Elicited Production Probes
Children will respond to 20 item elicited production probes that ask the child to produce the treated structures and a control structure. Elicited Production Probes are highly reliable (ICC \>.9), valid measures of children's use of a grammatical form. They have clinical relevance and align with the types of items that occur on standardized tests of language use.
Time frame: 2 week prior to the start of therapy; 2 week post therapy
Change in Comprehension probes (Proportion Looking)
Children will participate in an online looking while listening task with 24 items each for the treated target and a control (untreated) structure. Looks to areas of interest on the screen will be recorded. Proportion of time looking at the target picture will be the dependent variable. Looking patterns provide insight into the online processes associated with language comprehension and thus has the potential to inform future studies. These online measures have become well accepted as valid means of understanding comprehension. As far as we are aware there is limited psychometric data available for this age group, but Farris-Trimble \& McMurray (2013) have shown these types of paradigms to be reliable.
Time frame: 2 week prior to the start of therapy, 2 week post therapy
Estimated Dose Delivered
Adherence (attendance, reported therapy delivery)and treatment fidelity derived from recordings will be combined to estimate the number of exposures/recasts the caregiver provided to the child. This primary measure is important for future studies given the need to understand how well treatment is provided by parents and lab staff for these types of syntactic forms.
Time frame: During 10 week treatment period
Semi-structured interviews
Ethnographic interview examines the caregiver's comfort and understanding and motivation for participation in therapy. Ethnographic interviewing is a valid and reliable technique for qualitative data collection.
Time frame: within 2 weeks post therapy ( ~12- 14 week mark in study timeline)
Change in Comprehension probes (Pointing)
Children will participate in an online looking while listening task with 24 items each for the treated target and a control (untreated) structure. Points to the correct picture after the conclusion of eye gaze collection will be the dependent variable.
Time frame: 2 week prior to the start of therapy, 2 week post therapy
Palatability of treatment
Likert ratings of how much therapy is enjoyed
Time frame: During 10 week treatment period, immediately after each treatment session
Effortfulness of treatment
Likert ratings of how effortful therapy is to deliver.
Time frame: During 10 week treatment period, immediately after each treatment session
self-efficacy of treatment provider
Likert ratings of how efficacious the provider perceived the activities to be
Time frame: During 10 week treatment period, immediately after each treatment session
Caregiver grammar knowledge
Written grammar quiz adapted from Brimo (in press). This questionnaire was previously validated for pre-service SLPs, early childhood educators, and practicing SLPs. The first two sections (implicit knowledge) have been used by Brimo. The last two sections (labeling) have been used in our lab to assess the knowledge of graduate clinicians.
Time frame: In the first 1.5 weeks of the treatment period
Theoretical Domains Framework (TDF) Questionnaire
Questionnaire aligned with Theoretical Domains Framework constructs that examines the caregiver's comfort and understanding and motivation for participation in therapy. This questionnaire was previously validated for providers of Physical Therapy.
Time frame: within 2 weeks post therapy ( ~12- 14 week mark in study timeline)
PDFs hosted by the registry, ClinicalTrials.gov.
Plan to share: Yes — Summary results of the primary outcomes for Aims 1 \& 2 (elicited production and eye-gaze) will be uploaded within 12 months of the last data collection point for the final participant. We will track and provide information about participant flow. At each phase of participation, we will aggregate and report the following information: non-qualifiers: available screening information and reason for not continuing; qualifying participants who continue in the study: screening \& pretest information, by treatment group; participants who complete the study: post-test scores, by treatment group; participants who drop out: reasons given for dropout, along with any adverse events; It is not possible to fully de-identify the interviews utilized in the mixed methods study (Aim 3). Thus, these data will not be shared. Additional data at the individual participant level may be sharable upon request and IRB approval for particular access.
Supporting information: Study protocol, Statistical analysis plan, Informed consent form, Analytic code
Time frame: 1 year after final data collection is complete
Access criteria: IRB approval for access to data
Ran from Sep 2021 to primary completion in Apr 2026, 54 months.
Of 72 non-industry interventional studies with no phase under Language Development Disorders, half reached primary completion within 30 months of starting (the median), counting those still running; a quarter within 19 and three quarters within 57. This study's 54 months is above that.
Counting every sponsor, half of 72 studies reached it within 30 months; a quarter within 19 and three quarters within 57.
How these figures are worked out, and which studies are left out of them.
This study is completed, as verified in May 2026. You cannot join it, but the record below documents what was studied.
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