Clinical trials

Millions of children - 7-12% of the school-age population - have developmental language disorder (DLD), a disorder that affects language learning, comprehension, and use. These children have difficulty with sentence production and comprehension at every stage of their development. These difficulties have major implications for the educational attainment of children with DLD compared to children with typical development (TD). Children with TD and adults make rapid predictions of upcoming words following verbs (e.g., predicting the patient in The dog eats the bone or the agent in The bone is eaten by the dog). Extensive work in children and adults indicates that prediction facilitates sentence comprehension by inducing a state of preparedness and contributes to language development by tuning the language system to the input. Children with DLD have a poorer ability to make sentence predictions, which may compound and result in sentence-comprehension deficits. Prior work on prediction deficits in DLD has focused on broad sentence characteristics like typicality or broad participant characteristics like vocabulary test scores. However, studies with typical individuals have identified more specific sentence- and participant-level contributors to sentence prediction. These factors have not been systematically explored in children with DLD. The investigators explore three separate hypotheses concerning factors that affect prediction in DLD. First, sentence- and participant-level properties affect prediction in children with DLD. Second, children with DLD lack robust representations of the underlying linguistic knowledge needed to predict, particularly abstract semantic features. Third, children with DLD have differences in event processing that relate to sentence prediction skill. The investigators investigate these hypotheses in 5-7-year-old school-age children with DLD across three Aims. Aim 1: Measure the effect of sentence- and participant-level properties on sentence prediction. The investigators will measure two participant-level cognitive factors (processing speed, verbal working memory) and their effect on prediction of agents and patients in sentences varying across two properties (syntactic complexity, semantic competition). Aim 2: Measure linguistic knowledge that underlies sentence prediction. The investigators will measure knowledge of agent-verb and verb-patient cooccurrences (e.g., dog-bite, eat-apple) and knowledge of verb-specific semantic features (e.g., throw-\<round object\>). Aim 3: Measure event-processing skills that underlie sentence prediction. The investigators will measure how children with DLD categorize and attend to agents/patients in visual scenes. Impact: This project has the promise to be highly impactful. First, it bridges disparate literatures on language processing in adults, children with TD, and children with DLD, providing clarity about predictive processing in DLD. Second, it may influence intervention approaches by identifying areas of strength and need in children with DLD. Third, it sets the stage for larger-scale longitudinal work examining effects of early prediction ability, language knowledge, and event processing on later sentence comprehension.

This project will look at Milieu Teaching (i.e., a language intervention) that encourages looking to audiovisual speech cues (Milieu Teaching-AV) for infants with autistic older siblings (Baby Sibs), who are highly likely be diagnosed with autism or developmental language disorder (DLD), compared to Milieu Teaching alone (Milieu Teaching-NoAV). This study will specifically look at whether Milieu Teaching-AV (compared to Milieu Teaching-NoAV) results in (a) increased looking towards caregivers' faces, (b) increased communicative behaviors and language skill, and (c) increased engagement with the caregiver during play. We will also look at caregiver factors, such as their use of strategies and their attitudes toward the intervention they received.

Vestibular loss can co-occur with hearing loss causing dual sensory deficits. This project examines vestibular loss as a contributing factor to reading difficulties for children with hearing loss, where previously only the effects of hearing loss and subsequent language difficulties have been considered. These results are expected to influence the identification and habilitation of vestibular loss in children with hearing loss.

The broad aim of this clinical study is to assess the hypothesis that morphological and phonological deficits are linked by a broader deficit in sequential pattern learning. This hypothesis applies to learning in general, but is especially critical as an avenue for developing earlier assessments and more powerful interventions for children with developmental language disorder (DLD; also known as specific language impairment). Other populations, such as at-risk toddlers, may also benefit from this new approach.

Individuals with cerebral palsy are known to have a reduced amount of physical activity; yet, there are no known intervention strategies for improving the number of steps they take each day. This study will use wearable physical activity monitors to assess if behavioral coaching is a viable strategy for combating the reduced physical activity seen in this patient population.

Specific Aim 1: To further quantify the difference in the sensorimotor cortical activity, spinal cord activity, and corticospinal coherence of persons with CP. Overall hypotheses: The sensorimotor cortical activity, spinal cord activity, and corticospinal coherence will be uncharacteristic in persons with CP when compared with neurotypical controls. Furthermore, the extent of the alterations in the sensorimotor cortical activity, spinal cord activity, and corticospinal coherence will be tightly linked with the clinical presentations of persons with CP. Specific Aim 2: To investigate the effect of transcutaneous current stimulation applied over the cortex and/or spinal cord on the sensorimotor cortical activity, spinal cord dynamics, and corticospinal coherence. Overall hypotheses: Compared with the sham controls, those receiving the transcutaneous current stimulation will demonstrate alterations in the strength of the sensorimotor cortical activity, spinal cord activity, and corticospinal coherence. Moreover, the extent of the alterations in the sensorimotor cortical activity, spinal cord activity, and corticospinal coherence will be tightly linked with the clinical presentations of persons with CP.

Patients with hearing loss who use cochlear implants (CIs) show significant deficits and strong unexplained intersubject variability in their perception and production of spoken emotions in speech. This project will investigate the hypothesis that "cue-weighting", or how patients utilize the different acoustic cues to emotion, accounts for significant variance in emotional communication with CIs. The results will focus on children with CIs, but parallel measures in postlingually deaf adults with CIs will be made, ensuring that results of these studies benefit social communication by CI patients across the lifespan by informing the development of technological innovations and improved clinical protocols.

The goal of this clinical trial is to determine how memory and attention affect the ability of children with developmental language disorder (DLD) to learn and use new vocabulary.