An Alternative Grammatical Treatment for Children with Language Impairment

描述（由申请人提供）：目前对原发性语言障碍（PLD）儿童的语法治疗方法在经过长时间的治疗后只能产生中度显著的收益，因此是不充分的。据估计，大约14%的幼儿园儿童患有PLD，其中包括那些在语言方面表现出明显弱点的儿童，尽管他们没有达到智力残疾的标准。PLD对早期语言发展产生负面影响，并对社会交往、学术工作和终身成就产生长期不利影响。PLD儿童的核心语言缺陷之一是语法形式的使用不佳，这种缺陷一直持续到青春期。PLD长期负面影响的一个原因可能是目前的语法治疗使用无效的教学方法。传统的治疗方法使用归纳方法（例如，提供高频率的问题形式模型），在这种方法中，学习者被期望隐性地习得和概括目标语法形式。在其他语言相关学科中存在的证据表明，包含替代演绎教学方法比单独的归纳方法更有效。与传统的归纳法不同，演绎教学的目的是通过直接呈现模式或教学规则，使学习者明确地意识到潜在的语言模式。提出的研究的目的是比较传统的归纳方法的有效性，以一种方法，其中包括演绎教学。这项研究是一个研究项目的一个组成部分，该项目的重点是确定对语言障碍儿童有效和高效的干预措施。据预测，综合演绎-归纳（D-I）方法将积极参与儿童的元认知加工技能，并将导致更多的语法学习的PLD儿童比归纳（I-O）方法。在强有力的初步数据的指导下，这一预测将通过四个具体目标进行测试：(a)确定在教授新的语法形式时，D-I方法是否比I-O方法更有效；(b)确定D-I指令所取得的收益能否长期保持；(c)确定D-I方法在教授三种新的语法形式时是否有不同的效果；(d)确定d - i方法在教育有和没有明显语言理解缺陷的PLD儿童方面是否有不同的效果。为了实现这些目标，60名5至7岁的PLD儿童将被随机分配到D-I或I-O治疗中。两个小组的参与者都将有机会学习三种新的语法变化。学习的准确性和反应时间将在治疗后立即和治疗后1周进行评估。迄今为止，语言干预的主要重点是归纳方法；因此，建议评估替代干预方法代表了当前临床实践的创新转变。结合演绎方法可能会对PLD儿童的长期预后产生积极影响，并导致临床服务的转变。

DESCRIPTION (provided by applicant): Current grammatical treatment approaches for children with primary language disorder (PLD) yield only moderately significant gains after extensive treatment periods and are thus, inadequate. It is estimated that approximately 14% of kindergarten children have PLD, which includes children who exhibit significant weaknesses in language despite failing to meet criteria for intellectual disability. PLD negatively impacts early language development and has long-term detrimental effects on social interactions, academic work, and lifelong achievement. One of the core language weaknesses of children with PLD is poor use of grammatical forms with such weak- nesses persisting well into adolescence. One reason for the long-term negative effects of PLD may be that cur- rent grammatical treatments are using ineffective teaching approaches. Traditional treatments use inductive approaches (e.g., providing models of problematic forms at a high frequency) in which the learner is expected to implicitly acquire and generalize target grammatical forms. Evidence exists in other language-related disciplines that the inclusion of an alternative deductive teaching approach is more effective than inductive approaches alone. Unlike traditional inductive approaches, deductive instruction aims to make the learner explicitly aware of the underlying language pattern by directly presenting the pattern or pedagogic rule. The goal of the proposed study is to compare the efficacy of a traditional inductive approach to an approach that incorporates deductive instruction. This study is an integral component of a program of research focused on identifying effective and efficient interventions for children with language impairment. It is predicted that a combined deductive-inductive (D-I) approach will positively engage children's metacognitive processing skills and will lead to greater grammatical learning by children with PLD than an inductive-only (I-O) approach. Guided by strong preliminary data, this prediction will be tested through four specific aims: (a) to determine if a D-I approach is more efficacious than an I-O approach when teaching novel grammatical forms; (b) to determine whether gains made following D-I instruction are maintained over time; (c) to determine whether a D-I approach is differentially effective when teaching three novel grammatical forms; and (d) to determine if a D-I approach is differentially effective at teaching children with PLD who do and do not have significant language comprehension deficits. To address these aims, 60 5- to 7-year old children with PLD will be randomly assigned to either a D-I or I-O treatment. Participants in both groups will have the opportunity to learn three novel grammatical inflections. Learning will be assessed in terms of accuracy and response times' immediately following and 1-week post- treatment. To date, the primary emphasis on language intervention has been on inductive approaches; there- fore, the proposed evaluation of an alternative intervention approach represents an innovative shift in current clinical practice. The incorporation of deductive approaches may prove to positively impact the long-term out- comes of children with PLD and result in a transformation in clinical services. PUBLIC HEALTH RELEVANCE: The proposed research is relevant to public health because it aims to contribute to a program of research focused on significantly improving the clinical services offered to children with language impairment. Because the project is focused on ameliorating long-term grammatical weaknesses of children with significant language impairment, the project is relevant to NIDCD's mission to improve the lives of individuals with communication disorders.