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. 2021 Apr 14;64(4):1235-1255.
doi: 10.1044/2020_JSLHR-20-00525. Epub 2021 Mar 30.

A Vocabulary Acquisition and Usage for Late Talkers Treatment Efficacy Study: The Effect of Input Utterance Length and Identification of Responder Profiles

Mary Alt  1 , Cecilia R Figueroa  1 , Heidi M Mettler  1 , Nora Evans-Reitz  1 , Jessie A Erikson  1
Affiliations

A Vocabulary Acquisition and Usage for Late Talkers Treatment Efficacy Study: The Effect of Input Utterance Length and Identification of Responder Profiles

Mary Alt et al. J Speech Lang Hear Res. .

Abstract

Purpose This study examined the efficacy of the Vocabulary Acquisition and Usage for Late Talkers (VAULT) treatment in a version that manipulated the length of clinician utterance in which a target word was presented (dose length). The study also explored ways to characterize treatment responders versus nonresponders. Method Nineteen primarily English-speaking late-talking toddlers (aged 24-34 months at treatment onset) received VAULT and were quasirandomly assigned to have target words presented in grammatical utterances matching one of two lengths: brief (four words or fewer) or extended (five words or more). Children were measured on their pre- and posttreatment production of (a) target and control words specific to treatment and (b) words not specific to treatment. Classification and Regression Tree (CART) analysis was used to classify responders versus nonresponders. Results VAULT was successful as a whole (i.e., treatment effect sizes of greater than 0), with no difference between the brief and extended conditions. Despite the overall significant treatment effect, the treatment was not successful for all participants. CART results (using participants from the current study and a previous iteration of VAULT) provided a dual-node decision tree for classifying treatment responders versus nonresponders. Conclusions The input-based VAULT treatment protocol is efficacious and offers some flexibility in terms of utterance length. When VAULT works, it works well. The CART decision tree uses pretreatment vocabulary levels and performance in the first two treatment sessions to provide clinicians with promising guidelines for who is likely to be a nonresponder and thus might need a modified treatment plan. Supplemental Material https://doi.org/10.23641/asha.14226641.

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Figures

Figure 1.
Figure 1.
Participants' rates of vocabulary change (words per week) as measured by the MacArthur–Bates Communicative Development Inventories: Words and Sentences (MCDI). The rate of vocabulary change for each participant is depicted for three periods of time: the pretreatment delay period, during treatment, and the posttreatment period (from immediate posttreatment to follow-up). Participants have been grouped by responder profiles. aParticipant gained more words per week during treatment than during the pretreatment delay period. bParticipant gained more words per week during the posttreatment period than during the pretreatment delay period. cParticipant demonstrated a rate of zero words per week during one or more periods of measurement (pretreatment delay period, during treatment, posttreatment period). dRate for posttreatment period could not be calculated for this participant because one or more MCDI forms were not returned.
Figure 2.
Figure 2.
An example of a participant's cumulative unique target and control word productions across baseline and treatment sessions used in the Tau analysis.
Figure 3.
Figure 3.
A decision tree to inform clinicians' decisions on whether to maintain the Vocabulary Acquisition and Usage for Late Talkers (VAULT) treatment protocol or make adjustments to the treatment plan. MCDI = MacArthur–Bates Communicative Development Inventories: Words and Sentences.
None
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References

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