Learning to Learn: Initial Treatment of a Partially Acquired Grammatical Form Speeds Later Learning of Rarely Used Forms for Children With Developmental Language Disorder.

purposePreschool children with developmental language disorder (DLD) frequently omit or misuse multiple grammatical forms. We hypothesized that treatment of these errors might be more efficient if treatment first targeted a grammatical form anticipated to be easy to treat, because it was partially acquired by the child, before targeting a form that was rarely used that might be more difficult to learn.

methodThirty-four preschool children with DLD were treated for up to 25 sessions using Enhanced Conversational Recast therapy. Half received treatment targeting a grammatical form that they used rarely ("difficult," less than 7% pretreatment use on average), and half began with a grammatical form that they used more frequently ("easy," more than 50% pretreatment use on average) and then transitioned to a difficult form. An additional grammatical form that was rarely used served as an untreated control form for both groups. Generalization to untreated linguistic contexts was probed for both treated and untreated grammatical forms throughout the treatment period and after a period of no treatment to test retention.

resultsBayesian analyses provided support for the efficacy of the treatment overall. Children who first began with an easy target made stronger initial gains on their difficult target compared with children who began with a difficult target. Retention of treated grammatical forms was strongly correlated with their use at the end of treatment. DISCUSSION: The results suggest that children with DLD "learn to learn" in treatment and that beginning with a target that children use some of the time can facilitate learning of a subsequent, more difficult target. This could make treatment of multiple targets more efficient in clinical practice. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.31057249.