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Semantic Learning Deficits in School Age Children With Developmental Language Disorder

Semantic Learning Deficits in School Age Children With Developmental Language Disorder

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT04508699
Enrollment
167
Registered
2020-08-11
Start date
2022-10-31
Completion date
2024-10-08
Last updated
2024-12-13

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Developmental Language Disorder

Keywords

Semantic Learning, ERP, N400, ERSP

Brief summary

School age children with developmental language disorder (DLD) have known semantic learning deficits but what is less well understood is why semantic learning is difficult for these children. This project will combine behavioral and brain methods to investigate the cognitive and linguistic processes underlying semantic learning in children with DLD compared to typically developing peers. The outcomes will have implications for semantic learning intervention approaches in DLD.

Detailed description

This project will elucidate deficits in learning semantic information in developmental language disorder (DLD, formerly referred to as specific language impairment) by combining behavioral and neural measures to examine differences in the semantic learning process between school-age children with and without DLD. Vocabulary knowledge, particularly semantic knowledge, has a critical influence on reading comprehension and academic success. Despite the strong association between vocabulary knowledge and academic success, vocabulary is an under-recognized area of deficit in school-age children with DLD. Younger children with DLD have well-established deficits in vocabulary and word learning and weaknesses in semantic knowledge. Additionally, the rate of vocabulary growth in children with DLD decreases compared to typically developing peers around age 10 and semantic representations of known vocabulary items are sparse. Even with this knowledge, the field's ability to make progress toward improved semantic learning in school age DLD is hindered by the lack of basic information on the underlying nature of the semantic learning deficits in this population. This project establishes how and why semantic learning differs between school-age children with and without DLD, providing a much-needed theoretical foundation for clinical research. Storkel, expanding on an adult word learning model by Leach and Samuel, provides a clearly testable account of word learning that has been used with children with DLD. This account involves three processes: 1) triggering, in which a new lexical encounter is compared to existing lexical representations, 2) configuration, which adds information to the expanding lexical representation, and 3) engagement, which examines how the new lexical representation behaves dynamically with existing representations. The configuration process is arguably the most critical for semantic development. Successful configuration requires the simultaneous engagement of cognitive and linguistic processes, such as attention, inhibition, working memory, and semantic and syntactic processing. While it is widely accepted that configuration is the most affected word learning process in DLD, what is unknown is what underlies deficits in configuration and whether these deficits vary across the DLD profile. These questions are further compounded by difficulty measuring configuration and associated processes, given that they are largely internal, and therefore invisible. Electroencephalography (EEG) addresses this invisibility problem by allowing for a real-time examination of unconscious levels of semantic learning and cognitive and linguistic processes. A combined EEG-behavioral methods approach can illustrate how children with DLD are approaching configuration in terms of the relative contribution of these processes. The central hypothesis of this research is that children with DLD engage cognitive and linguistic processes at different points during configuration compared to their typical peers, resulting in poorer semantic learning outcomes. To test the central hypothesis, the investigators will record behavioral and EEG data from 10-12 year old children with DLD and typical-language peers as they complete a semantic learning task. This age aligns with the point where vocabulary growth rates in DLD further diverge from typical peers \[6\]. In the semantic learning task, children listen to sets of three sentences that all end with the same nonword: half of the sentence triplets support learning meaning of the nonword, half do not. The investigators will analyze EEG data for event-related potentials (ERPs) as well as changes in neural oscillations (time frequency analysis). The investigators will combine EEG and behavioral measures to examine the following aims: Aim 1. To investigate the cognitive and linguistic processes underlying configuration in children with DLD and typical language (TL) peers. This aim will include data from the semantic learning task. Based on the assessment of behavioral outcomes, the investigators predict that the TL group will be more accurate in semantic learning than the DLD group. ERP analyses will focus on the N400 component, associated with semantic processing. Time frequency analysis will focus on changes in the theta (4-8 Hz) and alpha (8-12 Hz) frequency bands, typically associated with lexical retrieval and attention/inhibition, respectively. For both neural measures, the investigators predict engagement of the same components (N400, theta, alpha) across groups but different patterns of change in those components during configuration between groups. Aim 2. To investigate individual differences in configuration in children with DLD and TL peers. This aim will include data from the semantic learning task and a behavioral assessment battery. Assessment of behavioral data will focus the types of errors children make during semantic learning. The investigators expect that children with DLD will provide incorrect meanings for the nonword that best fit with the first sentence in the triplet and that TL children will provide incorrect meanings that best fit with the last sentence. The investigators will also examine individual differences related to semantic learning outcomes and fine-grained differences in N400 learning effects across groups. Here, the investigators expect that individual differences in general language ability and semantic knowledge, measured via the behavioral assessment battery, will be most predictive of both behavioral semantic learning and N400 change during learning.

Interventions

OTHERsemantic learning

Experimental semantic learning from linguistic context task

Sponsors

San Diego State University
Lead SponsorOTHER

Study design

Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
DOUBLE (Subject, Caregiver)

Masking description

Some participants and care providers might not be aware of their child's language impairment

Intervention model description

Compare behavioral and EEG outcomes of semantic learning in children with and without developmental language disorder

Eligibility

Sex/Gender
ALL
Age
10 Years to 12 Years
Healthy volunteers
Yes

Inclusion criteria

* history of typical language development or history of language or literacy difficulties * must be willing to wear EEG cap * must be able to sit still for 1.5 hours to complete experimental tasks * must be literate

Exclusion criteria

* neurological disorders (i.e., ASD, ADHD) * significant neurological history (i.e., head injury, epilepsy) * left handedness * primary language other than English * medication other than over-the-counter allergy medications * and/or nonverbal IQ less than 70

Design outcomes

Primary

MeasureTime frameDescription
N400 Amplitude - Sentence 3immediately following treatment, on the same day as treatment, within 30 minutesMean amplitude (measured in microvolts) of the N400 time locked to the target word in sentence 3 collapsed across groups matched for age. Meaning plus condition only. Smaller/more negative indicates more effortful (harder) processing and larger/more positive indicates less effortful (easier) processing.
N400 Amplitude - Sentence 1immediately following treatment, on the same day as treatment, within 30 minutesMean amplitude (measured in microvolts) of the N400 time locked to the target word in sentence 1 collapsed across groups matched for age. Meaning plus condition only. Smaller/more negative indicates more effortful (harder) processing and larger/more positive indicates less effortful (easier) processing.
Theta Changesimmediately following treatment, on the same day as treatment, within 30 minutesChanges in theta band activity (measured in hertz) from sentence 1 to sentence 3, time locked to the final word in the sentence. Smaller/more negative indicates more effortful (harder) processing and larger/more positive indicates less effortful (easier) processing.
N400 Amplitude - Sentence 2immediately following treatment, on the same day as treatment, within 30 minutesMean amplitude (measured in microvolts) of the N400 time locked to the target word in sentence 2 collapsed across groups matched for age. Meaning plus condition only. Smaller/more negative indicates more effortful (harder) processing and larger/more positive indicates less effortful (easier) processing.
Mean Percent Correct Semantic Meaning Identificationimmediately following treatment, on the same day as treatment, within 30 minutesAccuracy on the semantic learning task. Did they correctly identify when there was a meaning or did they say there was no meaning when there should have been one (incorrect response) Higher is better outcome

Secondary

MeasureTime frameDescription
Nonverbal CognitionbaselineFull measure title: Wechsler Intelligence Scale for Children - 5th edition Nonverbal index subtests administered, considered the nonverbal subscale For the nonverbal subscale, raw scores converted to t-score: 100 indicates population mean and standard deviation is 15 Higher scores indicate a better outcome and lower scores indicate a poorer outcome Typical range = 85-115; below 70 is considered in the sub-clinical range indicating the presence of intellectual disability
Nonword Repetition Taskbaselineexperimental task gauging phonological memory
General Language LevelbaselineFull measure title: Clinical Evaluation of Language Fundamentals - 5th edition Standardized language omnibus measure Raw scores converted to t-score: 100 indicates population mean and standard deviation is 15 Higher scores indicate a better outcome and lower scores indicate a poorer outcome Typical range = 85-115; below 80 is considered in the sub-clinical range indicating the presence of a language disorder

Countries

United States

Participant flow

Recruitment details

Participants were recruited from online sources (e.g., Craiglist, Facebook groups), word of mouth, clinical sites (on-campus Clinic, private clinics), local public schools, and the local University.

Pre-assignment details

No events to report.

Participants by arm

ArmCount
Developmental Language Disorder
Children with language impairment but in the absence of cognitive deficits
15
Typical Language Children
Children with typical language development and typical cognitive development
97
Total112

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyLack of Efficacy215
Overall StudyWithdrawal by Subject02

Baseline characteristics

CharacteristicDevelopmental Language DisorderTypical Language ChildrenTotal
Age, Categorical
<=18 years
15 Participants97 Participants112 Participants
Age, Categorical
>=65 years
0 Participants0 Participants0 Participants
Age, Categorical
Between 18 and 65 years
0 Participants0 Participants0 Participants
Age, Continuous10 years
STANDARD_DEVIATION 1.69
11.7 years
STANDARD_DEVIATION 2.53
11.54 years
STANDARD_DEVIATION 2.54
Ethnicity (NIH/OMB)
Hispanic or Latino
4 Participants14 Participants18 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
4 Participants39 Participants43 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
7 Participants44 Participants51 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
0 Participants4 Participants4 Participants
Race (NIH/OMB)
Black or African American
0 Participants7 Participants7 Participants
Race (NIH/OMB)
More than one race
3 Participants13 Participants16 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
8 Participants49 Participants57 Participants
Race (NIH/OMB)
White
4 Participants24 Participants28 Participants
Region of Enrollment
United States
15 participants97 participants112 participants
Sex: Female, Male
Female
5 Participants50 Participants55 Participants
Sex: Female, Male
Male
10 Participants47 Participants57 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 150 / 97
other
Total, other adverse events
0 / 150 / 97
serious
Total, serious adverse events
0 / 150 / 97

Outcome results

Primary

Mean Percent Correct Semantic Meaning Identification

Accuracy on the semantic learning task. Did they correctly identify when there was a meaning or did they say there was no meaning when there should have been one (incorrect response) Higher is better outcome

Time frame: immediately following treatment, on the same day as treatment, within 30 minutes

Population: Data analyzed from complete data sets

ArmMeasureGroupValue (MEAN)Dispersion
Developmental Language DisorderMean Percent Correct Semantic Meaning IdentificationMeaning condition accuracy73.6 percentage of correct responsesStandard Deviation 16.4
Developmental Language DisorderMean Percent Correct Semantic Meaning IdentificationNo meaning condition accuracy77.1 percentage of correct responsesStandard Deviation 19.5
Typical Language ChildrenMean Percent Correct Semantic Meaning IdentificationMeaning condition accuracy75.12 percentage of correct responsesStandard Deviation 14.7
Typical Language ChildrenMean Percent Correct Semantic Meaning IdentificationNo meaning condition accuracy82.3 percentage of correct responsesStandard Deviation 15.2
p-value: 0.36t-test, 1 sided
Primary

N400 Amplitude - Sentence 1

Mean amplitude (measured in microvolts) of the N400 time locked to the target word in sentence 1 collapsed across groups matched for age. Meaning plus condition only. Smaller/more negative indicates more effortful (harder) processing and larger/more positive indicates less effortful (easier) processing.

Time frame: immediately following treatment, on the same day as treatment, within 30 minutes

Population: Children with usable EEG data and matched for age

ArmMeasureValue (MEAN)Dispersion
Developmental Language DisorderN400 Amplitude - Sentence 1-.1 microvoltsStandard Deviation 0.002
Typical Language ChildrenN400 Amplitude - Sentence 1-.27 microvoltsStandard Deviation 0.0045
p-value: <0.05ANOVA
Primary

N400 Amplitude - Sentence 2

Mean amplitude (measured in microvolts) of the N400 time locked to the target word in sentence 2 collapsed across groups matched for age. Meaning plus condition only. Smaller/more negative indicates more effortful (harder) processing and larger/more positive indicates less effortful (easier) processing.

Time frame: immediately following treatment, on the same day as treatment, within 30 minutes

Population: Participants with usable EEG data, groups matched for age

ArmMeasureValue (MEAN)Dispersion
Developmental Language DisorderN400 Amplitude - Sentence 2-0.1 microvoltsStandard Deviation 0.005
Typical Language ChildrenN400 Amplitude - Sentence 20.075 microvoltsStandard Deviation 0.003
p-value: <0.05ANOVA
Primary

N400 Amplitude - Sentence 3

Mean amplitude (measured in microvolts) of the N400 time locked to the target word in sentence 3 collapsed across groups matched for age. Meaning plus condition only. Smaller/more negative indicates more effortful (harder) processing and larger/more positive indicates less effortful (easier) processing.

Time frame: immediately following treatment, on the same day as treatment, within 30 minutes

Population: Children with usable EEG data and matched for age

ArmMeasureValue (MEAN)Dispersion
Developmental Language DisorderN400 Amplitude - Sentence 30.221 microvoltsStandard Deviation 0.004
Typical Language ChildrenN400 Amplitude - Sentence 3.662 microvoltsStandard Deviation 0.07
p-value: <0.05ANOVA
Primary

Theta Changes

Changes in theta band activity (measured in hertz) from sentence 1 to sentence 3, time locked to the final word in the sentence. Smaller/more negative indicates more effortful (harder) processing and larger/more positive indicates less effortful (easier) processing.

Time frame: immediately following treatment, on the same day as treatment, within 30 minutes

Population: Participants with complete EEG datasets, age matched

ArmMeasureValue (MEAN)Dispersion
Developmental Language DisorderTheta Changes.0521 HertzStandard Deviation 0.478
Typical Language ChildrenTheta Changes.121 HertzStandard Deviation 0.21
p-value: <0.05ANOVA
Secondary

General Language Level

Full measure title: Clinical Evaluation of Language Fundamentals - 5th edition Standardized language omnibus measure Raw scores converted to t-score: 100 indicates population mean and standard deviation is 15 Higher scores indicate a better outcome and lower scores indicate a poorer outcome Typical range = 85-115; below 80 is considered in the sub-clinical range indicating the presence of a language disorder

Time frame: baseline

Population: Data analyzed from complete datasets

ArmMeasureValue (MEAN)Dispersion
Developmental Language DisorderGeneral Language Level73.2 t-scoreStandard Deviation 11.6
Typical Language ChildrenGeneral Language Level110.9 t-scoreStandard Deviation 11.86
p-value: <0.00001t-test, 1 sided
Secondary

Nonverbal Cognition

Full measure title: Wechsler Intelligence Scale for Children - 5th edition Nonverbal index subtests administered, considered the nonverbal subscale For the nonverbal subscale, raw scores converted to t-score: 100 indicates population mean and standard deviation is 15 Higher scores indicate a better outcome and lower scores indicate a poorer outcome Typical range = 85-115; below 70 is considered in the sub-clinical range indicating the presence of intellectual disability

Time frame: baseline

Population: Participants with completed data sets

ArmMeasureValue (MEAN)Dispersion
Developmental Language DisorderNonverbal Cognition86.2 T-scoreStandard Deviation 11.2
Typical Language ChildrenNonverbal Cognition106.93 T-scoreStandard Deviation 12.3
p-value: <0.00001t-test, 1 sided
Secondary

Nonword Repetition Task

experimental task gauging phonological memory

Time frame: baseline

Population: Participants with complete datasets

ArmMeasureValue (MEAN)Dispersion
Developmental Language DisorderNonword Repetition Task83.9 percent consonants correctStandard Deviation 9.6
Typical Language ChildrenNonword Repetition Task92.9 percent consonants correctStandard Deviation 5.3
p-value: <0.00001t-test, 1 sided

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026