Efficacy of AMALS in Treating Language Impairment in Children

Study Overview
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Brief Summary
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The goal of this proposal is to examine the efficacy of a manualized treatment intervention, AMALS: Addressing Multiple Aspects of Language Simultaneously, which is designed to remediate semantic, morphological, and syntactic aspects of language in preschool children with language impairment. This study will target preschool children with language impairment living in a region characterized by nonmainstream dialects. Questions driving this work are: Will children participating in the AMALS treatment exhibit greater semantic, morphological, and syntactic complexity on multiple outcome measures at the completion of the intervention compared to a Discrete Trial Approach (DTA) group? Will these gains be maintained at one-month follow up? What is the impact of dialect on dependent variables, specifically morphosyntactic abilities? To answer these questions a randomized clinical trial will be conducted comparing AMALS, an integrated approach to treatment, with DTA, an additive approach to therapy. In this study rather than restrict the ethnic and cultural backgrounds of this population, children's use of dialect will be uniquely identified and examined.

Official Title
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AMALS: Addressing Multiple Aspects of Language Simultaneously: A Randomized Clinical Trial

Conditions
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Language Disorder

Intervention / Treatment
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* Behavioral: AMALS
* Behavioral: DTA


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Demonstrate sufficient intelligibility as determined by a score of 85% on percent consonant correct (PCC) measures; Demonstrate sufficient phonological ability to use grammatical morphemes as determined by use of word-final /s, z, t, d/ on sound- in-word subtest from the Goldman-Fristoe Test of Articulation-2 (GFTA; Goldman & Fristoe, 2000) Nonverbal IQ above 70 as scored on the Columbia Mental Maturity Scale (CMMS; Burgemeister, Blum, & Lorge, 1972); Below 1SD on the Diagnostic Evaluation of Language Variation: Norm-referenced Test (DELV; Seymour, Roeper & de Villiers, 2005); Below 1.39SD on the Structured Photographic Expressive Language Test-Preschool (SPELT-P; Werner & Kresheck, 1983); Documentation from teachers and/or parents of impressions of language status in comparison with peers; More than one standard deviation below the mean on both levels 3 and 4 of the Preschool Language Assessment Instrument (PLAI; Blank, Rose, & Berlin, 1978). Exclusion Criteria: English as the primary language No oral-motor impairment No hearing impairment No co-morbid psychiatric or neurological impairments

Ages Eligible for Study
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Minimum Age: 4 Years
Maximum Age: 6 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: AMALS<br>Addressing multiple aspects of language simultaneously | Behavioral: AMALS<br>* Addressing multiple aspects of language simultaneously<br>|
| Experimental: DTA<br>Discrete Trial Approach | Behavioral: DTA<br>* Discrete Trial Approach<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Language Sample Analysis | Samples were transcribed and segmented by utterance. Each was coded categorically. Reported measures include percentage of utterances at the interpretive/inferential label, percentage of utterances with one or more t-unit (i.e., noun phrase + verb phrase), percentage of utterances that required copula (is/are) or auxiliary (is/are) that were produced. | Language samples were obtained pre-treatment, post-treatment, and at one-month follow-up. | 
| Number of Verb Structures Per Utterance | Samples were transcribed and segmented by utterance. Utterances were analyzed for novel verb structures. Structures were included if they were produced more than one time. | Pre-treatment, post-treatment, 1-month follow-up |