Sentence Prediction in Developmental Language Disorder

Millions of children - 7-12% of the school-age population - have developmental language disorder (DLD), a disorder that affects language learning, comprehension, and use. These children have difficulty with sentence production and comprehension at every stage of their development. These difficulties have major implications for the educational attainment of children with DLD compared to children with typical development (TD). Children with TD and adults make rapid predictions of upcoming words following verbs (e.g., predicting the patient in The dog eats the bone or the agent in The bone is eaten by the dog). Extensive work in children and adults indicates that prediction facilitates sentence comprehension by inducing a state of preparedness and contributes to language development by tuning the language system to the input. Children with DLD have a poorer ability to make sentence predictions, which may compound and result in sentence-comprehension deficits. Prior work on prediction deficits in DLD has focused on broad sentence characteristics like typicality or broad participant characteristics like vocabulary test scores. However, studies with typical individuals have identified more specific sentence- and participant-level contributors to sentence prediction. These factors have not been systematically explored in children with DLD. The investigators explore three separate hypotheses concerning factors that affect prediction in DLD. First, sentence- and participant-level properties affect prediction in children with DLD. Second, children with DLD lack robust representations of the underlying linguistic knowledge needed to predict, particularly abstract semantic features. Third, children with DLD have differences in event processing that relate to sentence prediction skill. The investigators investigate these hypotheses in 5-7-year-old school-age children with DLD across three Aims. Aim 1: Measure the effect of sentence- and participant-level properties on sentence prediction. The investigators will measure two participant-level cognitive factors (processing speed, verbal working memory) and their effect on prediction of agents and patients in sentences varying across two properties (syntactic complexity, semantic competition). Aim 2: Measure linguistic knowledge that underlies sentence prediction. The investigators will measure knowledge of agent-verb and verb-patient cooccurrences (e.g., dog-bite, eat-apple) and knowledge of verb-specific semantic features (e.g., throw-<round object>). Aim 3: Measure event-processing skills that underlie sentence prediction. The investigators will measure how children with DLD categorize and attend to agents/patients in visual scenes. Impact: This project has the promise to be highly impactful. First, it bridges disparate literatures on language processing in adults, children with TD, and children with DLD, providing clarity about predictive processing in DLD. Second, it may influence intervention approaches by identifying areas of strength and need in children with DLD. Third, it sets the stage for larger-scale longitudinal work examining effects of early prediction ability, language knowledge, and event processing on later sentence comprehension.

Study Overview

• Status: Recruiting
• Conditions: Developmental Language Disorder
• Intervention / Treatment: Behavioral: Thematic role; Behavioral: Sentence complexity

• Study Type: Interventional
• Enrollment (Estimated): 80
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Justin Kueser, PhD; Phone Number: 531-355-5035; Email: justin.kueser@boystown.org
• Study Contact Backup: Name: Emma Kate Thome, PhD; Phone Number: 531-355-5695; Email: emmakate.thome@boystown.org

Study Locations

• United States
  • Nebraska
    • Omaha, Nebraska, United States, 68131
      • Recruiting
      • Boys Town National Research Hospital
      • Contact: Justin Kueser, PhD; Phone Number: 531-355-5035; Email: justin.kueser@boystown.org
      • Contact: Emma Kate Thome, PhD; Phone Number: 531-355-5695; Email: emmakate.thome@boystown.org
      • Principal Investigator: Justin Kueser, PhD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Pass a hearing screening at 25dB at 0.5, 1, 2, and 4 kHz
• Have normal or corrected-to-normal vision
• Have no history of neurological disorders
• For DLD group, Test of Narrative Language 2 (TNL-2) score less than 92
• For TD group, TNL-2 score greater than 92, a cut-off that provides excellent sensitivity/specificity (.92/.92).

Exclusion Criteria:

• Scores in the Autism range on the Childhood Autism Rating Scale 2 (CARS-2)
• Scores below 75 on the Visual Spatial Index of the Wechsler Preschool and Primary Scale of Intelligence 4 (WPPSI-IV)

Study Plan

How is the study designed?

Design Details

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

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Measure verb knowledge, sentence processing, and event processing; The investigators will measure participant-level cognitive factors and their effect on prediction of agents and patients in sentences varying across syntactic complexity and semantic competition. The investigators will measure knowledge of agent-verb and verb-patient cooccurrences (e.g., dog-bite, eat-apple) and knowledge of verb-specific semantic features (e.g., throw-<round object>). The investigators will measure how children with DLD categorize and attend to agents/patients in visual scenes.

Behavioral: Thematic role; The thematic role assessed for some trials will be the agent thematic role (i.e., the actor) and the thematic role assessed for the other trials will be the patient thematic role (i.e., the undergoer).; Behavioral: Sentence complexity; In half of the sentences, complexity will be simple (i.e., in simple active or passive sentences with no intervening linguistic material between the verb and the noun-to-be-predicted). In the other half of the sentences, complexity will be complex (i.e., additional linguistic material will intervene between the verb and the noun-to-be-predicted).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Behavioral response data	For verb knowledge tasks, the investigators will measure children's button presses for accuracy.	During sessions for verb knowledge tasks
Eye tracking gaze data	During sentence processing and event processing, the investigators will measure children's looking to one or more images presented on-screen as a sentence is played (Aim 1) or as they point to images (Aim 3). The investigators will analyze how intervention conditions (thematic role and sentence complexity) influences children's looking patterns.	During sessions for sentence processing and event processing tasks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Behavioral response data	For verb knowledge tasks, the investigators will measure children's button presses for latency.	During sessions for verb knowledge tasks

Collaborators and Investigators

• Sponsor: Father Flanagan's Boys' Home
• Collaborators: National Institute on Deafness and Other Communication Disorders (NIDCD)

Study record dates

Study Major Dates

• Study Start (Actual): February 16, 2026
• Primary Completion (Estimated): July 1, 2028
• Study Completion (Estimated): July 1, 2028

Study Registration Dates

• First Submitted: February 24, 2026
• First Submitted That Met QC Criteria: March 31, 2026
• First Posted (Actual): April 6, 2026

Study Record Updates

• Last Update Posted (Actual): April 6, 2026
• Last Update Submitted That Met QC Criteria: March 31, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Neurologic Manifestations; Nervous System Diseases; Neurobehavioral Manifestations; Communication Disorders; Language Disorders; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Language Development Disorders
• Other Study ID Numbers: R21DC022371-01 (U.S. NIH Grant/Contract); R21DC022371-01A1 (U.S. NIH Grant/Contract)

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No