Purpose Dosage has been identified as an important element of treatment that may affect treatment efficacy. The purpose of this study was to examine the role of dose schedule for treatment of grammatical morphology deficits in children with specific language impairment (SLI). Method Sixteen 4-to-5-year-old children with SLI participated in a 5-week intervention consisting of equivalent daily Enhanced Conversational Recast treatment (Plante et al., 2014) targeting grammatical morphology. Half of the children received treatment in one 30-min session ( massed condition). Half received treatment in three 10-min sessions ( spaced condition) within one 4-hr period. Progress was assessed 3 times weekly by probing a child's use of his or her treatment morpheme and untreated morpheme (a maturational control) in untreated contexts. Results Pre- to posttreatment morpheme usage differed significantly for children regardless of dosage condition, and pre to post usage of an untreated morpheme was unchanged, demonstrating overall treatment efficacy. There were no differences in treatment effects for the massed and spaced conditions. Conclusions The study adds to evidence that Enhanced Conversational Recast can produce positive results in a short period of time for children with SLI. Furthermore, clinicians may have some flexibility in terms of the dose schedule they use to deliver this treatment in an evidence-based manner.

Purpose Enhanced Conversational Recast treatment is an effective intervention for remediating expressive grammatical deficits in preschool-age children with developmental language disorder, but not all children respond equally well. In this study, we sought to identify which child-level variables predict response to treatment of morphological deficits. Method Predictor variables of interest, including pre-intervention test scores and target morpheme production, age, and mother's level of education (proxy for socio-economic status) were included in analyses. The sample included 105 children ( M = 5;1 [years;months]) with developmental language disorder who participated in 5 weeks of daily Enhanced Conversational Recast treatment. Classification and regression tree analysis was used to identify covariates that predicted children's generalization of their trained grammatical morpheme, as measured by treatment effect size d . Results Our analysis indicates that the Structured Photographic Expressive Language Test–Preschool 2 (SPELT-P 2) scores and the Peabody Picture Vocabulary Test–Fourth Edition scores significantly predicted the degree of benefit a child derived from Enhanced Conversational Recast treatment. Specifically, a SPELT-P 2 score above 75 (but still in the impaired range, < 87) combined with a high Peabody Picture Vocabulary Test–Fourth Edition score (> 100) yielded the largest treatment effect size, whereas a SPELT-P 2 score below 75 predicted the smallest treatment effect size. Other variables included in the model did not significantly predict treatment outcomes. Conclusions Understanding individual differences in response to treatment will allow service providers to make evidence-based decisions regarding how likely a child is to benefit from Enhanced Conversational Recast treatment and the expected magnitude of the response based on the child's background characteristics.

Purpose: The COVID-19 pandemic caused a rapid shift in service delivery; hence, many speech-language pathologists (SLPs) were delivering services to children and families via telepractice without advanced notice or preparation. This clinical focus article describes a caregiver coaching approach that can be implemented through telepractice and the results of a professional development training designed to assist early intervention (EI) providers in quickly implementing the caregiver coaching model. Method: Twenty-five EI providers participated in web-based professional development trainings describing the components of a caregiver coaching approach to be used in telepractice. Participants completed pre- and posttraining surveys to report on their current knowledge of caregiver coaching and self-reported changes in their provision of caregiver coaching through telepractice. Results: Most participants were able to list, describe, and identify caregiver coaching strategies following training. All providers also described changes in their implementation of the caregiver coaching practices during interactions with children and families in telehealth sessions after receiving training. Conclusions: This clinical focus article provides information for SLPs on the implementation of caregiver coaching approaches as applied in telepractice, as well as preliminary evidence of the effectiveness for web-based professional development training to expand SLPs' knowledge and skills related to caregiver coaching in EI. Future research, including ongoing professional development and coaching to ensure fidelity in the implementation of this approach, is discussed, as well as recommendations to expand practice and research in the area of caregiver coaching in telepractice.