Language Delay, Language Development Disorders
Conditions
Keywords
Shape bias, Late Talkers
Brief summary
Most studies regarding word learning have focused on understanding when and how infants learn words. At 24 months, typically developing infants know between 200 and 300 words and add new words to their vocabularies at a rapid rate. It is also during the first years of life that some principles that promote vocabulary learning are developed. The shape bias, which is a tendency to infer that objects that share the same shape will also share the same name, is the one that has been studied the most. At 24 months, typically developing infants use this principle as a strategy to learn novel words. In contrast, Late Talkers (children with a language delay in the absence of a physiological, cognitive or genetic disorder that may account for this delay) do not exhibit this preference. It has been found that teaching typically developing infants a shape bias prior to the end of the second year of life can boosts their word learning. Despite this, the possibility of teaching Late Talkers this principle and its effect on their vocabulary and language development has not been explored. Over a series of 9 weekly sessions, Late Talkers (diagnosed by Language Therapists from the Birmingham Community Healthcare National Health Services Foundation Trust, United Kingdom) will be introduced to one of two possible interventions: a shape bias intervention and a more conventional intervention called specific word intervention. Both interventions will be compared after 9 weeks. One year later, a follow up study will be conducted to assess the long-term effects each intervention has in word learning. Participants will be referred by a Speech and Language Therapists from the Birmingham Community Healthcare National Health Services Foundation Trust, United Kingdom, and all assessments and interventions will take place at the Infant and Child Lab at the University of Birmingham, United Kingdom.
Detailed description
The objectives of the present study are: A. To investigate whether it is possible to teach Late Talkers to attend to objects' shapes as a useful property for learning and generalizing novel object labels. B. To assess the benefits that this intervention programme has on Late Talkers' short-term vocabulary development compared to an intervention where infants will be taught specific words ('specific word' intervention). C. Assess whether the success of teaching Late Talkers a shape bias for noun extension is related to their sensitivity to object shape similarities. D. Assess whether the success of teaching Late Talkers a shape bias for noun extension is related to their ability of sustain their attention to novel objects that are presented to them. E. To assess the benefits of the intervention programme on language and cognitive development one year after the intervention compared to the 'specific word' intervention
Interventions
BEHAVIORALSpecific word training
In this intervention, participants will be taught the names of 28 real objects. The target words have been selected from the Wordbank database, which is an open database that lists the proportion of children that know a specific word at a specific age. Twenty-eight words that are understood by 80% of the total child population at 25 months were randomly selected as target words. Techniques such as focused stimulation and modelling target words, which have proved to be useful for word learning, will be used.
BEHAVIORALShape training intervention
This intervention is based on on a study conducted by Smith and colleagues (2002), where they found that teaching typically developing infants to attend to shape by the end of the second year of life significantly enhances their word learning. Participants will be taught that the significant property they should focus in when learning and extending novel labels is shape. This will be done through play-like sessions.
Sponsors
National Council of Science and Technology, Mexico
University of Birmingham
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Masking description
Participants will be randomly assigned to one of two possible groups. In both groups, they will receive an intervention, however participants and their parents will not know which one. At the end of the study, participants and their parents will be informed about which group they were in and a document containing a detailed description of each intervention will be provided to them.
Intervention model description
Over a series of 9 weekly sessions, children diagnosed as Late Talkers will be assessed in different tasks that can be divided into 5 phases: Vocabulary and developmental assessments, initial cognitive assessments, training sessions, word learning test 1, and word learning test 2. Each group (shape training group and specific word training group) will receive a different training programme, however the other assessments will be identical across the groups. In the shape training group, participants will be taught to attend to shape when learning and extending novel labels. In the specific word training group, participants will be taught specific words that they do not know. Before and after the intervention, participants vocabulary will be assessed to compare which intervention enhances word learning. One year later, all participants will be assessed with a language test and a cognitive test. The same assessments will be used in both groups.
Eligibility
Sex/Gender
ALL
Age
24 Months to 48 Months
Healthy volunteers
No
Inclusion criteria
* Children (boys and girls) between 24 and 48 months. * Children from Birmingham (United Kingdom) and its surrounding areas. * Monolingual English native speakers * Children with a moderate or severe language delay, as diagnosed by a Speech and Language Therapist of the Birmingham Community Healthcare National Health Service Foundation Trust, United Kingdom.
Exclusion criteria
* Children with a developmental, physiological, neurological or cognitive disorder that could explain their language delay. * Children with a mild language delay, as diagnosed by a Speech and Language Therapist of the Birmingham Community Healthcare National Health Service Foundation Trust, United Kingdom. * Children that speak or know another language different than English, either as first or additional language.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Assessment of Number of Words Known Before and After the Interventions. | Parents/guardians filled in a vocabulary checklist before (week 1) and after (week 9) the interventions. | In order to assess the benefits of each intervention programme, parents/guardians filled in a vocabulary checklist before (week 1) and after (week 9) the interventions. We compared the vocabulary growth (receptive and expressive vocabulary) in the group of children that took part in the shape bias intervention programme with that of the group of children that took part in the 'specific word' intervention. |
| Long-term Effects of Each Intervention on Visual Spatial Skills. | Visual spatial skills assessed one year after the end of the intervention programme. | Each child was expected to be assessed with a standardized visual spatial test. Due to closures related to the covid-19 pandemic, this assessment was not able to be conducted and the study was stopped. |
| Long-term Effects of Each Intervention on Working Memory. | Was expected to be assessed one year after the end of the intervention programme. | Each child was expected to be assessed with a memory test. Due to closures related to the covid-19 pandemic, this assessment was not able to be conducted. |
| Percentage of Shape Choices in Two Noun Extension Tests. | At week 8 after starting the interventions for known names and objects. At week 9 after starting the interventions for novel names and objects. | Assessed using two noun extension tests with known and novel names and objects. The objective was to assess if participants would extend known or novel names to objects sharing the same shape. The test with known names was conducted in week 8. The test with novel names was conducted at week 9 after starting the intervention. In each test, participants completed 8 trials. For each trial, participants were shown an object and heard its name. They were then asked to get another object that was also called the same from a set of 3 objects shown to them (one object shared the same shape, a second one shared the same colour and a third one shared the same texture). The same procedure was used on each trial but the objects and names used were different each time. If participants learned a shape bias, they should have mainly chosen the objects that shared the same shape. Below we show the average percentage of shape choices in each group for both tests. |
| Long-term Effects of Each Intervention on Language Development. | Was expected to be assessed one year after the end of the intervention programme. | This was expected to be assessed with a language test. Due to closures related to the covid-19 pandemic, this assessment was not able to be conducted and the study was stopped. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Children's Attention to Novel Objects. | Assessed with an attention task in the first week of the intervention. | Assessed by relating children's sustained attention during the presentation of a video showing a person presenting and moving novel objects before the intervention. Note that two participants preferred not to complete this assessment, therefore they are not included in this analysis. |
| Children's Sensitivity Towards Shape Similarities. | Assessed in the first week of the intervention. | Assessed by relating children's ability to sort objects by shape before the intervention. |
Countries
United Kingdom
Participant flow
Pre-assignment details
The number of participants recruited differs from the one described in the protocol as this study had to be stopped due to the covid-19 pandemic.
Participants by arm
| Arm | Count |
|---|---|
| Specific Word Training Intervention This training programme was similar to a typical word learning intervention and was the control group. Children were introduced to 28 real objects and their names (e.g. biscuit, trousers). These objects will be divided into 7 sets of four words, and during each session, children were presented with one of these sets. Each session consisted of a 15 min play session in which each object was presented at least 10 times and each object name mentioned at least 10 times. Additionally, techniques such as focused stimulation and modelling target words, which have proved to be useful for word learning, were used. | 7 |
| Shape Training Intervention In the shape training intervention, children were presented with four novel words paired with four novel sets of objects. Each set consisted of two exemplars with the same shape but with different colors and textures, and a contrasting object. Each set was presented in a play session, and the name of the objects were mentioned at least 10 times. The other three sets of exemplars were presented in the same way. Each session lasted 15 minutes. This intervention was based on a study conducted by Smith and colleagues (2002), where they found that typically developing infants that are taught to attend to shape at 17 months old, can enhance significantly their word learning. | 7 |
| Total | 14 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Closures due to the Covid-19 pandemic | 2 | 2 |
| Overall Study | Diagnosis or suspected diagnosis of Autism spectrum disorder (ASD) | 1 | 2 |
| Overall Study | Withdrawal by Subject | 2 | 3 |
Baseline characteristics
| Characteristic | Specific Word Training Intervention | Shape Training Intervention | Total |
|---|---|---|---|
| Age, Continuous | 2.61 Years STANDARD_DEVIATION 0.42 | 2.76 Years STANDARD_DEVIATION 0.52 | 2.69 Years STANDARD_DEVIATION 0.47 |
| Age of first words | 22.16 months STANDARD_DEVIATION 3.25 | 21.25 months STANDARD_DEVIATION 9.21 | 21.8 months STANDARD_DEVIATION 6.23 |
| Race and Ethnicity Not Collected | — | — | 0 Participants |
| Sex: Female, Male Female | 3 Participants | 1 Participants | 4 Participants |
| Sex: Female, Male Male | 4 Participants | 6 Participants | 10 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 0 | 0 / 0 |
| other Total, other adverse events | 0 / 0 | 0 / 0 |
| serious Total, serious adverse events | 0 / 0 | 0 / 0 |
Outcome results
Primary
Assessment of Number of Words Known Before and After the Interventions.
In order to assess the benefits of each intervention programme, parents/guardians filled in a vocabulary checklist before (week 1) and after (week 9) the interventions. We compared the vocabulary growth (receptive and expressive vocabulary) in the group of children that took part in the shape bias intervention programme with that of the group of children that took part in the 'specific word' intervention.
Time frame: Parents/guardians filled in a vocabulary checklist before (week 1) and after (week 9) the interventions.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Specific Word Training Intervention | Assessment of Number of Words Known Before and After the Interventions. | Receptive (week 1 - vocabulary at the start of the study) | 207 number of words | Standard Deviation 95.96 |
| Specific Word Training Intervention | Assessment of Number of Words Known Before and After the Interventions. | Receptive (week 9 - vocabulary at the end of the study) | 263.86 number of words | Standard Deviation 107.19 |
| Specific Word Training Intervention | Assessment of Number of Words Known Before and After the Interventions. | Expressive (week 1 - vocabulary at the start of the study) | 62 number of words | Standard Deviation 46.04 |
| Specific Word Training Intervention | Assessment of Number of Words Known Before and After the Interventions. | Expressive (week 9 - vocabulary at the end of the study) | 146.86 number of words | Standard Deviation 109.9 |
| Shape Training Intervention | Assessment of Number of Words Known Before and After the Interventions. | Expressive (week 9 - vocabulary at the end of the study) | 149.14 number of words | Standard Deviation 151.35 |
| Shape Training Intervention | Assessment of Number of Words Known Before and After the Interventions. | Receptive (week 1 - vocabulary at the start of the study) | 288.43 number of words | Standard Deviation 87.11 |
| Shape Training Intervention | Assessment of Number of Words Known Before and After the Interventions. | Expressive (week 1 - vocabulary at the start of the study) | 76.86 number of words | Standard Deviation 83.77 |
| Shape Training Intervention | Assessment of Number of Words Known Before and After the Interventions. | Receptive (week 9 - vocabulary at the end of the study) | 355.29 number of words | Standard Deviation 106.81 |
Primary
Long-term Effects of Each Intervention on Language Development.
This was expected to be assessed with a language test. Due to closures related to the covid-19 pandemic, this assessment was not able to be conducted and the study was stopped.
Time frame: Was expected to be assessed one year after the end of the intervention programme.
Population: Due to closures related to the covid-19 pandemic, this assessment was not able to be conducted and the study was stopped.
Primary
Long-term Effects of Each Intervention on Visual Spatial Skills.
Each child was expected to be assessed with a standardized visual spatial test. Due to closures related to the covid-19 pandemic, this assessment was not able to be conducted and the study was stopped.
Time frame: Visual spatial skills assessed one year after the end of the intervention programme.
Population: Due to closures related to the covid-19 pandemic, this assessment was not able to be conducted and the study was stopped.
Primary
Long-term Effects of Each Intervention on Working Memory.
Each child was expected to be assessed with a memory test. Due to closures related to the covid-19 pandemic, this assessment was not able to be conducted.
Time frame: Was expected to be assessed one year after the end of the intervention programme.
Population: Due to closures related to the covid-19 pandemic, this assessment was not able to be conducted.
Primary
Percentage of Shape Choices in Two Noun Extension Tests.
Assessed using two noun extension tests with known and novel names and objects. The objective was to assess if participants would extend known or novel names to objects sharing the same shape. The test with known names was conducted in week 8. The test with novel names was conducted at week 9 after starting the intervention. In each test, participants completed 8 trials. For each trial, participants were shown an object and heard its name. They were then asked to get another object that was also called the same from a set of 3 objects shown to them (one object shared the same shape, a second one shared the same colour and a third one shared the same texture). The same procedure was used on each trial but the objects and names used were different each time. If participants learned a shape bias, they should have mainly chosen the objects that shared the same shape. Below we show the average percentage of shape choices in each group for both tests.
Time frame: At week 8 after starting the interventions for known names and objects. At week 9 after starting the interventions for novel names and objects.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Specific Word Training Intervention | Percentage of Shape Choices in Two Noun Extension Tests. | Known objects (week 8 after starting the intervention) | 37.50 percentage of shape choices | Standard Deviation 10.2 |
| Specific Word Training Intervention | Percentage of Shape Choices in Two Noun Extension Tests. | Novel objects (week 9 after starting the intervention) | 34.69 percentage of shape choices | Standard Deviation 18.97 |
| Shape Training Intervention | Percentage of Shape Choices in Two Noun Extension Tests. | Known objects (week 8 after starting the intervention) | 56.63 percentage of shape choices | Standard Deviation 18.37 |
| Shape Training Intervention | Percentage of Shape Choices in Two Noun Extension Tests. | Novel objects (week 9 after starting the intervention) | 39.28 percentage of shape choices | Standard Deviation 13.36 |
Secondary
Children's Attention to Novel Objects.
Assessed by relating children's sustained attention during the presentation of a video showing a person presenting and moving novel objects before the intervention. Note that two participants preferred not to complete this assessment, therefore they are not included in this analysis.
Time frame: Assessed with an attention task in the first week of the intervention.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Specific Word Training Intervention | Children's Attention to Novel Objects. | Video 1 | 21.57 seconds | Standard Deviation 10.71 |
| Specific Word Training Intervention | Children's Attention to Novel Objects. | Video 5 | 4.16 seconds | Standard Deviation 10.2 |
| Shape Training Intervention | Children's Attention to Novel Objects. | Video 5 | 4.38 seconds | Standard Deviation 9.79 |
| Shape Training Intervention | Children's Attention to Novel Objects. | Video 1 | 14.45 seconds | Standard Deviation 12.46 |
Secondary
Children's Sensitivity Towards Shape Similarities.
Assessed by relating children's ability to sort objects by shape before the intervention.
Time frame: Assessed in the first week of the intervention.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Specific Word Training Intervention | Children's Sensitivity Towards Shape Similarities. | 41.66 percentage correctly sorted by shape | Standard Deviation 19.83 |
| Shape Training Intervention | Children's Sensitivity Towards Shape Similarities. | 42.85 percentage correctly sorted by shape | Standard Deviation 10.12 |