Maximizing Treatment Efficiency in Developmental Language Disorder: Positive Effects in Half the Time

Elena Plante, Heidi M Mettler, Alexander Tucci, Rebecca Vance, Elena Plante, Heidi M Mettler, Alexander Tucci, Rebecca Vance

Abstract

Purpose When a behavioral treatment is generally efficacious, the central research questions shift to optimized dose delivery. In this study, we determine whether a validated treatment method can be made more effective or efficient by increasing the dose density employed. Method Twenty children were treated with Enhanced Conversational Recast methods to treat morphological errors. Half received 24 doses per session within a half hour (approximately 1 dose/1.25 min), and the other received the same number of doses within 15 min (approximately 1 dose/38 s). Generalization of morpheme use was probed throughout treatment and at a 6-week follow-up. Spontaneous use of treated morphemes was also tracked. Results Although the treatment was effective overall, there were no significant differences between treatment conditions on any of the outcome measures. Follow-up performance correlated significantly with performance at the end of the treatment period. Conclusion Minimal between-groups differences suggest that performance does not suffer when dose rates are compressed into half the time during treatment, making the high-density dose delivery method a more efficient delivery method. This could make time available within a treatment session to address other goals or allow for more classroom instructional time for the child. Supplemental Material https://doi.org/10.23641/asha.8968559.

Figures

Figure 1.
Figure 1.
Group treatment effects for the Sparse and Dense treatment conditions. Target morphemes were those treated, and control morphemes were untreated but tracked over the course of treatment. Error bars indicate the standard error of the mean.
Figure 2.
Figure 2.
Posttreatment follow-up performance by children in Sparse and Dense treatment conditions.
Figure 3.
Figure 3.
Generalization data for individual children in the Dense and Sparse treatment conditions. Data reflect performance on generalization probes collected during the treatment period and collected 5–7 weeks posttreatment. Gaps in the line charts indicate absences during treatment or the time between treatment and retention testing.

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