Pilot Evaluation of the Developed Syntactic-Semantic Visual Configuration Intervention for Children With Language Impairment (SSVC-PILOT)

August 25, 2026 updated by: Riphah International University

This study will pilot a newly developed Syntactic-Semantic Visual Configuration Intervention (SSVCI) designed to help Urdu-speaking children with language impairment improve their ability to understand and produce phrases and sentences. The intervention was developed through extensive literature review, expert recommendations, and the structure of the Urdu language to ensure that it is appropriate for children in Pakistan.

Before pilot testing, experts in speech-language pathology and Urdu linguist according to the inclusion criteria reviewed the intervention material to evaluate whether the activities are relevant, culturally appropriate, and representative of the language skills being taught. Feedback from children and caregivers was also be used to in the first phase of need assessment, before the intervention material was finalized.

The pilot study will include 20 children aged 6 to 12 years, including 10 children with language impairment and 10 children with typical language development. Participants will be recruited from selected schools, hospitals, and special education centers in Islamabad. Children with language impairment conditions , with primary diagnosis of autism spectrum disorder, hearing impairment, cerebral palsy, or Down syndrome, provided they meet the study eligibility criteria will be included.

Participants will complete language assessments before taking part in the intervention activities. These assessments will measure language skills such as sentence formation, understanding of spoken language, and narrative abilities. Information collected during the pilot study will help researchers determine whether the intervention materials are clear, practical, culturally appropriate, and suitable for use in a larger clinical trial. Findings from this study will also be used to refine the intervention by identifying activities or items that require modification or removal before final implementation.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Language impairment affects a child's ability to understand and use spoken language, particularly the development of phrases and sentences. Urdu-speaking children with conditions like autism, hearing impairment , down syndrome and cerebral palsy , often experience difficulties with syntactic and semantic language skills; however, there is currently no standardized, culturally appropriate intervention developed specifically for the Urdu language. The Syntactic-Semantic Visual Configuration Intervention (SSVCI) was developed to address this gap by providing a structured, visually supported language intervention based on the linguistic characteristics of Urdu.

The intervention was developed through a systematic review of evidence and literature on language intervention approaches, followed by the identification of foundational syntactic and semantic domains relevant to Urdu-speaking children. Intervention materials were designed , with reference to different domains using visual configuration cues to facilitate language comprehension and expression. Before pilot implementation, the content underwent expert review to evaluate its relevance, representativeness, technical quality, and cultural appropriateness. Feedback from SLPs and Urdu linguistic experts and representatives of the target population was incorporated to refine the intervention materials.

The purpose of this pilot study is to evaluate the feasibility, acceptability, and preliminary clinical utility of the SSVCI in Urdu-speaking children with language impairment. The study will also determine whether the intervention procedures, session structure, assessment methods, and treatment materials are suitable for implementation in a larger clinical trial.

All enrolled participants will receive the SSVCI. This pilot study uses a single-group, quasi-experimental pretest-posttest design, and no control group or randomization will be used during this phase.

Participants will complete baseline language assessments before beginning the intervention. Following baseline assessment, participants will receive 16 individual therapy sessions, delivered by a qualified speech-language pathologist two to three times per week, with each session lasting approximately 30 minutes.

The intervention is organized into progressive stages. The initial sessions focus on baseline assessment of language abilities. The second stage introduces children to the visual configuration system and its symbolic cues that support comprehension and production of language. Therapy activities target foundational syntactic and semantic concepts, including understanding and answering questions . The final stage targets early grammatical structures, , through structured visual supports and functional language activities designed to promote phrase and sentence development.

Participant progress will be monitored throughout the intervention using standardized probe activities and language assessments administered before and after treatment. Measures of participant engagement, treatment adherence, intervention delivery, and language performance will also be collected to evaluate the practicality and acceptability of the intervention.

The findings of this pilot study will be used to refine the intervention protocol, improve treatment materials and procedures, and establish the feasibility of conducting a future randomized controlled trial to evaluate the effectiveness of the Syntactic-Semantic Visual Configuration Intervention in Urdu-speaking children with language impairment.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
20

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Child

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Both genders will be included
  • Children of age range 6-12 years.
  • Children whose primary Language is Urdu.
  • Children who have the concept of noun, verbs, adjectives and prepositional concepts.
  • Children who are unable to join them to form phrases and sentences.
  • Diagnosed cases of ASD, hearing impairments, Cerebral Palsy and Down syndrome.

Exclusion Criteria:

  • Children with any co morbid conditions.
  • Children with Behavioral issues.
  • Children with attention deficit hyper activity.
  • Hearing impaired children not using amplifying and assistive devices.
  • Children with impaired vision.
  • Children not able to perform on ICW level 1 and blank level

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Experimental: Syntactic-Semantic Visual Configuration Intervention (SSVCI)
Participants will receive the Syntactic-Semantic Visual Configuration Intervention (SSVCI), a structured, visually supported Urdu language intervention designed to improve syntactic and semantic language skills in children with language impairment. The intervention consists of 16 individual therapy sessions delivered by a qualified speech-language pathologist, two to three times per week, with each session lasting approximately 30 minutes. The intervention progresses from foundational language concepts to early grammatical structures using visual configuration cues and structured language activities.
Behavioral: Syntactic-Semantic Visual Configuration Intervention (SSVCI)
The Syntactic-Semantic Visual Configuration Intervention (SSVCI) is a structured, therapist-delivered language intervention developed specifically for Urdu-speaking children with language impairment. The intervention integrates syntactic and semantic language instruction with a visual configuration system that uses standardized visual cues to facilitate language comprehension and expressive language production. Therapy progresses systematically from foundational language concepts to early grammatical structures, including question forms, descriptive language, location concepts, negation, and plural forms. The intervention is culturally and linguistically tailored to Urdu and is delivered individually by a qualified speech-language pathologist in sixteen 30-minute sessions conducted two to three times per week.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Outcome 1: Change in Narrative Performance (MAIN)
Time Frame: Baseline and immediately after completion of the 16 intervention sessions (approximately 8 weeks).

Description:

Narrative language performance will be assessed using the Urdu version of the Multilingual Assessment Instrument for Narratives (MAIN). At baseline and post-intervention, each participant will be presented with a standardized six-picture narrative sequence and will be asked to produce the corresponding story. Narrative production will be scored according to the standardized MAIN Urdu scoring criteria, including story structure and structural complexity. Narrative comprehension will be assessed using the standardized MAIN comprehension questions administered following the narrative task.

For each participant, the MAIN narrative production score and narrative comprehension score will be calculated according to the instrument's predefined scoring criteria. Higher scores indicate better narrative production and/or comprehension performance. The outcome will be evaluated as the change in MAIN scores from baseline to immediately after completion of the intervention.
Baseline and immediately after completion of the 16 intervention sessions (approximately 8 weeks).
Outcome Measure 2 Title: Change in Mean Length of Utterance in Words Derived from the Narrative Language Sam
Time Frame: Baseline and immediately after completion of the 16 intervention sessions (approximately 8 weeks).

Description

Description:

Mean Length of Utterance in words (MLU-w) will be calculated from each participant's recorded narrative language sample obtained during the story-production task at baseline and after completion of the intervention. The participant's narrative will be audio-recorded and transcribed verbatim. The transcript will be segmented into utterances using predefined language-sample segmentation rules.

MLU-w will be calculated as:

MLU-w = Total number of words produced ÷ Total number of utterances

A separate MLU-w value will be calculated for each participant at baseline and post-intervention. The outcome will be the change in MLU-w from baseline to post-intervention, with a higher MLU-w indicating production of longer utterances and greater expressive syntactic complexity.
Baseline and immediately after completion of the 16 intervention sessions (approximately 8 weeks).

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Riphah International University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Study Chair: Humaira Shamim Kiyani, Phd, Riphah International University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
September 1, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
September 23, 2026

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
September 23, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
July 27, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
August 25, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
August 26, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
August 26, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
August 25, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
August 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • REC/014187 Naima Farooq

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data will not be shared because the study involves a small sample of children, and sharing individual-level data may increase the risk of participant identification. Results will be reported in aggregate form to protect participant confidentiality and privacy.

There are no current plans to share individual participant data. Study findings will be published in aggregate form, and participant confidentiality will be maintained in accordance with institutional ethics requirements.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Cookie Settings

We use cookies to ensure that we give you the best experience on our website. For more details carefully read our Privacy and Cookies Policy. ...>>>You can change your preferences or withdraw your consent at any time by deleting the cookies from your website or computer as described in the policy. Please accept it and choose your preferences by ticking the corresponding boxes in the "Manage Settings" section below. Please carefully read our Terms of Service before you proceed with using any part of this website.
«Manage Settings