Recast Therapy for Treating Syntax in Bilingual Children With Developmental Language Disorder: A Feasibility and Early Efficacy Study Examining the Role of Language of Intervention on Outcomes

Purpose: The purpose of this study is to examine the feasibility of the delivery of complex syntax recast therapy via telepractice to Spanish–English bilingual children and provide preliminary evidence of the efficacy of this approach. Method: Fifteen bilingual children with developmental language disorders were stratified based on language proficiency and randomized to one of three treatment conditions: Spanish only ( n = 5), English only ( n = 6), or Spanish + English ( n = 4). Using a within-subject design, we hypothesized that we could document treatment efficacy based on change in the treated structure in the absence of change in an untreated comparison structure. All 15 children completed ~16 hr of treatment via telepractice and participated in pre- and posttesting of their production of conditional adverbs (treated structure) and subject relative clauses (untreated structure) carried out by a masked assessor. Results: Analyses included all participants. Treatment fidelity was high, and participant attendance was remarkable, indicating feasibility. Regarding efficacy, recast therapy led to group-level gains on treated syntactic structures that exceeded those observed for the untreated comparison structure. For the 11 children who received therapy in only one language, approximately equal gains were observed in both the treated and untreated languages for conditional adverbials. Conclusions: Preliminary evidence suggests that for highly overlapping structures like conditional adverbials, recast therapy is effective and leads to change in both of the child's languages. Larger studies are required to understand how language of administration and proficiency may affect outcomes. Supplemental Material: https://doi.org/10.23641/asha.23739996