NCT03525951

Brief Summary

Children with poor early language skills are at risk for academic, social, vocational, and health difficulties across the lifespan. Parent training-as part of early language intervention-is a cost-effective option to address this public health issue, but these interventions demonstrate large individual differences in outcomes and barriers to scalability. The purpose of this research is to examine parent-level predictors of early language interaction quality and modifiability during training, which will help increase intervention effectiveness.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
156

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Mar 2021

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

May 3, 2018

Completed
13 days until next milestone

First Posted

Study publicly available on registry

May 16, 2018

Completed
2.9 years until next milestone

Study Start

First participant enrolled

March 22, 2021

Completed
4.5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 18, 2025

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

September 18, 2025

Completed
Last Updated

November 13, 2025

Status Verified

November 1, 2025

Enrollment Period

4.5 years

First QC Date

May 3, 2018

Last Update Submit

November 10, 2025

Conditions

Outcome Measures

Primary Outcomes (2)

  • Parental Language Stimulation Strategies (Study 2; Remote)

    The investigators will code the structured interaction task for parents' use of language stimulation strategies.The investigators will code use of trained strategies (i.e., responsive interaction, matched turns, language modeling, and expansions) and untrained generalization measures like constructive directives and scaffolds. This primary outcome will be a composite score of these language stimulation strategies (e.g., responsive interaction, matched turns, language modeling, expansions, constructive directives, and scaffolds). This composite will be measured at baseline and post-treatment during the structured interaction task, so the same amount of time will be given to each participant to interact. This is a continuous outcome variable, with values greater than or equal to zero. Higher values are generally representative of higher-quality language interactions.

    Baseline to Post-treatment (Five Weeks)

  • Parental Language Stimulation Strategies (Study 1; Remote)

    The investigators will code the structured interaction task for parents' use of language stimulation strategies.The investigators will code use of trained strategies (i.e., responsive interaction, matched turns, language modeling, and expansions) and untrained generalization measures like constructive directives and scaffolds. This primary outcome will be a composite score of these language stimulation strategies (e.g., responsive interaction, matched turns, language modeling, expansions, constructive directives, and scaffolds). This composite will be measured once during the structured interaction task, so the same amount of time will be given to each participant to interact. This is a continuous outcome variable, with values greater than or equal to zero. Higher values are generally representative of higher-quality language interactions.

    Baseline (Single Timepoint)

Secondary Outcomes (2)

  • Adult-Child Conversational Turns (Study 2; Remote)

    Baseline to Post-treatment (Five Weeks)

  • Adult-Child Conversational Turns (Study 1; Remote)

    Baseline (Single Timepoint)

Study Arms (5)

Typically Developing Children Study 2 (TD2)

OTHER

No-intervention comparison group measured over time.

Other: no intervention comparison group

Children with Dev Language Disorder Study 2 (DLD2)

EXPERIMENTAL

Enhanced Milieu Teaching

Behavioral: Enhanced Milieu Teaching

Children with Autism Spectrum Disorders Study 2 (ASD+DLD 2)

EXPERIMENTAL

Enhanced Milieu Teaching

Behavioral: Enhanced Milieu Teaching

Typically Developing Children Study 1 (TD1)

OTHER

No-intervention group for observational data comparison.

Other: no intervention comparison group

Children with Dev Language Disorder Study 1 (DLD1)

OTHER

No-intervention group for observational data comparison.

Other: no intervention comparison group

Interventions

The parent training will incorporate the EMT strategies of responsive interaction, matched turns, language modeling, and expansions. There will be three, hour-long parent training sessions following the teach-model-coach-review format (TMCR). The TMCR framework teaching component will involve 10 minutes of verbal and visual instruction on the language stimulation target of interest. The teaching component will be followed by 15 minutes of clinician modeling of the target strategies with the child while the parent watches. The parent will then have the opportunity to practice using the strategy during naturalistic interaction with their child. The clinician will provide individualized coaching on the use of the target strategy during this 20-minute, parent-child interaction. Finally, the clinician will review the target strategies and set goals.

Children with Autism Spectrum Disorders Study 2 (ASD+DLD 2)Children with Dev Language Disorder Study 2 (DLD2)

No intervention for observational (Study 1 and 2) and training (Study 2) data comparison.

Children with Dev Language Disorder Study 1 (DLD1)Typically Developing Children Study 1 (TD1)Typically Developing Children Study 2 (TD2)

Eligibility Criteria

Age30 Months+
Sexall
Healthy VolunteersYes
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

  • Have no parent reported disabling developmental or acquired disorders/impairments that might significantly affect their performance including speech- language disorders (e.g., ASD, DLD, cancer, stroke, legal blindness, intellectual disability, Down Syndrome, traumatic head injury, cerebral palsy, seizures, or a genetic condition associated with neurodevelopmental disability).
  • Pass the Modified Checklist for Autism in Toddlers-Revised with Follow-Up screener
  • age 2 years 6 months - 4 years 0 months 0 days at the start of testing
  • English dominant (at least 80%)
  • No parent-reported diagnosed hearing loss (or no concerns if the child has not been tested).
  • Qualify as at risk for persistent language disorder by meeting two criteria:
  • Score at or below the 10th percentile on the Mac Arthur-Bates Communicative Development Inventory-III (CDI-III) Sentences section using sex-specific norms. For children over 37 mos., score must be less than or equal to the 10th percentile equivalent for 37 mos.
  • Score at or below the 10th percentile on the CDI-III Vocabulary section using sex-specific norms. For children over 37 mos., score must be less than or equal to the 10th percentile equivalent for 37 mos. The child must also produce at least 10 different words on either the CDI-III or CDI-Words and Sentences (CDI-WS long form).
  • Have no parent reported disabling developmental or acquired disorders/impairments that might significantly affect their performance beyond speech- language disorders (e.g., ASD, cancer, stroke, legal blindness, intellectual disability, Down Syndrome, traumatic head injury, cerebral palsy, seizures, or a genetic condition associated with neurodevelopmental disability other than DLD).
  • Pass the Modified Checklist for Autism in Toddlers-Revised with Follow-Up screener
  • years 6 months - 4 years 0 months 0 days at the start of testing
  • English dominant (at least 80%)
  • No parent-reported diagnosed hearing loss (or no concerns if the child has not been tested).
  • Have received ASD diagnosis from a healthcare professional prior to beginning the study.
  • Qualify as at risk for persistent language disorder by meeting two criteria:
  • +4 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

University of Wisconsin

Madison, Wisconsin, 53705, United States

Location

MeSH Terms

Conditions

Language Development DisordersAutism Spectrum Disorder

Condition Hierarchy (Ancestors)

Language DisordersCommunication DisordersNeurobehavioral ManifestationsNeurologic ManifestationsNervous System DiseasesSigns and SymptomsPathological Conditions, Signs and SymptomsChild Development Disorders, PervasiveNeurodevelopmental DisordersMental Disorders

Study Officials

  • Rebecca M Alper, Ph.D., CCC-SLP

    University of Wisconsin, Madison

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NON RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Masking Details
The research team members doing the language sample analysis and behavioral coding will be blind to group membership (Study 1 and 2) and whether the session was recorded pre-test vs. posttest (Study 2).
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: Study 1 (Remote) : Participants in the TD and DLD groups will receive no treatment; observational data only. Study 2 (Remote): Participants in the DLD and ASD+DLD groups will receive the Enhanced Milieu Teaching intervention. Participants in the TD will serve as the no-treatment comparison group.
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

May 3, 2018

First Posted

May 16, 2018

Study Start

March 22, 2021

Primary Completion

September 18, 2025

Study Completion

September 18, 2025

Last Updated

November 13, 2025

Record last verified: 2025-11

Data Sharing

IPD Sharing
Will share

The investigators will make every effort to share the data and findings widely within the allowances of human subjects and other relevant regulations. The study protocol and deidentified data will be made available via clinicaltrials.gov in accordance with those policies. Dr. Alper is an approved PI through Databrary-a secure video data library for behavioral scientists. Participants will have the opportunity to consent to share their data with other approved researchers on Databrary. A variety of permission levels are allowed through Databrary (e.g., solely for approved researchers, for educational and research purposes, etc.).

Shared Documents
STUDY PROTOCOL, SAP, ICF
Time Frame
All tasks (e.g., the behavioral awareness assessment), protocols (e.g., the parent-child interaction coding), and other research products developed as part of this study will be made available to other researchers upon request after publication of the findings.The parent-child interaction videos and deidentified data that have been released for Databrary will be shared to the repository after the publication of the findings. The consent form will be uploaded within 60 days of the last study visit. The analysis plan will be uploaded with the final results.
Access Criteria
Described above.

Locations